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Ligneous gingivitis: A case report

Year 2013, Volume: 19 Issue: 2, 128 - 130, 01.03.2013

Abstract

Ligneous gingivitis, also known as destructive membranous periodontal disease is a rare periodontal condition. While first case was published by Frimodt-Moller at 1973, ligneous conjunctivitis was first described in 1847 by Bouisson. It is characterized by nodular gingival enlargement with ulcerations. Usually conjunctival and gingival lesions were observed together and have same histopathological changes. A 32 month-old female patient with ligneous conjunctivitis, was referred to Gaziantep University, Faculty of Dentistry, Department of Periodontology clinic with the diagnosis of spread gingival enlargement at the mandible and maxilla. These gingival enlargements were painless, hyperemic, nodular, and woody-like and covered by pseudo membrane. Radiographic evaluation showed normal alveolar bone and no attachment loss. Hematological analyses showed an increase in white blood cells, and increase in lymphocytes but decrease in neutrophils. As far as we know this is the youngest case reporting ligneous gingivitis after Frimodt-Mollers' case. Although most of the case reports focused on histopathological change and level of plasminogen in these patients, up to now exact information about pathogenesis of ligneous gingivitis and conjunctivitis is not available in the literature. Question of the researchers about how to manage and effectively treat this disease remains unclear.

References

  • 1. Gunhan O, Avci A, Dereci O, Akgun S, Celasun B. Extensive fibrin accumulation and accompanying epithelial changes in the pathogenesis of ligneous mucosal disease (ligneous periodontitis). Am J Dermatopathol 2012;34(1):35-40.
  • 2. Schuster V, Seregard S. Ligneous conjunctivitis. Surv Ophthalmol 2003;48(4):369-88.
  • 3. Tefs K, Gueorguieva M, Klammt J, Allen CM, Aktas D, Anlar FY, et al. Molecular and clinical spectrum of type I plasminogen deficiency: a series of 50 patients. Blood 2006;108(9):3021-6.
  • 4. Tefs K, Georgieva M, Seregard S, Tait CR, Luchtman-Jones L, Ziegler M, et al. Characterization of plasminogen variants in healthy subjects and plasminogen mutants in patients with inherited plasminogen deficiency by isoelectric focusing gel electrophoresis. Thromb Haemost 2004;92(2):352-7.
  • 5. Schuster V, Seidenspinner S, Zeitler P, Escher C, Pleyer U, Bernauer W, et al. Compound-heterozygous mutations in the plasminogen gene predispose to the development of ligneous conjunctivitis. Blood 1999;93(10):3457-66.
  • 6. Colucci M, D'Aprile AM, Italia A, Gresele P, Morser J, Semeraro N. Thrombin activatable fibrinolysis inhibitor (TAFI) does not inhibit in vitro thrombolysis by pharmacological concentrations of t-PA. Thromb Haemost 2001;85(4):661-6.
  • 7. Frimodt-Moller J. Conjunctivitis ligneosa combined with a dental affection. Report of a case. Acta Ophthalmol (Copenh) 1973;51(1):34-8.
  • 8. Sivolella S, De Biagi M, Sartori MT, Berengo M, Bressan E. Destructive membranous periodontal disease (ligneous gingivitis): a literature review. J Periodontol 2012;83(4):465-76.
  • 9. Chi AC, Prichard E, Richardson MS, Rasenberger KP, Weathers DR, Neville BW. Pseudomembranous disease (ligneous inflammation) of the female genital tract, peritoneum, gingiva, and paranasal sinuses associated with plasminogen deficiency. Ann Diagn Pathol 2009;13(2):132-9.
  • 10. Gunhan O, Gunhan M, Berker E, Gurgan CA, Yildirim H. Destructive membranous periodontal disease (ligneous periodontitis). J Periodontol 1999;70(8):919-25.
  • 11. Kurtulus I, Kazmi B, Lewis MP, Solakoglu S, Schuster V, Scully C, et al. Altered functional activity patterns of fibroblasts related to periodontitis by systemic plasminogen deficiency (ligneous periodontitis). Quintessence Int 2011;42(7):601-9.
  • 12. Baltacioglu E, Akalin FA, Topaloglu E, Sukuroglu E, Cobanoglu U. Ligneous periodontitis and gingival antioxidant status: report of two cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104(6):803-8.
  • 13. Baykul T, Bozkurt Y. Destructive membranous periodontal disease (ligneous periodontitis): a case report and 3 years follow-up. Br Dent J 2004;197(8):467-8.

