The Journal of the American Dental Association
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

J Am Dent Assoc, Vol 138, No 5, 641-651.
© 2007 American Dental Association
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Chi, A. C.
Right arrow Articles by Neville, B. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Chi, A. C.
Right arrow Articles by Neville, B. W.
Related Collections
Right arrow Infection Control

RESEARCH

JADA Continuing Education

Is alveolar ridge keratosis a true leukoplakia?

A clinicopathologic comparison of 2,153 lesions



Angela C. Chi, DMD, Paul R. Lambert III, BS, MBA, Yi Pan, MS, Ruosha Li, BS, Doan-Trang Vo, BS, Erin Edwards, BS, Paul Gangarosa, MPH and Brad W. Neville, DDS

Background. Alveolar ridge keratosis (ARK) is not widely recognized as a distinct clinicopathologic entity, and it often is included in studies of oral leukoplakia (OL), thereby implying premalignant potential. The authors’ objectives were to characterize the clinicopathologic features of ARK and determine whether removing ARK from the OL category would significantly affect the prevalence of dysplasia or carcinoma in OL.

Methods. The authors conducted a retrospective consecutive case review of 477 ARK cases and 1,676 OL cases submitted to their biopsy service from 1995 through 2004. The authors defined ARK as a white plaque without erythema or ulceration and limited to the retromolar pad or edentulous ridge.

Results. Microscopically, most ARK cases (97.9 percent) exhibited hyperkeratosis without dysplasia. The few dysplastic cases (2.1 percent) were associated with one or more of the following: verrucous appearance, tobacco or alcohol use, multiple OL lesions and previous oral squamous cell carcinoma. Excluding ARK from OL increased the percentage of OL cases exhibiting dysplasia or carcinoma from 20.2 percent to 24.8 percent. Including versus excluding ARK resulted in good but less than excellent agreement in the OL case definition ({kappa} = 0.6128).

Conclusions. ARK in patients without high-risk habits or other clinical warning signs appears to be a distinctly different lesion from OL, with a much smaller proportion of dysplasia or carcinoma evident among ARK versus OL cases. However, prospective studies are needed to confirm this hypothesis.

Clinical Implications. Although most cases clinically consistent with ARK are benign hyperkeratoses, dysplasia or carcinoma can be excluded only by means of biopsy and histopathologic examination.

Key Words: Alveolar ridge keratosis; hyperkeratosis; oral dysplasia; oral leukoplakia; oral premalignant lesions

Abbreviations: ARK: Alveolar ridge keratosis • OL: Oral leukoplakia • PVL: Proliferative verrucous leukoplakia






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright©1995-2007 American Dental Association (ADA).
Reproduction or republication strictly prohibited without prior written permission of ADA.