Histopathologic Analysis of Gingival Lesions: A 10-Year Retrospective Study

Abstract

Background: Lesions of the gingiva account for a significant portion of the diagnostic workload of any oral pathology practice. Biopsy is important in establishing a definitive diagnosis. The aim of this study was to determine the relative frequency and distribution of biopsied gingival lesions in a Nigerian population. Methods: This was a retrospective study of all gingival biopsies performed over a 10-year period. Data on age, gender, site (maxillary or mandibular) and histopathological diagnosis were recorded. The lesions were categorized into two groups: non-neoplastic and neoplastic, with the neoplastic lesions further divided into benign and malignant lesions. Data analysis was done using SPSS version 23. Results: There were a total of 501 orofacial biopsies during the period under review, with gingival biopsies accounting for 73 (14.6%) cases. The mean age of subjects was 29.6 ± 20.1 years. There were 48 (65.8%) females and 25 (34.2%) males. Non-neoplastic lesions were 50 (68.5%), while neoplastic lesions were 23 (31.5%). The non-neoplastic lesions had an average age of 25.9 ± 17.7 years, and were encountered most frequently in the 10-19 years age group. Eighteen (36.0%) cases occurred in males, while 32 (64.0%) cases were seen in females. The maxillary gingiva (56.0%) was affected more often than the mandibular gingiva (44.0%). Pyogenic granuloma was the most frequent non-neoplastic lesion, accounting for 35 (70%) cases, followed by peripheral ossifying fibroma (n=6; 12%). The neoplastic lesions had a mean age of 37.1 ± 22.9 years, and consisted of 20 (87%) benign and 3 (13%) malignant lesions. The mean age for benign lesions was 35.3 ± 21.6 years, with a peak occurrence between 20 – 49 years. Females were almost twice more frequently affected than males. The mandibular gingiva accounted for 55% of the benign lesions. The most common benign lesion was fibroma (n=8; 40%) followed by ameloblastoma (n=3; 15%). Malignant lesions accounted for 4.1 % of the biopsied gingival lesions, with a mean age 48.7 ± 33.2 years. There was one case each of Kaposi’s sarcoma, polymorphous low-grade adenocarcinoma and mucosa-associated lymphoma. Conclusion: There is need for histologic examination of all excised gingival swellings.

Prevalence of Histopathologic Types of Gingival Lesions in the Iranian Population: A 22‐Year Retrospective Study

“…The likely reason for this discrepancy might be the small sample size in this study. The mean age of gingival lesions in this study was 37 ± 18.9 years and the highest number of cases were observed in the age group of 20-39 years, which is consistent with most of the reviewed studies (Alblowi and Binmadi 2018;Gupta et al 2022;Li et al 2021;Montazer Lotf-Elahi, Farzinnia, and Jaafari-Ashkavandi 2022;Shamim et al 2008;Orikpete and Iyogun 2021;Ababneh 2006). However, Hernández-Ríos et al ( 2018) reported the most presence of gingival lesions in older individuals, with the majority in sixth decade of life, which could potentially be attributed to geographical differences.…”

“…Furthermore, a higher occurrence was observed in women. This is in line with the results of other studies (Alblowi and Binmadi 2018 ; Gupta et al 2022 ; Tamiolakis et al 2018 ; Manjunatha et al 2014 ; Hernández‐Ríos et al 2018 ; Kamath, Vidya, and Anand 2013 ; Carbone et al 2012 ; Shamim et al 2008 ; Orikpete and Iyogun 2021 ) However, Gupta et al ( 2022 ) reported a higher prevalence in men. The likely reason for this discrepancy might be the small sample size in this study.…”

“…One of the main problems in comparing relevant studies is the lack of a practical and unanimous categorization. Numerous studies classified lesions mainly as either neoplastic or nonneoplastic (Manjunatha et al 2014 ; Kamath, Vidya, and Anand 2013 ; Carbone et al 2012 ; Shamim et al 2008 ; Orikpete and Iyogun 2021 ), We find this classification to be less advantageous since it primarily emphasizes the aspect of malignancy. Multiple investigation reported their data based on nonplaque‐induced gingival diseases' classification proposed by Holmstrup et al (Gupta et al 2022 ; Li et al 2021 ; Hernández‐Ríos et al 2018 ; Holmstrup, Plemons, and Meyle 2018 ).…”

“…In our study, 662 lesions were observed on the gingiva, accounting for 8.9% of the total examined samples. Other studies reported 3.2% in India (Gupta et al 2022 ), 6.23% in Greece (Tamiolakis et al 2018 ), 6.7% in Israel (Buchner, Shnaiderman‐Shapiro, and Vered 2010 ), 9.5% in Saudi Arabia (Alblowi and Binmadi 2018 ), 14.6% in Nigeria (Orikpete and Iyogun 2021 ) 15% in the United States (Dovigi et al 2016 ), 11.9% (Moridani, Shaahsavari, and Bagher 2014 ), and 18.9% in Iran (Montazer Lotf‐Elahi, Farzinnia, and Jaafari‐Ashkavandi 2022 ), and 38.9% in Turkey (Sengüven et al 2015 ). This disparity could potentially arise from geographical differences and variations in the study duration or criteria.…”

“…To our understanding, several studies examined all types of gingival lesions (Alblowi and Binmadi 2018 ; Gupta et al 2022 ; Li et al 2021 ; Montazer Lotf‐Elahi, Farzinnia, and Jaafari‐Ashkavandi 2022 ; Tamiolakis et al 2018 ; Manjunatha et al 2014 ; Hernández‐Ríos et al 2018 ; Kamath, Vidya, and Anand 2013 ; Carbone et al 2012 ; Shamim et al 2008 ; Orikpete and Iyogun 2021 ). Yet the absence of a consensus on classification posed challenges in comparing the findings.…”