Spectrum of Reactive and Neoplastic Oral Lesions in Children: A Retrospective Analysis

Abstract

Background: Oral lesions in the pediatric population encompass a wide and heterogeneous spectrum ranging from reactive, inflammatory, and traumatic lesions to benign and malignant neoplasms. Despite their clinical and histopathological diversity, these lesions remain undercharacterized in pediatric cohorts across the Arabian Gulf region, with limited institutional data available to guide clinical decision-making and surveillance strategies.

Objective: To analyze the frequency, distribution, clinicopathological characteristics, and histopathological patterns of reactive and neoplastic oral lesions excised from pediatric patients over a defined retrospective period at a tertiary dental institution in Saudi Arabia.

Methods: A retrospective analysis was performed on biopsy records of pediatric patients aged 0–18 years presenting with oral soft tissue and hard tissue lesions over a 10-year study period. Data including patient age, sex, anatomical site, clinical presentation, and definitive histopathological diagnosis were extracted and categorized into reactive lesions, cysts, benign neoplasms, and malignant neoplasms. Frequencies and proportions were computed and analyzed.

Results: A total of 248 biopsy specimens from pediatric patients were analyzed. Reactive lesions constituted the largest diagnostic category (58.5%), with pyogenic granuloma being the most prevalent entity (22.6%). Cysts accounted for 18.1% of cases, predominantly odontogenic keratocysts and dentigerous cysts. Benign neoplasms comprised 19.8%, while malignant neoplasms were rare, representing 3.6% of all cases. The gingiva and oral mucosa were the most frequently involved sites. Males were slightly more affected than females (ratio 1.3:1).

Conclusion: Reactive lesions dominate the spectrum of pediatric oral biopsies, though neoplastic lesions are not uncommon and require vigilant clinical and histopathological evaluation. Early biopsy and accurate pathological diagnosis are essential for appropriate management and improved outcomes in pediatric patients.