Linea alba is a common alteration of the buccal mucosa that
is most likely associated with pressure, frictional irritation, or sucking
trauma from the facial surfaces of the teeth. In one study of 256 young men,
the alteration was present in 13%. No other associated problem, such as
insufficient horizontal overlap or rough restorations of the teeth, is
necessary for the development of linea alba.
Clinical Features
As the name implies, the alteration consists of a white line
that is usually bilateral. It may be scalloped and is located on the buccal mucosa
at the level of the occlusal plane of the adjacent teeth (figure 1-1). The line
varies in prominence and is usually restricted to edentulous areas. It often is
more pronounced adjacent to the posterior teeth.
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Figure 1-1 Linea Alba on both Buccal Mucosa
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Histopathologic Features
Biopsy is rarely indicated. If a biopsy is performed,
hyperorthokeratosis is seen overlying otherwise normal oral mucosa. On
occasion, intracellular edema of the underlying connective tissue may be noted.
Treatment and Prognosis
No treatment is required for patients with linea alba, and
no difficulties are documented as a result of its development. Spontaneous
regression may occur.