Oral Leukoplakia Lesions Research Articles

Surgical protocols for oral leukoplakia and precancerous lesions across three different anatomic sites.

This systematic review and meta-analysis aimed to compare the risk of recurrence and cancer progression after surgical treatment for oral potentially malignant disorders (OPMD) and precancerous lesions in different anatomical sites. A comprehensive search was conducted in nine databases and grey literature. We included randomized controlled trials assessing surgical treatment efficacy for OPMD and precancerous lesions of cervical, vaginal, anal, and penile sites. Excision or ablation surgical treatments were considered. Overall, 12 studies met the eligibility criteria for oral leukoplakia (OL), proliferative verrucous leukoplakia, cervical intraepithelial neoplasia (CIN), vaginal intraepithelial neoplasia, and anal intraepithelial neoplasia (AIN). In qualitative analysis of surgical protocols, the lack of margin description impacts the clinical outcomes of OL and AIN, and the ablative protocols were heterogeneous in both OPMD and precancerous lesions. No significant difference in OL (risk ratio 0.82 [95% CI: 0.59-1.15]) and CIN (risk ratio 0.31 [95% CI: 0.09-1.09]) for recurrence was observed when cold-knife was compared with ablative protocols. OL exhibited higher recurrence and cancer progression rates compared to CIN and AIN. There is no difference in recurrence risk post-surgical treatment for OL and CIN. Surgical protocols for oral leukoplakia and CIN/AIN lack standardized approaches.

Imiquimod for the treatment of oral leukoplakia: A two-center retrospective study.

We aimed to assess the effectiveness of the use of topical imiquimod for the management of oral leukoplakia (OL). This was a retrospective study. Medical chart reviews were conducted to identify patients with biopsy-proven OL treated with topical 5% imiquimod. Data included OL characteristics, histopathological diagnosis, treatment outcome, and adverse events (AEs). Treatment response was assessed by measuring the percentage reduction in the size of OL lesions. 33 patients (51.5% females; median age: 65 years) with 38 lesions were included. OLs were either localized (23.7%) or multifocal lesions (76.3%), with the majority on the gingiva (86.8%). Pretreatment histopathological diagnoses were dysplasia in 84.2% and nonreactive hyperkeratosis in 15.8%. Most regimens consisted of 60-minute applications, 5-days-a-week, for 6 weeks. At the end of treatment, 81.6% of 38 lesions showed a reduction in size with 68.4% exhibiting ≥50% reduction in size, and 42.1% exhibiting complete resolution. Application site reactions were the most common with pain/soreness/sensitivity occurring in 86.8%. Fatigue was the most frequently reported systemic AE (28.9%). Two-thirds of OL lesions had ≥50% reduction in size. Most AEs were temporary and resolved upon treatment discontinuation. Prospective studies are needed to further assess Imiquimod's effectiveness in OL management.

Clinical and mycological analysis of colonization by Candida spp. in oral leukoplakia and oral lichen planus.

This study aims to analyze the prevalence of Candida spp. colonization in oral leukoplakia and oral lichen planus lesions, verify the influence of systemic and local factors, besides identify and determine the in vitro antifungal susceptibility profile of Candida species. Samples were collected by swabbing from oral lesions and healthy mucosa and cultured on Sabouraud Dextrose and CHROMagar® Candida plates. Species identification was confirmed with MALDI-TOF MS analysis. Candida spp. was found in 36.8% of cases of oral leukoplakia and 18.2% of cases of oral lichen planus. Candida albicans was the only species found in oral lichen planus lesions (n = 2, 100%) and the most prevalent in oral leukoplakia (n = 5, 76.4%). Among the non-albicans Candida species found in oral leukoplakia were C. parapsilosis (n = 2, 25.5%) and C. tropicalis (n = 1, 14.1%). Candida isolates were susceptible to all antifungals tested. C. albicans was the most commonly found species in the studied lesions. No correlation was found between systemic and local factors with positive cases of oral lichen planus. However, smoking and alcohol consumption may be associated with positive cases of oral leukoplakia, especially the non-homogeneous clinical form. In addition, there is a possible predisposition to associated Candida colonization in cases of epithelial dysplasia found in oral leukoplakia. The antifungal medications tested showed excellent efficacy against isolates.

Potential Roles of Activin in Head and Neck Squamous Cell Carcinoma Progression and Mortality.

