Prevalence Of Oral Reactive Lesions Among Oral Biopsies - An Institutional Based Study

Main Article Content

Aathira. C. M
Dr. Abilasha R


Gingival reactive lesions, histopathology, innovative technique, peripheral giant cell granuloma, Pyogenic granuloma, inflammatory fibroepithelial hyperplasia


Introduction: Gingival mucosa is very often under mild irritation as a result of masticatory forces, entrapment of food debris, ill fitting appliances and the multitudinous array of normal microflora which may turn pathogenic under altered circumstances. The response of the gingival mucosa towards these irritants sometimes turn out to be hyperplastic which may lead to a class of oral reactive lesions namely inflammatory fibroepithelial hyperplasia, Pyogenic granuloma, angiomatous granuloma, peripheral ossifying fibromyalgia and central giant cell granuloma.
Aim: The study aims to assess the prevalence of oral reactive lesions who reported to the dental institution.
Materials and methods: All the data regarding the study population was obtained from DIAS( Dental Information Archiving Software)- all patient records from management. The data collected was tabulated and imported to SPSS software. Statistical analysis was done using Chi square tests.
Results: results from the study indicate that inflammatory fibroepithelial hyperplasia is highly prevalent followed by angiomatous granuloma. And also, females between the age group 30 - 40 years commonly presented with oral reactive lesions when compared to males. ‘
Conclusion: Therefore from the results obtained, it can be concluded that amongst the oral reactive lesions inflammatory fibroepithelial hyperplasia was highly prevalent among females of age 30 - 40 years.

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1. Shenoy SS, Dinkar AD. Pyogenic granuloma associated with bone loss in an eight year old child: A case report [Internet]. Vol. 24, Journal of
Indian Society of Pedodontics and Preventive Dentistry. 2006. p. 201. Available from:
2. Eversole LR, Rovin S. Reactive lesions of the gingiva [Internet]. Vol. 1, Journal of Oral Pathology & Medicine. 1972. p. 30–8. Available
3. Yamunadevi A, Pratibha R, Rajmohan M, Ganapathy N, Porkodisudha J, Pavithrah D, et al. Molecular insight into odontogenesis in
hyperglycemic environment: A systematic review [Internet]. Vol. 12, Journal of Pharmacy And Bioallied Sciences. 2020. p. 49. Available from:
4. Antony JVM, Vini Mary Antony J, Ramani P, Ramasubramanian A, Sukumaran G. Particle size, penetration rate and effects of smoke and
smokeless tobacco products – an invitro analysis [Internet]. Vol. 7, Heliyon. 2021. p. e06455.
Available from:
5. R H, Hannah R, Ramani P, Ramanathan A, Jancy MR, Gheena S, et al. CYP2 C9 polymorphism among patients with oral squamous cell
carcinoma and its role in altering the metabolism of benzo[a]pyrene [Internet]. Vol. 130, Oral Surgery, Oral Medicine, Oral Pathology and Oral
Radiology. 2020. p. 306–12. Available from:
6. Analysis of Prevalence of Oral Squamous Cell Carcinoma in Patients with History of Chronic Irritation of Oral Tissues - A Retrospective Study
[Internet]. Indian Journal of Forensic Medicine & Toxicology. 2020. Available from:
7. Umashankar K, R. A, R. H, Ramani P, S. G. Knowledge and Attitude About COVID-19 Pathogenesis Among Oral Pathologists in
Chennai [Internet]. Vol. 12, International Journal of Current Research and Review. 2020. p. 143–51. Available from:
8. Fujita R, Jass JR, Kaminishi M, Schlemper RJ. Early Cancer of the Gastrointestinal Tract: Endoscopy, Pathology, and Treatment. Springer Science & Business Media; 2008. 275 p.
