Reactive Lesions Of Oral Cavity Research Articles

Reactive lesions of oral cavity

Oral mucosa is constantly subjected to various external and internal stimuli that leads to various reactive lesions. They are non-neoplastic in nature, but clinically these lesions closely mimic benign neoplastic lesions leading the clinician to misdiagnosis and sub-optimal treatment. Reactive lesions are typically occurring as a response to chronic inflammation caused by various forms of low-grade chronic irritations to the oral mucosa such as dental plaque and calculus, sharp edges of grossly carious teeth, faulty dental restorations, chronic biting habits, ill-fitting dental/oral appliances and food impactions. This review article summarizes the various reactive lesions of oral cavity and their distinctive histopathologic features.

Role of apoptosis in pathogenesis of oral lesions: Molecular approach

Research in histology, genetics, and molecular biology indicate that virtually all animal cells are armed with the genetic machinery to die. Under normal physiological circumstances, damaged cells are removed through a genetically programmed type of cell death. The aberrations in the regulation of genetically programmed cell death have been found to cause disease and deformity. Cell death, the ultimate result of cell injury, is one of the most crucial events in pathology, affecting every cell type and being the major consequence of ischemia (lack of blood flow), infection, toxins and immune reactions. Cell death is critical during normal embryogenosis, lymphoid tissue development and normally induced involution and is the aim of cancer radiotherapy and chemotherapy. This article discusses role of apoptotis in pathologies of potentially malignant, malignant, autoimmune and reactive lesions of oral cavity.

Assessment of reactive gingival lesions of oral cavity: A histopathological study.

Background:In the literature, many studies were attempted to analyze the distribution of oral reactive lesions in terms of age, gender and location. However, very few studies have focused on the detailed histopathological features of these reactive lesions of oral cavity. Thus, the purpose of this paper is to document the occurrence, distribution and various histopathological features of reactive gingival lesions.Materials and Methods:This study is a retrospective archival review of reactive gingival lesions of oral cavity such as irritational fibroma (IF), inflammatory gingival hyperplasia (IGF), pyogenic granuloma (PG), peripheral giant cell granuloma (PGCG) and peripheral ossifying fibroma involving gingival tissues. All the cases were histopathologically reviewed on some microscopical parameters according to the criteria given by Peralles et al.Results:Regarding epithelial morphology, atrophy, ulceration and hyperplasia were found predominantly in PG. Connective tissue was predominantly dense in IGF and IF with fibroblastic proliferation; whereas loose connective tissue was seen in PG. Vascular proliferation, especially capillary, was commonly present in PG and inflammatory gingival hyperplasia (IGH). Inflammatory cell infiltrate was intense in both PG and IGH. Mineralization showed a marked affinity for peripheral cement-ossifying fibroma, and bone/bone-like areas were found in about ten cases of them. The Foreign body type of multinucleated giant cells was found exclusively on PGCG.Conclusion:Despite their clinical similarities, the findings of this study reports that all reactive gingival lesions show some differences in age, type, location, duration and histopathological features. Nevertheless, the differing histological pictures are a range of a single lesion in diverse stages of maturation. Essential in the treatment of reactive lesions is the total removal of the lesion with local irritants such as defective restorations or calculus formation.

Reactive lesions of oral cavity: A retrospective study of 659 cases.

Objective:This study reviews, analyzes, and compares the demographic data, histopathological features and discusses the treatment and prognosis of reactive lesions (RLs).Materials and Methods:Retrospective study was performed on the departmental archives from July 2006 to July 2016 (total 5000 cases) comprising of 659 cases of RLs of the oral cavity. The recorded data included age, gender, size, site, duration, habits, etiology, histopathological diagnosis, treatment, and prognosis.Results:The most common lesion was found to be inflammatory fibrous hyperplasia (47%) followed by pyogenic granuloma (PG) (27.16%) and the least cases were of peripheral giant cell granuloma (1.6%). The mean age for the occurrence was 4th–5th decade in all the RL's exceptperipheral ossifying fibroma (POF) which presented in the third decade. Female predominance was noted in all lesions except irritational FIB. The sizes of majority of the lesions were approximately 0.5–1 cm. The common sites were anterior maxilla followed by posterior mandible and least in tongue with no associated habits (82.2%). The duration of all the lesions was seen to be <1 year. Majority of them presented with poor oral hygiene status (87.2%). Recurrences were present in 13.5% of surgically excised lesions.Conclusion:The RLs present commonly in oral cavity secondary to injury and local factors which can mimic benign to rarely malignant lesions. The clinical and histopathological examination helps to categorize the type of lesions. The complete removal of local irritants with follow-up and maintenance of oral hygiene helps to prevent the recurrences of such lesions.

