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.
Key Words
Abbreviation Key:
ASG (Acute spongiotic gingivitis), CO2 (Carbon dioxide), LEAT (Low-energy ablation therapy), OLP (Oral lichen planus), SLS (Sodium laurel sulfate)
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References
Juvenile spongiotic gingivitis.
J Periodontol. 2007; 78: 1235-1240
Localized juvenile spongiotic gingival hyperplasia.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106: 411-418
Localized juvenile spongiotic gingival hyperplasia: a report of 3 cases.
Pediatr Dent. 2013; 35: 360-363
Spongiotic gingival hyperplasia synchronously involving multiple sites: case report and review of the literature.
Head Neck Pathol. 2018; 12: 517-521
Juvenile spongiotic gingivitis associated with idiopathic gingival papillokeratosis with crypt formation.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2019; 129: e35-e36
Localized juvenile spongiotic gingival inflammation: a report on 3 cases.
Clujul Med. 2014; 87: 198-202
Localized juvenile spongiotic gingival hyperplasia: a report of 27 cases.
J Cutan Pathol. 2019; 46: 839-843
Reappraising localized juvenile spongiotic gingival hyperplasia.
JADA. 2019; 150: 147-153
Localized spongiotic gingival hyperplasia in adults.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 114: e63-e64
Localized juvenile spongiotic gingivitis: literature review.
Rev Mex Periodontol. 2019; 10: 13-17
Multifocal localized juvenile spongiotic gingival hyperplasia treated with combined laser and topical corticosteroid therapy.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2017; 124: e219
Conservative management of juvenile spongiotic gingivitis: a series of ten cases.
Br Dent J. 2020; 229: 287-291
Conservative treatment of localized juvenile spongiotic gingival hyperplasia.
Clinical Advances Perio. 2011; 1: 199-204
A conservative approach for localized spongiotic gingivitis hyperplasia using photodynamic therapy: a case report and review of the literature.
Photobiomodul Photomed Laser Surg. 2019; 37: 57-61
Localized juvenile spongiotic gingival hyperplasia possibly originates from the junctional gingival epithelium: an immunohistochemical study.
Histopathology. 2016; 68: 549-555
Cryotherapy for localized juvenile spongiotic gingival hyperplasia: preliminary findings on two cases.
Int J Paediatr Dent. 2017; 27: 231-235
A clinical investigation of the management of oral lichen planus with CO2 laser surgery.
J Clin Laser Med Surg. 1992; 10: 445-449
The 9300 CO2 dental laser: Technical development and early clinical experiences.
J Laser Dent. 2014; 22
Schuster G, Roberts E. The clinical impact of 9300nm CO2 laser low energy ablation therapy on oral lichen planus: a case report. J Laser Dent. Forthcoming.
A randomised clinical study comparing the effect of Steareth 30 and SLS containing toothpastes on oral epithelial integrity (desquamation).
J Dent. 2019; 80: S33-S39
Different CO2 laser vaporization protocols for the therapy of oral precancerous lesions and precancerous conditions: a 10-year follow-up.
Lasers Med Sci. 2012; 27: 59-63
Biography
Dr. Schuster is an associate professor and the director of Clinical Faculty, College of Dental Medicine, Midwestern University, Glendale, AZ.
Biography
Dr. Roberts is an associate clinical professor, College of Dental Medicine, Midwestern University, Glendale, AZ.
Biography
Dr. Haub is an assistant clinical professor, College of Dental Medicine, Midwestern University, Glendale, AZ.
Article Info
Publication History
Published online: August 14, 2021
Publication stage
In Press Corrected Proof
Footnotes
Disclosures. None of the authors reported any disclosures.
Identification
DOI: https://doi.org/10.1016/j.adaj.2021.05.019
Copyright
© 2021 American Dental Association. All rights reserved.
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