A Clinicopathological Study of Marginal Gingival Leukoplakia

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.