Involvement of mast cells and microvessels density in reactive lesions of oral cavity: A comparative immunohistochemical study

In view of the similarity of clinicopathological features between reactive lesions of the oral cavity, the objective of the present study was to investigate the density of MCs (mast cells) and microvessels in a series of these lesions. Thirty-seven cases of reactive lesions including fibrous hyperplasia (FH, n=10), inflammatory fibrous hyperplasia (IFH, n=10), peripheral giant cell lesion (PGCL, n=10) and lobular capillary hemangioma (LCH, n=7) were investigated using immunohistochemistry for mast cell tryptase and CD34. For comparative purposes, central giant cell lesions (CGCL, n=5) were included. A higher MC density was observed in LCH (37.01), while CGCL exhibited the lowest density (n=8.14). There was a significant difference in MC density when all reactive lesions were compared to CGCL (p=0.001). The largest mean density of microvessels was observed in LCH (n=21.69). The smallest number was observed in CGCL (n=6.24). There was a significant difference in microvessel density when the reactive lesions were compared to CGCL (p=0.003). There was a significant and direct correlation between the density of MCs and microvessels only for IFH (p=0.048) and CGCL (p=0.005). A significant and direct correlation between the mean density of MCs and microvessels was observed when the reactive lesions were analyzed as a whole (p=0.005). Our results suggest that mast cells contribute to the connective tissue framework and angiogenic function, as well as the development, of reactive lesions of the oral cavity, including FH, IFH, LCH and PGCL.

Peripheral Ossifying Fibroma

Peripheral ossifying fibroma is classified under reactive lesions of oral cavity. They are relatively uncommon gingival growth and constitute about 10% of all reactive lesions. Chronic irritation and trauma are considered to be etiological agent. Usually occur in young adults with a female predominance and are solitary in nature. We report a case of peripheral ossifying fibroma in a 22-year old female.

ORAL KAVİTENİN REAKTİF LEZYONLARI: 147 VAKA ÜZERİNE RETROSPEKTİF BİR ÇALIŞMA

Amac: Agiz mukozasinin cok katli yassi epiteli patojenik faktorlere karsi koruyucu gorev yapar. Mukozayi etkileyen lokal ve sistemik faktorler epitel yapiyi zedelerse; reaktif, inflamatuar, gelisimsel ve neoplazik lezyonlar ortaya cikar. Bu calismanin amaci; Hatay ve Gaziantep’te dis hekimligi fakultelerine basvuran hastalarda, agiz kavitesinin reaktif lezyonlarinin gorulme sikligini, cinsiyet, yas ve lokalizasyona gore dagilimini belirlemektir. Gerec-Yontem: Bu retrospektif calisma, Ocak 2009-Agustos 2013 arasinda Mustafa Kemal Universitesi ve Gaziantep Universitesi Dis Hekimligi fakultelerinde biyopsi alinan ve patolojik inceleme yapilip, tani konulmus 147 hastanin sonuclari degerlendirilerek olusturulmustur. Arastirmada lezyonlarin yasa ve cinsiyete gore dagilimi belirlenmis, lokalizasyonlari analiz edilmistir. Bulgular: Periferal dev hucreli granulom 56 vakada (%38,09), piyojenik granulom 39 vakada (%26,53), irritasyon fibromu 10 vakada(%6,8), semento-ossifiye fibrom 7 vakada (%4,76), inflamatuar fibroz hiperplazi 8 vakada (%5,44), inflamatuar papiller hiperplazi 1 vakada (%0,68), epulis fissuratum 26 vakada (%17,68) gorulmustur. Lezyonlar kadinlarda (n=83, %56,46) erkeklerden (n=64, % 43,54) daha sik gorulmektedir. Dis eti agiz icinde reaktif lezyonlarin en cok etkiledigi yerdir (n=115, %78,23). Sonuc: Oral reaktif lezyonlar siklikla kadinlarda gorulmektedir ve en cok dis etini etkilemektedir. Yaptigimiz calisma en cok rastlanan reaktif lezyonun periferal dev hucreli granulom oldugunu gostermektedir. Anahtar Kelimeler: oral kavite, reaktif lezyon, retrospektif calisma

