Background: While inflammatory diseases such as gingivitis and periodontitis induced by dental plaque biofilms constitute the majority of gingival lesions, gingiva can also be affected by a variety of diseases that show etiologies different from bacterial biofilms. The aim of this study was to retrospectively analyze the frequency and distribution of non-dental plaque-induced gingival diseases (NDPIGDs) in a Chinese population.
Methods: A total of 6859 samples of biopsied gingival diseases during the period of 2000-2019 were obtained from the Department of Pathology, Peking University Hospital of Stomatology. Lesions were categorized by histopathological diagnosis, pathological nature and the new classification of gingival health and gingival diseases/conditions. Demographic information, such as gender, location, and age, were also analyzed.
Results: Among 6859 biopsied NDPIGD samples, the five most frequent diagnoses included oral squamous cell carcinoma (OSCC, n=2094), fibrous hyperplasia (n=2026), pyogenic granuloma (n=478), epithelial dysplasia (n=477), and epithelial hyperplasia/hyperkeratosis (n=436). All types could be grouped into nine categories according to their pathological characteristics. The most frequently common biopsied NDPIGDs category was “hyperplastic lesions” (n=2648, 38.61%), followed by “malignant neoplasms” (n=2275, 33.17%). The most common diagnosis types in each category were fibrous hyperplasia and OSCC. Of all NDPIGDs, most lesions could be categorized into the new classification of gingival health and gingival diseases/conditions; only 7.07% did not fit the current classification system.
Conclusions: The present study represents the first report on the frequency and distribution of biopsied NDPIGDs in a Chinese population. Unlike previous studies, the most prevalent categories were “hyperplastic lesions” and “malignant neoplasms”. The proportion of “malignant neoplasms” and “oral potentially malignant disorders” was remarkably higher than in previous research. Nevertheless, the study provided epidemiological information for many NDPIGDs, which could be useful for future health policies as well as screening programs.