Comprehensive Clinicopathological Analysis of Oral Reactive Hyperplastic Lesions Diagnosed in Libyan Population: Cross-Sectional Multicentric Study

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Oral reactive hyperplastic lesions (ORHLs) are non-neoplastic tumor-like hyperplasia frequently developing in the oral mucosa due to chronic inflammation caused by many low-grade irritations. They are relatively common, and their clinical appearance resembles neoplastic proliferations. This study aims to determine the prevalence and distribution of ORHLs based on WHO's head and neck tumor classification (2022) in the Libyan population over the last 20 years and compare the results with previous literature. In this retrospective study, all the records of histologically diagnosed ORHLs between 2002 and 2023 collected from the Tripoli University Hospital and Saray Salam Center in Tripoli, Libya, were reviewed. Information regarding the age at diagnosis, gender, site affection, and histopathological diagnosis was extracted and analyzed using SPSS statistical software (V.26) using the Chi-square test. ORHLs constituted 14.5% of the total diagnosed cases (335/3210) in registered oral and maxillofacial biopsies. Pyogenic granuloma (PG) was the most common type of ORHL (48%) followed by irritational fibroma (IF) (30%), and peripheral giant cell granuloma (PGCG) (8%). The peak incidence of ORHLs was in the third and fourth decades (37.6% and 32.8% retrospectively), with an overall age at onset of diagnosis (Mean ± SD 36.4±7). The relationship between the age categories and ORHLs was statistically significant (P=0.03). Female predominance was found in all lesions with a ratio (2:1). Gingiva was the most prevalent anatomical location for ORHLs, accounting for 31% of cases. There have been some similarities and inconsistencies between our findings and previous studies involving various populations. We found a clear geographic difference in the relative incidence of oral reactive lesions in each Libyan governorate. The occurrence of ORHRLs in different nations can be retrospectively evaluated to improve knowledge of ORHLs, which is critical for pathologists and oral and maxillofacial surgeons.