Surgical management of oral leukoplakia with free gingival graft: a case report

Background: Oral Leukoplakia is a potentially malignant disorder of oral mucosa. The etiology is considered multifactorial but smoking is the most frequent factor. A 49-year-old male patient was referred to the department of periodontology for the surgical excision of the leukoplakic lesion on the left lower buccal gingival region. Patient was treated with topical and systemic steroids for the same since last 2 years. On eliciting personal history, the patient had a habit of pan chewing since last 15 years and had quit the habit from 3 years. Intraorally the lesion revealed an irregular whitish plaque on the left lower buccal gingiva, firm in consistency measuring approximately 2.5 cm × 1cm. The lesion had well-defined boundaries. The surface over the lesion appeared to be rough and wrinkled. The lesions were non scrapable and nontender. No bleeding on probing from the site was noticed. Based on patient’s history and clinical features a clinical diagnosis of homogeneous type of oral leukoplakia was made. Excision of the lesion followed by a Free Gingival Graft (FGG) was planned
Treatment: Excision of the leukoplakic lesion was done and the recipient bedfor FGG was prepared. A horizontal incision along with a vertical incision in the region of 35 and 38 were given to separate the lesion from connective tissue. An FGG from the 24 to 27 region of the palate was harvested and adapted onto recipient bed & the donor site was protected by Hawley’s retainer. The graft was secured using resorbable sutures and periodontal dressing. The patient was followed up for a week, 2 weeks and further follow up of the patient is awaited. After two weeks, the color and appearance of the FGG was similar to the adjacent gingiva.
Conclusion: Conventional surgical approach of managing leukoplakia with free gingival graft was successful with uneventful healing.