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.