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Background The present study aims to assess the prevalence of diferent types of soft and hard tissue lesions diagnosed through anatomopathological examination, in a sample from the central region of Portugal; to analyze the risk factors associated with these lesions; as well as the prevalence of malignant neoplasms. Materials and methods A search of the anatomopathological records of soft and hard tissue lesions was carried out, between january 2017 and december 2021. The following variables were analyzed: gender, age at the time of biopsy, exposure to risk factors, anatomical location, and the prevalence of malignant neoplasms. All data were anonymized and kept confdential throughout the investigation, being for the exclusive use of the research team. Results 52 biopsies were performed. The most diagnosed pathology was fbroma, followed by epulis. The gender most afected was the female with 59.62% and the mean age of patients was 56.54 years. Smoking habits and the use of ill-ftting dentures were the most common risk factors among the patients. The prevalence of malignant neoplasms was 5.77%, with a higher incidence among females (3.85%) and in the age group between 71-80 years (3.85%). Conclusions The various lesions diagnosed confrm that biopsy followed by anatomopathological examination is a highly relevant procedure, together with clinical examination and a detailed anamnesis, to obtain an accurate and defnitive diagnosis of oral cavity lesions. The study protocol was approved by the Ethics Commission for Health of the Universidade Católica Portuguesa (Comissão de Ética para Saúde da UCP, Report number 169, november 18, 2021).