9. Stablein MJ, Silverglade LB. Comparative Analysis of Biopsy Specimens from Gingiva and Alveolar Mucosa [Internet]. Vol. 56, Journal of
Periodontology. 1985. p. 671–6. Available from:
10. Philip Sapp J, Eversole LR, Wysocki GP. Contemporary Oral and Maxillofacial Pathology. Mosby Incorporated; 2004. 450 p.
11. Lee FD. A comparative study of Kaposi’s sarcoma and granuloma pyogenicum in Uganda [Internet]. Vol. 21, Journal of Clinical Pathology.
1968. p. 119–28. Available from:
12. Schoelch ML, Sekandari N, Regezi JA, Silverman S. Laser management of oral leukoplakias: A follow-up study of 70 patients [Internet]. Vol.
109, The Laryngoscope. 1999. p. 949–53. Available from:
13. Cardesa A, Slootweg PJ, Gale N, Franchi A. Pathology of the Head and Neck. Springer; 2017. 854 p.
14. White JM, Chaudhry SI, Kudler JJ, Sekandari N, Schoelch ML, Silverman S. Nd:YAG and CO2Laser Therapy of Oral Mucosal Lesions
[Internet]. Vol. 16, Journal of Clinical Laser Medicine & Surgery. 1998. p. 299–304. Available from:
15. Neville BW, Damm DD, Allen CM, Chi AC. Epithelial Pathology [Internet]. Color Atlas of Oral and Maxillofacial Diseases. 2019. p. 223–71. Available from:
16. Sapp JP, Philip Sapp J, Eversole LR, Wysocki GP. Developmental Disturbances of the Oral Region [Internet]. Contemporary Oral and
Maxillofacial Pathology. 2004. p. 1–44. Available from:
17. K M, Monica K, Vijayshree PJ, Gheena S, Ramani P, Abhilasha R, et al. IN SILICO GENE EXPRESSION ANALYSIS OF CRUCIAL CELL CYCLE CONTROL GENE CDKN2A AND CDKN2B IN HEAD AND NECK SQUAMOUS CELL CARCINOMA [Internet]. Vol. 23, Annals of Tropical Medicine & Public Health. 2020. Available from:
18. Sinduja P, Ramani P, Gheena S, Ramasubramanian A. Expression of metallothionein in oral squamous cell carcinoma: A systematic review [Internet]. Vol. 24, Journal of Oral and Maxillofacial Pathology. 2020. p. 143. Available from:
19. Ramani P, Krishnan R, Karunagaran M, Muthusekhar MR. Odontogenic sarcoma: First report after new who nomenclature with
systematic review [Internet]. Vol. 24, Journal of Oral and Maxillofacial Pathology. 2020. p. 157. Available from:
20. Ramasubramanian A, Ramani P, Sherlin H, Premkumar P, Natesan A, Thiruvengadam C. Immunohistochemical evaluation of oral
epithelial dysplasia using cyclin-D1, p27 and p63 expression as predictors of malignant transformation [Internet]. Vol. 4, Journal of Natural Science, Biology and Medicine. 2013. p. 349. Available from:
21. Carbone M, Broccoletti R, Gambino A, Carrozzo M, Tanteri C, Calogiuri PL, et al. Clinical and histological features of gingival lesions: A 17-year retrospective analysis in a northern Italian population [Internet]. Medicina Oral Patología Oral y Cirugia Bucal. 2012. p. e555–61. Available from:
22. Megarbane JM, Kassir A, Mokbel N, Naaman N. Root Resection and Hemisection Revisited. Part II: A Retrospective Analysis of 195 Treated Patients with Up to 40 Years of Follow-up [Internet]. Vol. 38, The International Journal of Periodontics & Restorative Dentistry. 2018. p. 783–9. Available from:
23. Eversole LR. Clinical Outline of Oral Pathology: Diagnosis and Treatment. PMPH-USA; 2001. 469 p.
24. Sapp JP, Philip Sapp J, Eversole LR, Wysocki GP. Oral Infections [Internet]. Contemporary Oral and Maxillofacial Pathology. 2004. p. 207–51. Available from:
25. Kfir Y, Buchner A, Hansen LS. Reactive Lesions of the Gingiva: A Clinicopathological Study of 741 Cases [Internet]. Vol. 51, Journal of Periodontology. 1980. p. 655–61. Available from:
26. Kleinman DV, Swango PA, Pindborg JJ. Epidemiology of oral mucosal lesions in United States schoolchildren: 1986-87. Community Dent
Oral Epidemiol. 1994 Aug;22(4):243–53.
