Histopathologic analysis of gingival lesions: A 20-year retrospective study at one academic dental center

Abstract

BackgroundThe gingiva is part of the periodontium supporting structures surrounding the teeth and commonly involved in gingival and periodontal conditions. Assessing the distribution of gingival lesions is important for evaluating the prevalence of periodontal disease in the population to optimize the oral health care services. The purpose of this study is to report the frequency and distribution of gingival lesions biopsied from 1996–2016.Material and MethodsThis cross-sectional retrospective study retrieved data from all gingival lesions biopsied from 1996–2016 and sent to the King Abdulaziz University Dental Hospital oral pathology laboratory. Histologic sections were reviewed in a blinded manner by a certified oral pathologist to confirm the initial histologic diagnosis.ResultsOf the 1,248 oral-maxillofacial lesions, 119 (9.5%) gingival lesions were diagnosed. The mean age was 41.58 years. Gingival lesions were more prevalent in female patients than male patients (53.8%). The most common diagnoses were reactive lesions (41.2%). Pyogenic granuloma was the predominant lesion in the category (n=26, 21.8%), and followed by inflammatory conditions (24.4%), benign neoplasm (9.2%), malignant neoplasm (7.6%), epithelial lesions (7.6%), miscellaneous (5%), and immune-mediated diseases (5%). Squamous cell carcinoma was the only malignant neoplasm reported (7.6%; mean age, 57.44 years) and more common in male than female patients (2:1). Most biopsies were sent from oral and maxillofacial surgeons (55.6%) followed by general dentists (22.2%) and periodontists (12.8%).ConclusionsPyogenic granuloma was the most common gingival lesion. Squamous cell carcinoma was the only malignant lesion in which histologic examination was the definitive diagnostic measure. This study provides information about the frequencies and distributions of gingival lesions over 20 years. Key words:Gingival biopsies, retrospective, reactive lesions, oral pathology.

Effective management of focal reactive gingival overgrowths by diode laser: A review and report of two cases.

“…Peripheral fibroma may show calcified bone-like structures in the form of osteoid or the calcification may resemble cementum-like substance. 27,32) In case-2 the connective tissue is covered with ulcerated and acanthotic stratified squamous epithelium and stroma is showing few calcifications in the form of osteoid (Figure 3b). The overgrowth was involving midline in relation to diastema of #12 and #21.…”

Gingival and alveolar ridge overgrowths: A histopathological evaluation from Saudi Arabia

“…This finding is in accordance with almost every previous study on this subject. The most common lesion type in several studies was PG ( Ababneh, 2006 , Shamim et al, 2008 , Effiom et al, 2011 , Alblowi and Binmadi, 2018 ), while other reports found fibromas to be the most common of the four dominant lesions ( Zhang et al, 2007 , Buchner et al, 2010 , Hernandez-Rios et al, 2018 , Li et al, 2021 ). There may be a true difference in the prevalence of these four lesions based on specific geographical locations, or it may be related to the timing of presentation, as it has been suggested that long-standing PGs can mature into fibromas, which would explain the predominance of fibromas in some studies ( Eversole and Rovin 1972 ).…”

“…One of the problems associated with the true prevalence of benign tumors in the gingiva is that the classification was not consistent across the various studies. Some studies categorized reactive entities, such as POFs, giant cell fibromas, fibromas, angiofibromas, and squamous papillomas, as benign tumors ( Stablein and Silverglade, 1985 , Ababneh, 2006 , Shamim et al, 2008 , Alblowi and Binmadi, 2018 , Hernandez-Rios et al, 2018 ), which may account for the relatively high prevalence reported in those studies. In the present study, any lesion in which the major pathology was a non-neoplastic hyperplasia of fibrous and/or epithelial tissue was classified as reactive.…”

“…Microscopic examination of biopsy specimens by oral pathologists provides a reliable way to diagnose and categorize gingival and alveolar ridge (GAR) lesions to ensure that appropriate management procedures are selected. Previous studies have focused on GAR mucosal lesions ( Eversole and Rovin, 1972 , Anneroth and Sigurdson, 1983 , Barasch et al, 1995 , Ababneh, 2006 , Zhang et al, 2007 , Shamim et al, 2008 , Buchner et al, 2010 , Effiom et al, 2011 , Carbone et al, 2012 , Hunasgi et al, 2017 , Alblowi and Binmadi, 2018 , Hernandez-Rios et al, 2018 ), although many were solely devoted to reactive lesions ( Eversole and Rovin, 1972 , Anneroth and Sigurdson, 1983 , Zhang et al, 2007 , Buchner et al, 2010 , Effiom et al, 2011 , Hunasgi et al, 2017 ), a specific neoplasm only ( Barasch et al, 1995 ), or a mixture of NPIGDs and DPIGCs ( Carbone et al, 2012 , Alblowi and Binmadi, 2018 ).…”

Which Clinicopathologic Factors Affect the Prognosis of Gingival Squamous Cell Carcinoma: A Population Analysis of 4,345 Cases

“…2 As such, the oral cavity can be broadly divided into the lips, oral tongue, floor of the mouth, buccal mucosa, gingiva, retromolar trigone, and hard palate. 1 The gingiva is the third most common site of oral SCC, after the tongue and floor of the mouth 2,3 ; however, because gingival malignancies are infrequent relative to other benign gingival lesions, 4,5 gingival cancer poses a diagnostic challenge for clinicians, who may not suspect a malignancy in light of other more commonly encountered pathologies. Furthermore, because the attached gingiva is relatively thin, gingival cancers show early invasion of the underlying bone, and the prognostic implications of this behavior are presently unclear.…”