Oral Potentially Malignant Disorders: Current Concepts in Classification, Etiopathogenesis, and Malignant Transformation – A Narrative Review

AbstractBackground: Oral potentially malignant disorders (OPMDs) comprise a heterogeneous group of mucosal abnormalities associated with an increased risk of progression to oral squamous cell carcinoma (OSCC). The evolution of terminology, understanding of etiopathogenesis, and refinement of diagnostic criteria have significantly improved risk stratification and clinical management.Objective: To comprehensively review the historical evolution, classification systems, clinicopathological features, molecular events, and malignant transformation potential of major oral potentially malignant disorders.Materials and Methods: A narrative review was prepared using peer-reviewed literature compiled for a postgraduate library dissertation. Data sources included WHO consensus documents, epidemiological studies, clinicopathological analyses, and molecular investigations related to OPMDs.Results: OPMDs represent a “field cancerization” phenomenon influenced by environmental carcinogens, genetic susceptibility, and immune dysregulation. Leukoplakia, proliferative verrucous leukoplakia, oral submucous fibrosis, and oral lichen planus demonstrate variable malignant transformation rates, influenced by clinical presentation, histological dysplasia, molecular alterations, and patient-related factors.Conclusion: Early identification, standardized classification, and histopathological grading remain the cornerstone for predicting malignant transformation. Integration of molecular biomarkers may enhance future diagnostic precision and individualized management strategies.