Activin, a member of the TGF-β super family of cytokines, is involved in head and neck squamous cell carcinoma (HNSCC). This study examined the constituents of the activin axis in order to further elucidate the role of activin A in HNSCC progression. Immunohistochemistry (IHC), reverse transcription polymerase chain reaction (RT-PCR), MTT, and matrigel invasion assays, in addition to analysis of the tumor cancer genome atlas (TCGA), were employed. IHC in HNSCC and oral leukoplakia (OPL) lesions demonstrated increased expression of the inhibin subunit βA (INHBA) (p<0.0001), as well as activin receptor type IB (ACVR1B) (p<0.0032) compared to normal mucosa. TCGA analysis revealed increased INHBA expression was associated with lymph node positive tumors (p=0.024), decreased overall survival (p=0.0167), and decreased promoter methylation (p<0.0001). Concomitant up-regulated expression of gene pathways strongly correlated with INHBA expression demonstrated further deleterious effects on survival (p<0.0148). Activin may be an important component of early carcinogenesis in OPL and HNSCC with unfavorable effects on clinical end-points such as survival.

Somatic Variants and Exon-Level Copy Number Changes in Five Hyperplastic Oral Leukoplakias

Oral leukoplakia (OL), an oral potentially malignant disorder, begins with a hyperplastic/hyperkeratotic stage at which no genome-scale somatic single nucleotide variant profiles have been described so far. We performed exome sequencing of five cases at this stage with no evidence of dysplasia to identify genetic alterations (exon-level copy number alterations, indels, and single nucleotide variants), their association with transcript levels, and relationship with oral cancer susceptibility. Pathway enrichment analysis of genes associated with tobacco chewing and age-related mutation signatures, transcripts with variants predicted to be functionally damaging and those with significantly altered levels all indicated the involvement of focal adhesion, ECM-receptor interactions, regulation of cytoskeleton, and DNA repair. Two novel mutations identified in FAT1 tumor suppressor gene were associated with decreased transcript levels. In addition, 16 expressed cancer driver genes contained functionally damaging variants. Many of the affected genes were also reported in dysplastic OL lesions. The presence of variants in cancer driver genes and those shared with oral dysplasias possibly provides a basis for further progression and increased susceptibility to oral cancer.

Elucidating the Genetic Landscape of Oral Leukoplakia to Predict Malignant Transformation.

Oral leukoplakia is the most common oral potentially malignant disorder with an annual malignant transformation rate of 1% to 5%. Consequently, oral leukoplakia patients have a 30% to 50% lifetime risk to develop oral squamous cell carcinoma. Although risk factors for malignant transformation of oral leukoplakia have been investigated, no definitive risk stratification model has been proposed. Next-generation sequencing can elucidate the genetic landscape of oral leukoplakia, which may be used to predict the risk for malignant transformation. We investigated a retrospective cohort of 89 oral leukoplakia patients, and analyzed their oral leukoplakia lesions for the presence of genomic copy-number alterations and mutations in genes associated with oral squamous cell carcinoma. In 25 of 89 (28%) patients, oral squamous cell carcinoma developed during follow-up. Seventy-nine of 89 (89%) oral leukoplakias harbored at least one genetic event. Copy-number alterations were present in 61 of 89 (69%) oral leukoplakias, most commonly gains of chromosome regions 8q24 (46%) and 20p11 (20%) and loss of 13q12 (19%). Mutations were present in 59 of 89 (66%) oral leukoplakias, most commonly in TP53 (28%), FAT1 (20%), and NOTCH1 (13%). Genetic data were combined with the presence of dysplasia to generate a prediction model, identifying three groups with a distinct risk for malignant transformation. We provide an extensive description of genetic alterations in oral leukoplakia and its relation to malignant transformation. On the basis of our data we provide a model for the prediction of malignant transformation of oral leukoplakia using dysplasia and genetic markers.

“Comparative Evaluation of Laser and Surgical Treatment Modalities of Oral Leukoplakia” -A Systematic Review

Introduction: Oral leukoplakia (OL) is considered a potentially malignant lesion of the oral cavity. Aim: This systematic review aims to evaluate effectiveness of different laser and surgical treatment in management of OL. Materials and Methods: A comprehensive search was done using the MeSH [medical subject headings] terms and keyword search in the electronic databases, namely PubMed and Google Scholar. The search was limited to articles published as full text in English, which were screened by two reviewers for eligibility. Results: The search yielded nine articles out of which seven articles were only included based on the inclusion criteria. The outcome measure evaluated blood loss, pain, malignant transformation, recurrence, healing, scarring, and adverse outcomes. Conclusion: Lasers are more effective in treating OL lesions, but further comparative studies needed to assess their long-term efficacy.