Retrospective analysis of the clinical features of 530 cases of reactive lesions of oral cavity

Background: Most common localized reactive lesions of oral cavity are focal fibrous hyperplasia, pyogenic granuloma (PG), irritational fibroma, peripheral giant cell granuloma (PGCG), peripheral ossifying fibroma (POF), fibro-epithelial hyperplasia/polyp, inflammatory fibrous hyperplasia and inflammatory gingival hyperplasia. Clinically, these reactive lesions often present diagnostic challenges because they mimic different groups of pathologic processes. The aim of this paper is to document the occurrence, distribution of clinical features of reactive lesions of oral cavity in 15 years of clinical practice in Raichur, Karnataka. Materials and Methods: This study is a retrospective archival review of 530 cases of focal reactive lesions of the oral cavity. The cases for inclusion in this study were PG, PGCG, POF, irritational fibroma, fibro-epithelial hyperplasia/polyp, inflammatory fibrous hyperplasia and inflammatory gingival hyperplasia. Clinical data of each patient such as age, gender, location, and treatment were retrieved from the records. Results: Inflammatory gingival hyperplasia was the most prevalent lesion and followed by PG. The age ranged from 7 to 63 years, with a mean age of 40.5 years. 261 cases were males and 269 cases were females. Male to female ratio being 1:1. With the exception of PG and inflammatory gingival hyperplasia, all reactive lesions were more common in males. Gingiva with 470 cases was the most frequent site of reactive lesions, followed by buccal mucosa and palate. Conclusion: Reported results on the age, gender, and location of the individual types of lesions are not consistent in different studies. Some of the differences may be attributed to the geographic or ethnic factors. Nevertheless, there is need for more epidemiological studies to establish a better and adequate program to educate general population. Inaddition an early diagnosis and elimination of such lesions may minimize possible dentoalveolar complications.

Pyogenic Granuloma of Gingiva: A Misnomer

A varied spectrum of lesions ranging from developmental, reactive, inflammatory to neoplastic manifests in the oral cavity ,as oral mucosa is constantly subjected to varied stimuli. These lesions may be either generalized or localized. Most of the localized oral overgrowths are considered to be reactive rather than neoplastic in nature. The reactive lesions of oral cavity are associated with injuries of soft tissue which stimulate an exuberant or excessive response and have high prevalence rates and different involvement pattern.

Reactive lesions of oral cavity: A survey of 100 cases in Eluru, West Godavari district

Aim:Reactive lesions of the oral cavity are associated with injuries of soft tissue and have high prevalence rates and different involvement patterns in different parts of the world. This study reviews the pathogenesis and analyzes demographic data, histopathological features and compares the clinico-pathologic profiles of the diseases to those previously reported.Materials and Methods:Patient records of the Department of Oral Pathology during one and half year period were reviewed for diagnosis of oral connective tissue reactive hyperplastic lesion. Data including the area involved and the type of lesion were collected and analyzed using descriptive statistical methods and ANOVA test.Results:100 cases (mean age 36 years, male:female ratio 1:2) matched study criterion. The most common affected site was mandibular anterior region and buccal mucosa and the most common lesion was pyogenic granuloma and focal fibrous hyperplasia. All the lesions were more common in the mandible than in the maxilla. PGCG was seen to be equally distributed in males and females.Conclusion:Reactive hyperplastic lesions of the oral connective tissue are more common in females and the majority of the lesions occur in gingiva. This study supports previous assertions that PG and FFH may occur on any oral mucosal site with special preference for the mandibular anterior gingiva and buccal mucosa while PGCG and POF occur exclusively on the mandibular gingiva.