GD569 - Clinicopathologic features and treatment outcomes of marginal gingival (ring around the collar) leukoplakia: a systematic review of emerging evidence-GD569 Article

GD569 Article

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This systematic review examined the clinical features, pathology, and treatment outcomes of marginal gingival leukoplakia, also called “ring around the collar” leukoplakia. The authors analyzed 17 observational studies involving 66 patients; most evidence came from case reports and case series.<br /><br />Patients had a mean age of 60, and 59% were women. Lesions were often homogeneous, and two-thirds involved the gingiva around adjacent teeth. One-third of cases were diagnosed as proliferative verrucous leukoplakia (PVL). Tobacco and alcohol use were uncommon in the reported cases, unlike in conventional oral leukoplakia. Histopathology most often showed hyperkeratosis; mild epithelial dysplasia was reported in 21% of lesions.<br /><br />Scalpel excision was the most common treatment, followed by laser excision. Overall, 45.4% of cases recurred and 24.2% underwent malignant transformation. Recurrence was reported in 44.9% after scalpel excision and 80% after laser excision, but these figures should be interpreted cautiously: studies rarely compared treatments directly, and the evidence was limited.<br /><br />The findings suggest that marginal gingival leukoplakia may share features with PVL, including its typical patient profile and tendency to recur. Lesions can be mistaken for benign frictional keratosis, so diagnosis should incorporate both clinical and microscopic findings. The authors recommend individualized management and careful follow-up. Because the available studies were few, often incomplete, and generally had limited follow-up, stronger prospective research is needed to clarify the condition’s behavior and optimal treatment.

Keywords

marginal gingival leukoplakia

ring around the collar leukoplakia

systematic review

proliferative verrucous leukoplakia

oral leukoplakia

gingival lesions

hyperkeratosis

epithelial dysplasia

recurrence

malignant transformation