Oral cancer prediction by noninvasive genetic screening.

Oral squamous cell carcinomas (OSCCs) develop in genetically altered epithelium in the mucosal lining, also coined as fields, which are mostly not visible but occasionally present as white oral leukoplakia (OL) lesions. We developed a noninvasive genetic assay using next-generation sequencing (NGS) on brushed cells to detect the presence of genetically altered fields, including those that are not macroscopically visible. The assay demonstrated high accuracy in OL patients when brush samples were compared with biopsies as gold standard. In a cohort of Fanconi anemia patients, detection of mutations in prospectively collected oral brushes predicted oral cancer also when visible abnormalities were absent. We further provide insight in the molecular landscape of OL with frequent changes of TP53, FAT1 and NOTCH1. NGS analysis of noninvasively collected samples offers a highly accurate method to detect genetically altered fields in the oral cavity, and predicts development of OSCC in high-risk individuals. Noninvasive genetic screening can be employed to screen high-risk populations for cancer and precancer, map the extension of OL lesions beyond what is visible, map the oral cavity for precancerous changes even when visible abnormalities are absent, test accuracy of promising imaging modalities, monitor interventions and determine genetic progression as well as the natural history of the disease in the human patient.

Prediction of the risk of cancer and the grade of dysplasia in leukoplakia lesions using deep learning

ObjectivesTo estimate the probability of malignancy of an oral leukoplakia lesion using Deep Learning, in terms of evolution to cancer and high-risk dysplasia. Materials and MethodsA total of 261 oral leukoplakia lesions with a mean of 5.5 years follow-up were analysed from standard digital photographs. A deep learning pipeline composed by a U-Net based segmentation of the lesion followed by a multi-task CNN classifier was used to predict the malignant transformation and the risk of dysplasia of the lesion. An explainability heatmap is constructed using LIME in order to interpret the decision of the model for each output. ResultsA Dice coefficient of 0.561 was achieved on the segmentation task. For the prediction of a malignant transformation, the model provided a sensitivity of 1 with a specificity of 0.692. For the prediction of high-risk dysplasia, the model achieved a specificity of 0.740 and a sensitivity of 0.928. ConclusionThe proposed model using deep learning can be a helpful tool for predicting the possible malignant evolution of oral leukoplakias. The generated heatmap provides a high confidence on the output of the model and enables its interpretability.

Use of the Fractal Dimension to Differentiate Epithelium and Connective Tissue in Oral Leukoplakias.

Simple SummaryDysplasia grade identification is the only consolidated factor by which to evaluate the risk of developing oral cancer from oral leukoplakia lesions. An objective manner to determine dysplasia grade is still lacking and this has prompted our research. Our findings can help dentists and pathologists to predict oral leukoplakia prognosis with a non-invasive, easy-to-use tool, using the fractal dimension as invariant.Background: Oral leukoplakia (OL) is considered one of the most common potentially malignant oral disorders (OPMD), with a verified increased risk of developing oral cancer. The identification of the dysplasia grade (low–high) is the only consolidated factor used to evaluate this risk. The objective of this study was to verify the role of the fractal dimension (FD) in assessing this dysplasia. Methods: To begin, 29 OL and 10 normal oral mucosa (NOM) biopsies were retrieved for FD analysis of the epithelial (dime) and the connective (dimc) tissue. Results: In the OL group, the median value of dime is higher (1.67, IQR = 0.12) than for the NOM group (1.56, IQR = 0.08), with statistically significant differences (Wilcoxon test, p = 0.0031). There were no differences in relation to dimc. Significant differences were observed between the non-dysplasia vs. high-grade (p = 0.0156) and low-grade vs. high-grade (p = 0.0049) groups. No significant differences were identified in relation to dimc for the different degrees of dysplasia. For a cut-off point of 1.44 of dime, a specificity of 96.6% was obtained, a sensitivity of 100%, and an AUC = 0.819 (p = 0.003). Conclusions: FD at the level of the epithelium may be used as a diagnostic tool in OL.

