Retrocuspid Papillae

RCP presenting as bilateral sessile papules on the gingiva lingual to the mandibular canines (circles). (from Non-HPV Papillary Lesions of the Oral Mucosa: Clinical and Histopathologic Features of Reactive and Neoplastic Conditions)

RCP are small, sessile, pink papules, with or without a papillary surface, located on the gingiva lingual to the mandibular cuspids. RCP are asymptomatic, often bilateral and measure < 5 mm in diameter (Fig. 5). They have been reported in 11%–99% of children and young adults under 20 years of age. This prevalence decreases to approximately 8% by the 5th decade of life, which supports the idea that RCP represent a normal anatomic structure that regresses with age. Once recognized, no treatment is indicated.

The clinical significance of RCPs is that they may mimic gingival growths, from which they must be distinguished to avoid unnecessary biopsy. Since they are microscopically similar to GCF, the proper diagnosis requires clinico-pathologic correlation.

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