Generalized Aggressive Periodontitis Associated With a Plasma Cell Gingivitis Lesion: A Case Report and Non‐Surgical Treatment

Abstract

Introduction: Plasma cell gingivitis (PCG) is an unusual inflammatory condition characterized by dense, band-like polyclonal plasmacytic infiltration of the lamina propria. Clinically, it appears as gingival enlargement with erythema and swelling of the attached and free gingiva and is not associated with any loss of attachment. The aim of this report is to present a rare case of severe generalized aggressive periodontitis (GAgP) associated with a PCG lesion that was successfully treated and maintained non-surgically.Case Presentation: A 32-year-old white male with a non-contributory medical history presented with gingival enlargement with diffuse erythema and edematous swelling, predominantly around teeth #5 through #8. Clinical and radiographic examination revealed generalized severe periodontal breakdown. A complete blood count and biochemical tests were within normal limits. Histologic and immunohistochemical examination were consistent with PCG. A diagnosis of severe GAgP associated with a PCG lesion was assigned. Treatment included elimination of possible allergens and nonsurgical periodontal treatment in combination with azithromycin. Clinical examination at reevaluation revealed complete resolution of gingival enlargement, erythema, and edema and localized residual probing depths of 5 mm. One year after treatment, the clinical condition was stable. Radiographs indicated improved bone levels and formation of crestal lamina dura.Conclusion: This case report highlights the unusual coexistence of GAgP and PCG, in which non-surgical treatment with elimination of all possible causes in combination with antimicrobials resulted in elimination of the gingival enlargement and significant improvement of periodontal parameters. Clin Adv Periodontics 2015;5:91-98.

Plasma Cell Gingivitis Treated with Photobiomodulation, with No Recurrence for a Five-Year Follow-Up

“…Only in some patients is it possible to recognize a specific irritant cause that could favor the disease, with consequent remission of the disease after removal [1,2,4,6,7]. The role that bacterial plaque plays in the etiology of the disease is not Although the lesions often appear in anatomical areas compatible with plaque-induced gingivitis, patients generally do not have significant indices of periodontal inflammation, but a general condition of periodontitis is associated [1,2,4,12].…”

“…The role that bacterial plaque plays in the etiology of the disease is not clear. Although the lesions often appear in anatomical areas compatible with plaque-induced gingivitis, patients generally do not have significant indices of periodontal inflammation, but a general condition of periodontitis is associated [ 1 , 2 , 4 , 12 ].…”

“…The pharmacological treatment is usually symptom-related, based on local and systemic corticosteroids, immunomodulators, antibiotics, and plaque-control local mouthwashes that represent the most frequent choice as first-line therapy, to delete local irritants and to reduce immunological cell-mediated and cytokine-mediate response, preventing recurrence [ 1 , 2 , 12 ]. Gum improvements are always related to oral hygiene levels.…”