Diagnostic Accuracy of High-Grade Intraepithelial Papillary Capillary Loops by Narrow Band Imaging for Early Detection of Oral Malignancy: A Cross-Sectional Clinicopathological Imaging Study.

Simple SummaryThis study aimed to clarify the advantages and disadvantages of conventional visual inspection (CVI), endoscopic white light imaging (WLI), and narrow-band imaging (NBI) and to examine the diagnostic accuracy of intraepithelial papillary capillary loops (IPCL) for the detection of oral squamous cell carcinoma (OSCC). All OSCC cases showed high-grade (Type III–IV) IPCL. A non-homogeneous lesion with high-grade IPCL strongly suggested malignancy. Our results indicate that WLI and NBI are powerful tools for detecting precancerous and cancerous lesions using IPCL. However, NBI is influenced by mucosal thickness; therefore, image interpretation is important.This study aimed to clarify the advantages and disadvantages of conventional visual inspection (CVI), endoscopic white light imaging (WLI), and narrow-band imaging (NBI) and to examine the diagnostic accuracy of intraepithelial papillary capillary loops (IPCL) for the detection of oral squamous cell carcinoma (OSCC). This cross-sectional study included 60 participants with oral mucosal diseases suspected of having oral potentially malignant disorders (OPMDs) or OSCC. The patients underwent CVI, WLI, NBI, and incisional biopsy. Images were evaluated to assess the lesion size, color, texture, and IPCL. Oral lichen planus (OLP) and oral leukoplakia lesions were observed in larger areas with NBI than with WLI; 75.0% were associated with low-grade (Type 0–II) IPCL. Various types of oral leukoplakia were seen; however, all OSCC cases showed high-grade (Type III–IV) IPCL. The diagnostic accuracy of high-grade IPCL for OSCC showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 80.9%, 59.1%, 100%, and 85.0%, respectively. A non-homogeneous lesion with high-grade IPCL strongly suggested malignancy. Overall, our results indicate that WLI and NBI are powerful tools for detecting precancerous and cancerous lesions using IPCL. However, NBI is influenced by mucosal thickness; therefore, image interpretation is important for accurate diagnosis.

Onco-preventive management of oral leukoplakia lesions by topical 5-ALA-mediated photodynamic therapy: A systematic review of clinical trials

Oral leukoplakia is the most prevalent potentially malignant disorder of the oral mucosa globally and its management remains a challenge. Photodynamic therapy is a minimally invasive alternative method in the treatment of premalignant lesions; and the use of the topical 5-ALA photosensitizer plus irradiation with light emitting diode (LED) or laser light has been one of the most recommended approaches for the treatments of oral leukoplakia by photodynamic therapy. The present study was carried out to determine its clinical efficacy as a chemoprevention alternative in the different clinical forms of oral leukoplakia. An exhaustive search of scientific articles published in the last 30 years in English was carried out, using keywords with the MeSH guideline, about the use of topical 5-ALA-mediated photodynamic therapy as a photosensitizer and under low intensity laser radiation or light LED as a source of illumination, in different digital bases. The systematic review under PRISMA guidance recognized an efficacy of 88.6% for this mode of phototherapy in the management of oral leukoplakia, with a greater effect size in the homogeneous clinical forms with dysplastic changes, regardless of the type of light source. However, the evidence used in this analysis was moderate. Based on the results of the present study, we can conclude that topical 5-ALA-mediated photodynamic therapy appears to be a high-performance alternative in the oncopreventive management of oral leukoplakia lesions. However, we recommend running controlled and randomized clinical trials with homogeneous methodologies that allow us to generate a met analysis with a high level of evidence.

Onco-preventive management of oral leukoplakia lesions by topical 5-ALA-mediated photodynamic therapy: A systematic review of clinical trials

Onco-preventive management of oral leukoplakia lesions by topical 5-ALA-mediated photodynamic therapy: A systematic review of clinical trials

Can tissue biomarkers be used to determine the prognosis of oral leukoplakia lesions with regards to malignant transformation?

