Localized gingivitis

Abstract: This is a report of a patient with bilateral symmetrical lymphangiomas of the mandibular gingiva which presented clinically as chronic localized gingivitis. The lesions were removed by conventional gingivectomy and have not recurred after 2 years. Both lesions were of the cavernous type and apparently confined to the gingiva. Their distribution indicates them to be developmental anomalies rather than tumors. For this reason it is felt that local excision is adequate even if the mass is incompletely removed. Anomalies should not recur in the same fashion as a tumor.

Abstract: Background and Overview To date, only about 125 cases of juvenile or adult spongiotic gingivitis have been described in the literature, primarily from retrospective biopsy searches. Spongiotic gingivitis is a relatively new, often misdiagnosed, periodontal pathology that was originally attributed only to juveniles. This is the first case report to our knowledge on spongiotic gingivitis diagnosed in a middle-aged adult man and treated with a novel carbon dioxide (CO2) laser low-energy ablation therapy. Case Description A 56-year-old man sought treatment for a localized erythematous lesion on the facial gingiva of the maxillary left central incisor (tooth no. 9). Initial treatment was conventional excisional surgery and biopsy. Diagnosed as spongiotic gingivitis, it reoccurred in the same location within 4 months. It was then treated in 3 sessions using a novel 9,300-nm CO2 laser low-energy ablation set at 0.4 W and 1.25-mm cut width for an irradiance of 33.3 W/cm2 and energy density of 0.21 J/cm2. The lesion was significantly reduced and has shown no hyperplastic reoccurrence to date. Conclusions and Practical Implications This case report brings to dental professionals’ attention that acute spongiotic gingivitis may occur in older adults, not just juveniles. As such, spongiotic gingivitis may be underreported in adults with localized gingivitis, possibly attributed to toothpastes containing sodium laurel sulfate. 9,300-nm CO2 laser therapy may successfully treat lesions such as acute spongiotic gingivitis without the need for anesthesia or additional medications. This report may also encourage further research on treatment modalities, biopsy of lesions resembling this entity, and improved reporting of adult spongiotic gingivitis to better understand this unique gingival pathology.

Abstract: Purpose The purpose of this study was to examine the rate of dental caries and the periodontal status of children and adolescents with cleft lip and palate (CLP) and to compare them with gender- and age-matched control subjects. Methods A total of 156 five- to 18-year-olds, with or without CLP, were examined for dental caries (decayed, missing and filled permanent teeth and primary surfaces [DMFT and dmfs, respectively] indices), plaque index (PI), the gingival bleeding index (BI), clinical attachment level (CAL), and probing pocket depth (PPD). Diagnoses of gingivitis (localized and generalized) and periodontitis (mild, moderate, and advanced) were performed. Characteristics such as gender, age group, cleft type, socioeconomic status, dental occlusion, and the use of orthodontic appliance were analyzed. Results DMFT and dmfs scores were significantly higher in the control group. The PI, BI, and PPD indices were higher in the CLP group. Respectively, in individuals with and without CLP, 49 percent and 75 percent, had good gingival health, 22 percent and 24 percent had localized gingivitis, and 29 percent and one percent had generalized gingivitis. Conclusions The results demonstrate that caries experience in both dentitions was higher for CLP patients, and the presence of CLP is a determining factor for higher risk of gingival inflammation.