Histopathological diagnosis in geriatric stomatology: a 45-year retrospective study from Brazil

This study analyzed the frequency and distribution of biopsied oral and maxillofacial lesions in a Brazilian geriatric population. Biopsy records of patients aged ≥60 years diagnosed over the last 45 years were retrospectively reviewed. Data on sex, age, anatomical site, and histopathological diagnosis were collected. Absolute and relative frequencies and their associations with clinicopathological variables were evaluated using the chi-square test and the two-proportions Z test. Among 21,367 lesions diagnosed between 1978 and 2023, 2,794 (13.1%) occurred in patients aged ≥60 years, predominantly in the 60-79 age group (90.6%) and in females (54.6%). The most frequent diagnostic categories were reactive lesions (56.6%), neoplasms (25.1%), and cysts/pseudocysts (8.5%). Fibrous hyperplasia (32.9%) and oral squamous cell carcinoma (15%) were the most common individual diagnoses. Females showed higher proportions of reactive lesions, immunological diseases, and bone lesions, with male-to-female ratios of 1:1.7, 1:2.2, and 1:5.7, respectively. The frequency and profile of oral and maxillofacial lesions in older Brazilians are consistent with previous reports. The high burden of inflammatory and neoplastic lesions reflects the cumulative effects of poor oral health and limited healthcare access. These findings highlight the need for strengthened preventive, diagnostic, and long-term oral healthcare strategies, particularly focusing on the aging population.