Design Systematic review looking at published studies which aimed to identify human tissue biomarkers which could predict malignant transformation of oral leukoplakia (OL) lesions.Case/control selection Articles were identified from PubMed, EBSCO and Cochrane library databases using combinations of keywords. Randomised clinical trials, case-control studies and prospective and retrospective cohort studies were included. All studies had to include follow-up data. There were no restrictions regarding gender, age groups, geographic origin, or year of publication. The selection process involved two of the researchers independently analysing titles and abstracts to identify articles for full-text reading. The same authors then read the articles identified for full-text reading, applying the eligibility criteria. If there was a disagreement with regards to the selection, a discussion was had until a consensus was reached.Data analysis Qualitative data was presented as reported from the primary studies. Quantitative analysis was not carried out due to the high heterogeneity across the studies.Results Forty-six studies were included within the systematic review. These studies identified a total of 3,783 patients with OL, of which 1,047 went on to develop oral cancer, giving an average malignant transformation incidence of 27.6%. Forty-nine different tissue biomarkers were evaluated among the included studies, with the p53 and podoplanin proteins and loss of heterozygosity the most frequently discussed.Conclusions Of the biomarkers studied, podoplanin and chromosomal loci abnormalities (such as loss of heterozygosity) would appear the most promising in being able to predict malignant transformation of OL lesions; however, further research is required.

Risk assessment of malignant transformation of oral leukoplakia in patients with previous oral squamous cell carcinoma

The aim of this study was to identify the risk factors associated with developing oral squamous cell carcinoma (OSCC) from surgically excised oral leukoplakia (OL) in patients with previous oral cavity cancer. Clinicopathological data of 84 patients who were treated for OL between July 2002 and July 2020 and who had previously received treatment for OSCC were reviewed retrospectively. The follow-up time ranged from 0.69 to 17.99 years (mean 6.78 ± 4.25 years). The overall cumulative malignant transformation rate was 25% and the annual transformation rate was 5.73%. Kaplan–Meier survival analysis and the log-rank test showed that Candida infection (P = 0.010) was a risk factor associated with malignant transformation. In the multivariate Cox regression analysis, tongue and floor of the mouth as the location of the leukoplakia (P = 0.039), multifocal lesions of OL (P = 0.047), and Candida infection (P = 0.018) were the three independent prognostic factors related to the development of OSCC from the treated OL. A cautious approach to OL of the tongue with Candida infection or multifocal disease in this group of patients would be appropriate.

Deep Learning Predicts the Malignant-Transformation-Free Survival of Oral Potentially Malignant Disorders.

Simple SummaryMouth cancer is the most common malignancy in the head-and-neck region. Usually, these tumors develop from white lesions in the mouth that appear long before cancer diagnosis. However, platforms that can estimate the time-factored risk of cancer occurring from these diseases and guide treatment and monitoring approaches are elusive. To this end, our study presents time-to-event models that are based on machine learning for prediction of the risk of malignancy from oral white lesions following pathological diagnosis as a function of time. These models displayed very satisfactory discrimination and calibration after multiple tests. To facilitate their preliminary use in clinical practice and further validation, we created a website supporting the use of these models to aid decision making.Machine-intelligence platforms for the prediction of the probability of malignant transformation of oral potentially malignant disorders are required as adjunctive decision-making platforms in contemporary clinical practice. This study utilized time-to-event learning models to predict malignant transformation in oral leukoplakia and oral lichenoid lesions. A total of 1098 patients with oral white lesions from two institutions were included in this study. In all, 26 features available from electronic health records were used to train four learning algorithms—Cox-Time, DeepHit, DeepSurv, random survival forest (RSF)—and one standard statistical method—Cox proportional hazards model. Discriminatory performance, calibration of survival estimates, and model stability were assessed using a concordance index (c-index), integrated Brier score (IBS), and standard deviation of the averaged c-index and IBS following training cross-validation. This study found that DeepSurv (c-index: 0.95, IBS: 0.04) and RSF (c-index: 0.91, IBS: 0.03) were the two outperforming models based on discrimination and calibration following internal validation. However, DeepSurv was more stable than RSF upon cross-validation. External validation confirmed the utility of DeepSurv for discrimination (c-index—0.82 vs. 0.73) and RSF for individual survival estimates (0.18 vs. 0.03). We deployed the DeepSurv model to encourage incipient application in clinical practice. Overall, time-to-event models are successful in predicting the malignant transformation of oral leukoplakia and oral lichenoid lesions.

