My master Ruth Tramontani always said to us: "Watch from WHAT tissue the lesion came and it will be more simple to diagnose it." So, in oral cavity, we mostly have epitelium and conective tissue... following this line, most of the lesions in oral cavity arise from epitelium or conective tissue (wich includes dense conective tissue lesions, like Fibroma) According to Neville, Regezi, Boraks, and my clinical experience the most common is Fibroma. Thanks for asking, the most simple questions are the more Important!
Dear Alexandre Giannini, Iam very much impressed about your explanation. I truly agree with your master Ruth Tramontani.
Yes I also agree with you that the most simple questions are the more Important, but still their is deviation in opinions among great professors between different benign tumours for the most common one.
In my opinion, Fibroma of the oral cavity is not a true neoplasm. It is a reactive lesion. In a recent article by Naderi et al (2012) on "Reactive lesions of the oral cavity: A retrospective study on 2068 cases" [Dent Res J (Isfahan). 2012 May;9(3):251-5] they have stated that Irritation Fibroma (n=288, 13.93%), is the 4th most common reactive lesion. But they have separated Inflammatory fibrous hyperplasia (n=177, 8.56%). If these two are considered the same lesions but different names, then Irritation Fibroma would be the 2nd most common reactive lesion (22.5%). True (non-ossifying) fibroma is extremely rare. Hemangioma and Lymphangiomas are hamartomas rather than true neoplasms. Papilloma is probably the most common benign oral neoplasm.
Out of those 4 I agree with the fibroma being most common, however I also agree with Dr. Subramanyam - it arises as a reactive hyperplasia and actually if we want to be slightly cheeky, I´d say lipoma is the most common actual tumor from those four presented by Dr. Mohammed because there are many misdiagnosed vascular malformations labeled as "hemangioma" that are not actual monoclonal tumours :)
Dr Gianninis answer is also excellent: in order to diagnose disorders of certain parts of the body we must know what cells are present there - I was told a few weeks ago that upon showing a clinical and a histopathologic picture of an oral dysplasia to a student and asking what can be seen there, the student answered that there is cartilage present in the sample. Now, if this had been true from an oral sample it would almost certainly indicate a sarcoma of some sort since cartilage should not be found in the oral cavity at all and it would need to have come from somewhere else!
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