27. Neelakantan P, Grotra D, Sharma S. Retreatability of 2 mineral trioxide aggregatebased root canal sealers: a cone-beam computed tomography analysis. J Endod. 2013 Jul;39(7):893–6.
28. Aldhuwayhi S, Mallineni SK, Sakhamuri S, Thakare AA, Mallineni S, Sajja R, et al. Covid-19 Knowledge and Perceptions Among Dental
Specialists: A Cross-Sectional Online Questionnaire Survey. Risk Manag Healthc Policy. 2021 Jul 7;14:2851–61.
29. Sheriff KAH, Ahmed Hilal Sheriff K, Santhanam A. Knowledge and Awareness towards Oral Biopsy among Students of Saveetha Dental
College [Internet]. Vol. 11, Research Journal of Pharmacy and Technology. 2018. p. 543. Available from:
30. Markov A, Thangavelu L, Aravindhan S, Zekiy AO, Jarahian M, Chartrand MS, et al. Mesenchymal stem/stromal cells as a valuable
source for the treatment of immune-mediated disorders. Stem Cell Res Ther. 2021 Mar 18;12(1):192.
31. Jayaraj G, Ramani P, Herald J. Sherlin, Premkumar P, Anuja N. Inter-observer agreement in grading oral epithelial dysplasia – A systematic
review [Internet]. Vol. 27, Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology. 2015. p. 112–6. Available from:
32. Paramasivam A, Priyadharsini JV, Raghunandhakumar S, Elumalai P. A novel COVID-19 and its effects on cardiovascular disease. Hypertens Res. 2020 Jul;43(7):729–30.
33. Li Z, Veeraraghavan VP, Mohan SK, Bolla SR, Lakshmanan H, Kumaran S, et al. Apoptotic induction and anti-metastatic activity of eugenol encapsulated chitosan nanopolymer on rat glioma C6 cells via alleviating the MMP signaling pathway [Internet]. Vol. 203, Journal of
Photochemistry and Photobiology B: Biology. 2020. p. 111773. Available from:
34. Gan H, Zhang Y, Zhou Q, Zheng L, Xie X, Veeraraghavan VP, et al. Zingerone induced caspase-dependent apoptosis in MCF-7 cells and prevents 7,12-dimethylbenz(a)anthraceneinduced mammary carcinogenesis in experimental rats. J Biochem Mol Toxicol. 2019 Oct;33(10):e22387.
35. Dua K, Wadhwa R, Singhvi G, Rapalli V, Shukla SD, Shastri MD, et al. The potential of siRNA based drug delivery in respiratory disorders: Recent advances and progress. Drug Dev Res. 2019 Sep;80(6):714–30.
36. Mohan M, Jagannathan N. Oral field cancerization: an update on current concepts. Oncol Rev. 2014 Mar 17;8(1):244.
37. Haubold HJ, Onuora LI. Basic Space Science: Proceedings of the Conference Held in Lagos, Nigeria, October 1993. Amer Inst of Physics; 1995. 304 p.
