Abstract
This retrospective study aims to investigate the prevalence and the clinicopathological characteristics of oral thrombus (OT) in a Brazilian population. Sociodemographic and clinical data were obtained from biopsy records, and histological sections were reviewed for all cases diagnosed as OT at a referral center for Oral Pathology (1967–2024). The fibrin content of the specimens was evaluated using scores, and the thrombus surface area was determined by morphometric analysis. The data collected were submitted to descriptive analysis, and Mann–Whitney, Kruskal–Wallis, Pearson's chi-square, Fisher's tests, and Spearman's correlation tests were applied ( p ≤ 0.05). OT accounted for 0.16% ( n = 33) of all lesions diagnosed at the center. There was a slight predominance of female patients (51.5%), and the most affected site was the lower lip (33.3%). Clinically, the lesions typically presented as nodules (90.6%), and histopathologically, a balanced mixture of red blood cells and fibrin was predominant (51.5%). In addition, the thrombi area was significantly associated with the histological evolution phase ( p = 0.019) and showed a positive correlation with fibrin concentration ( p = 0.026). Understanding the clinicopathological features of OT is crucial for improving the identification of this rare condition's profile. This understanding enables dental clinicians to make an early and accurate differential diagnosis, implement appropriate management of these lesions, and improve their patients' prognosis.

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