A multi-center retrospective analysis of oral and maxillofacial lesions in the southernmost region of Thailand
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Abstract
Objectives: This multi-center retrospective study aimed to analyze the demographic distribution, lesion characteristics, and referral patterns of oral and maxillofacial lesions (OMFLs) in Thailand’s three southernmost provinces.
Materials and Methods: Histopathologically confirmed OMFLs diagnosed from 2018-2024 were reviewed using records of four public hospitals representing Thailand’s healthcare system tiers. Lesions were categorized as soft tissue lesions (STLs) or odontogenic and maxillofacial bone tumors (OMBTs), and analyzed by age, sex, anatomical site, and referral level. Statistical analyses included the Mann– Whitney U test and Pearson’s Chi-Square test (p < 0.05).
Results: A total of 512 OMFLs were identified. STLs (53.7%) slightly outnumbered OMBTs (46.3%). Patients with STLs were significantly older than those with OMBTs (median age: 46 [IQR 23-60] vs. 28 [IQR 19-44] years; p < 0.001). The most common STLs were mucosal and soft tissue tumors, particularly irritation fibroma (IF) in the buccal mucosa and pyogenic granuloma (PG) in the gingiva. IF was predominant in patients over 40, while PG mainly affected those under 40. Mucoceles were the most frequent salivary gland lesions in younger patients. Jaw cysts were the most common OMBTs, with radicular cysts more prevalent in the maxilla and dentigerous cysts in the mandible. Ameloblastoma, primarily found in the mandible, was the most frequent odontogenic tumor. Within the four-tier healthcare system of the study area, complex cases tended to escalate to higher tiers. All oral cancer (OC) cases appeared at provincial hospitals (third-tier), as at the regional (highest) level they were diverted to ENT, reflecting interdepartmental separation of case management.
Conclusion: OMFLs in this region show distribution patterns consistent with previous reports. Progressive management trends reflect Thailand’s structured referral system. Lower-tier hospitals can aid OC control through early detection and gatekeeping referral, while bridging interdepartmental gaps may strengthen OC case coordination at the regional level.
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