38. E A, Aswani E, Gheena S, Pratibha R, Abilasha R, Hannah R, et al. Overexpression of HNRNPA2B1 is Associated with Poor Prognosis in Head and Neck Squamous Cell Carcinoma [Internet]. International Journal of Current Research and Review. 2020. p. 15–8. Available from:
39. Hassona Y, Al Boosh D, Al Saed A, Al Mousa M, Barghout N, Al Kayed A, et al. The range of pathological diagnoses of oral diseases in Jordan: An 11-year-retrospective study [Internet]. Vol. 7, Saudi Journal of Oral Sciences. 2020. p. 151. Available from:
40. Vilmann A, Vilmann P, Vilmann H. Pyogenic granuloma: Evaluation of oral conditions [Internet]. Vol. 24, British Journal of Oral and Maxillofacial Surgery. 1986. p. 376–82. Available from:
41. Jordan RCK, Daniels TE, Greenspan JS, Regezi JA. Advanced diagnostic methods in oral and maxillofacial pathology. Part I: Molecular
methods [Internet]. Vol. 92, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2001. p. 650–69. Available from:
42. Requena RBEBL, Bragado R, Bello E, Requena L. Increased Expression of Vascular Endothelial Growth Factor in Pyogenic Granulomas
[Internet]. Vol. 79, Acta Dermato-Venereologica. 1999. p. 422–5. Available from:
43. Igarashi A, Hayashi N, Nashiro K, Takehara K. Differential expression of connective tissue growth factor gene in cutaneous fibrohistiocytic
and vascular tumors [Internet]. Vol. 25, Journal of Cutaneous Pathology. 1998. p. 143–8. Available from:
44. Hagiwara K, Khaskhely NM, Uezato H, Nonaka S. Mast Cell “Densities” in Vascular Proliferations: A Preliminary Study of Pyogenic
Granuloma, Portwine Stain, Cavernous Hemangioma, Cherry Angioma, Kaposi’s Sarcoma, and Malignant Hemangioendothelioma [Internet]. Vol. 26, The Journal of Dermatology. 1999. p. 577–86. Available from:
45. Soyele OO, Ladeji AM, Adebiyi KE, Adesina OM, Aborisade AO, Olatunji AS, et al. Pattern of distribution of reactive localised hyperplasia of the oral cavity in patients at a tertiary health institution in Nigeria [Internet]. Vol. 19, African Health Sciences. 2019. p. 1687. Available from:
46. S S, Sivaharini S, Herald J. Sherlin, Narayan V. Reactive lesions of the oral cavity - A retrospective study [Internet]. Vol. 11, International Journal of Research in Pharmaceutical Sciences. 2020. p. 809–16. Available from:
47. Reddy V, Saxena S, Saxena S, Reddy M. Reactive hyperplastic lesions of the oral cavity: A ten year observational study on North Indian Population [Internet]. Journal of Clinical and Experimental Dentistry. 2012. p. e136–40. Available from:
48. Association of the Depth of Invasion wth Lymph Node Metastasis in Oral Squamous Cell Carcinoma Patients - A Retrospective Study [Internet]. Indian Journal of Forensic Medicine & Toxicology. 2020. Available from:
49. Sukumaran G, Ramani P, Ramasubramanian A, Karunagaran M, Ravikumar H. Implantation Dermoid Cyst [Internet]. Vol. 8, Journal of
Evolution of Medical and Dental Sciences. 2019. p. 4023–5. Available from:
50. Buchner A, Shnaiderman-Shapiro A, Vered M. Relative frequency of localized reactive hyperplastic lesions of the gingiva: a retrospective
study of 1675 cases from Israel [Internet]. Vol. 39, Journal of Oral Pathology & Medicine. 2010. p. 631–8. Available from:
51. Fan X, Chen D, Bao S, Bai R, Fang F, Dong X, et al. A retrospective cohort study on a pharmaceutical consultation mode of multidisciplinary individualized medication recommendations [Internet]. Available from:
52. Ramu S, Rodrigues C. Reactive Hyperplastic Lesions of the Gingiva: A Retrospective Study of 260 Cases [Internet]. Vol. 3, World Journal of Dentistry. 2012. p. 126–30. Available from: