A Clinicopathological Study of Marginal Gingival Leukoplakia

Abstract

Background: Marginal gingival leukoplakias are relatively uncommon and rarely discussed in the scientific literature. Studies suggest they are distinct from other leukoplakias due to aggressive behavior and a strong association with proliferative verrucous leukoplakia. This study aimed to evaluate the clinicopathological characteristics of patients diagnosed with marginal gingival lesions. Methods: This retrospective study analyzed 32 patients diagnosed with marginal gingival leukoplakia. Clinicopathological data were extracted. K-means clustering and principal component analyses identified subgroups within the dataset. Histopathological findings were assessed by two oral pathologists using World Health Organization criteria for grading oral epithelial dysplasia. Results: The lesions predominantly affected older individuals (mean age: 60.4 years), 16 men and 16 women, and exhibited multifocality in 75% of cases. Proliferative verrucous leukoplakia was diagnosed in 24 patients (75%), and most lesions were homogeneous (84.4%). Thirteen patients were treated (three scalpel, eight laser, two both), while 19 underwent “wait and see.” Over a 95.4-month average follow-up, 11 recurrences (73.3%) were noted: four after scalpel (80%) and seven after laser excision (70%). Malignant transformation occurred in three cases. The most common histopathological feature was hyperkeratosis (n = 24), and eight cases showed mild, one moderate, and two severe epithelial dysplasia. Cluster analysis revealed five subgroups. Conclusion: Marginal gingival leukoplakias demonstrate significant heterogeneity but seem to be strongly associated with proliferative verrucous leukoplakia. Recurrence is a common outcome, and laser excision might be a better option for lesion control. Close monitoring remains essential for early intervention and improved outcomes.