Osteopontin expression and clinicopathologic correlation of oral hyperplastic reactive lesions: An institutional 6-year retrospective study

Abstract

Background and Objective:Reactive proliferations of oral cavity comprise pyogenic granuloma (PG), fibrous hyperplasia (FH), peripheral ossifying fibroma (POF), and peripheral giant-cell granuloma (PGCG). They often pose diagnostic challenges due to their overlapping clinical and histopathological features. This study was conducted to determine the frequency and clinicopathological correlation of reactive hyperplastic lesions in the oral cavity reported in our institute and compared it with other previous studies. Further evaluation of osteopontin (OPN) expression in normal gingival tissue and different types of focal reactive lesions was also done.Materials and Methods:Data of all reactive hyperplasias were retrieved, reviewed, and analyzed for age, gender, clinical presentation, and site of location. Presence and distribution of OPN were assessed using immunohistochemistry in these reactive lesions.Results:Two hundred and forty-eight reactive lesions were comprised of FH (38%), PG (23%), POF (13%), and PGCG (7%). FH was more common in males (55%) whereas other reactive lesions were more in females (68%–73%). The most frequently involved site was gingiva (59%), and most common clinical presentation was sessile growth on gingiva. OPN expression was minimal in normal gingiva. Few cases of FH, PG, and all cases of POF showed positivity for OPN in inflammatory cells, stromal cells, extracellular matrix, and in calcifications.Conclusion:Reactive hyperplastic lesions of oral cavity are mucosal responses to chronic low-grade irritation caused by plaque, calculus, and any other irritant. It is helpful to know their frequency and presentation as their early identification enables accurate patient evaluation and management.

Development of peripheral ossifying fibroma following micro-osteoperforation

“…Furthermore, numerous studies have shown that OPN is expressed in inflammation by macrophages and is also activated at sites of ectopic pathologic calcification. 7,13,14 It is possible that inflammation associated with MOP induced the development of the POF described in the present study.…”

“…12 Upon immunohistochemical examination, reactive gingival nodules including POF have been shown to express osteopontin (OPN). 7,13 OPN is a matricellular…”

A large-cohort study of 2971 cases of epulis: focusing on risk factors associated with recurrence

“…Epulis is a very common oral disease with a prevalence of varying from 5.6 to 20.6% [ 5 , 9 – 11 ]. The overgrowth of the gingival has multiple impacts including aesthetic problems, functional disorders, difficulty in chewing and speech, even serious psychological problems [ 12 ].…”

Recurrent Peripheral Giant Cell Granuloma: A Case Report

“…RLs often pose diagnostic challenges due to their overlapping clinical features [14]. Therefore, the differential diagnosis of PGCG includes besides the other reactive lesions [13], fibrous epulis, peripheral odontogenic fibroma, papilloma, hemangioma, lymphangioma, metastatic tumors of gingiva, nevi or other nodular melanomas and other inflammatory hyperplastic lesions [15,16] all of which present with similar clinical and radiographic findings.…”