Randomized comparative study in the treatment of oral leucoplakia with laser and conventional surgery

Objective: High-energy lasers are used as an alternative to surgical treatment of potentially malignant disorders in the oral cavity. The present article aims to make a prospective randomised comparative clinical assessment of the effect of laser surgery and conventional surgery in the treatment of oral leukoplakia (OL). Materials and methods: In the study were included 89 patients with histologically confirmed oral leukoplakia lesions. Laser excision of the lesions using Er YAG laser was performed in 36 of the patients, while standard surgical excision was used in 53 of the cases. Following clinical assessment comparing the two treatment methods was conducted based on: pain, wound healing, infection and recurrence of the lesions. Results: A statistically significant difference between two groups according pain in the postoperative period was found. Patients treated with laser ablation experienced far less pain than those treated with surgical excision. The healing time was significantly faster in the group treated with Er YAG laser, and regarding the occurrence of postoperative infections, the results of the two methods did not differ significantly. Recurrence was observed earlier in the group treated with laser ablation, but the levels align over a longer period of time. Conclusion: Er YAG laser ablation is a contemporary method for the treatment of oral leukoplakia without dysplasia, providing similar success, compared to conventional surgical excision, with less postoperative discomfort for the patients. Keywords Er YAG laser; Leukoplakia; Potentially malignant disorders.

Malignant Transformation and Treatment Recommendations of Chronic Hyperplastic Candidiasis-A Six-year Retrospective Cohort Study.

Oral chronic hyperplastic candidiasis (CHC) is the most uncommon type of oral candidiasis with diverse manifestations. Up to date the diagnosis, long-term management and prognosis of this oral potentially malignant disorder remain obscure. The aim of this study was to provide the recommendations guiding the diagnostic procedure, clinical management and prognosis assessment of CHC. A retrospective cohort study was performed during January 2015 to April 2021 involving patients with a definite diagnosis of CHC in the Department of Oral Medicine of Peking University School and Hospital of Stomatology. Demographic features, clinical and histopathological features, treatment protocols and follow-ups including malignancy transformation were analysed. Fourty eight CHC patients were collected and reviewed, with a male-to-female ratio of 2.69:1. The average age at diagnosis was 54.92±9.79 (36-80) years old. Clinically, the multiform oral lesions were diverse and frequently presented as white plaque and erythematous lesions. As a result, the initial diagnostic accordance rate was only 54.17%, and the most common presumptive initial diagnoses were oral lichen planus (22.92%), oral leukoplakia (20.83%) and traumatic lesion (2.08%). Histopathologically, ten (20.83%) patients had varying degrees of epithelial dysplasia, and two (4.17%) patients had malignant transformation with a mean transformation time of 6.5±6.36months. Among the 28 patients who underwent fungal culture, 24 patients were exclusively infected by Candida albicans, with two patients each mixed infected by Cglabrata and Ctropicalis, respectively. Notably, treatment with fluconazole had the lower recurrence rate compared with topical nystatin. The diagnosis and management of CHC remain a challenge due to its polymorphic clinical presentations, chronic progression and potential of malignant transformation.

Matrix Metalloproteinases (MMPs) in skin and oral pathology - Premalignant Diseases, Spinocellular Carcinoma and Basocellular Carcinoma (markers).

Matrix Metalloproteinases (MMPs) in skin and oral pathology - Premalignant Diseases, Spinocellular Carcinoma and Basocellular Carcinoma (markers).

Assessment of Pattern of Oral Prosthetic Treatment and Prevalence of Oral Diseases in Edentulous Patients in North Indian Population: A Cross-sectional Study.

Background:The present study was undertaken for assessing the pattern of oral prosthetic treatment and prevalence of dental diseases in edentulous patients in North Indian population.Materials and Methods:A survey was carried out in North Indian population, and screening of the edentulous patients was done. Five hundred edentulous patients were enrolled. Complete oral and general examination was carried out. Pro forma was framed, and clinical details were recorded. Using mouth mirror and explorer, complete oral examination was carried out. Demographic profile was also evaluated. Prosthetic rehabilitation pattern of all the participants was also recorded.Results:Complete removable denture and removable partial denture were method of rehabilitation in 28% and 31% of the participants. Dental implant-supported complete denture was used in 8% of the patients, whereas dental implant-supported overdenture was used in 33% of the participants. Ulcerative lesions were present in 5% of the patients, whereas oral leukoplakia was present in 4% of the patients. Oral lichen planus and torus were present in 2% and 1% of the patients.Conclusion:Majority of the geriatric patients prefer having removable denture. Furthermore, due to nutritional deficiency associated with geriatric age, oral leukoplakia and ulcerative lesions are more common in them.