Lignöz gingivitis: Olgu sunumu

Year 2013, Volume: 19 Issue: 2, 128 - 130, 01.03.2013

Abstract

Lignöz gingivitis, çok nadir görülen ve destrüktif membranöz hastalık diye de adlandırılan bir periodontal durumdur. Lignöz gingivitis 1973 yılında Frimodt-Moller tarafından tanımlanmasına rağmen, lignöz konjüktivitin tanımlanması daha eskidir. Lignöz konjuktivit 1847 yılında Bouisson tarafından tanımlanmıştır. Lignöz gingivitis ülserasyonlu gingival büyümeler ile karakterizedir. Genellikle konjüktival lezyonlar ile gingival lezyonlar bir arada gözlenir ve aynı histopatolojik değişime sahiptir. 32 aylık, maksilla ve mandibulasında dişeti büyümeleri olan hasta velileri tarafından ağrı şikâyeti ile Gaziantep Üniversitesi Diş Hekimliği Fakültesi, Periodontoloji Anabilim Dalı'na muayene için getirildi. Gingival büyümeler ağrılı, hiperemik, nodüler, tahtamsı sertlikte ve üzeri pseudomembran ile kaplı idi. Maksiller ve mandibular dişlerde radyografik olarak; ataçman kaybı gözlenmezken, alveolar kemik seviyesi normal idi. Hematolojik analizinde ise artmış beyaz kan hücresi ve lenfosit gözlenirken, nötrofil sayısında dramatik bir düşüş mevcuttu. Bu olgu Frimodt-Mollers'den bu yana gözlemlenen en genç ikinci lignözgingivitis vakası olma özelliğini taşımaktadır. Birçok vaka raporunda, histopatolojik değişimlere ve plazminojen seviyesine odaklanılmasına rağmen, lignöz gingivitis ve konjüktivitisin patolojisi tam olarak aydınlatılamamıştır ve klinisyenlerin en çok zorlandıkları/zorlanacakları konu ise şimdiye kadar yapılan tedavilerin etkinliği nasıl arttırılacağı yönündedir.

References

  • 1. Gunhan O, Avci A, Dereci O, Akgun S, Celasun B. Extensive fibrin accumulation and accompanying epithelial changes in the pathogenesis of ligneous mucosal disease (ligneous periodontitis). Am J Dermatopathol 2012;34(1):35-40.
  • 2. Schuster V, Seregard S. Ligneous conjunctivitis. Surv Ophthalmol 2003;48(4):369-88.
  • 3. Tefs K, Gueorguieva M, Klammt J, Allen CM, Aktas D, Anlar FY, et al. Molecular and clinical spectrum of type I plasminogen deficiency: a series of 50 patients. Blood 2006;108(9):3021-6.
  • 4. Tefs K, Georgieva M, Seregard S, Tait CR, Luchtman-Jones L, Ziegler M, et al. Characterization of plasminogen variants in healthy subjects and plasminogen mutants in patients with inherited plasminogen deficiency by isoelectric focusing gel electrophoresis. Thromb Haemost 2004;92(2):352-7.
  • 5. Schuster V, Seidenspinner S, Zeitler P, Escher C, Pleyer U, Bernauer W, et al. Compound-heterozygous mutations in the plasminogen gene predispose to the development of ligneous conjunctivitis. Blood 1999;93(10):3457-66.
  • 6. Colucci M, D'Aprile AM, Italia A, Gresele P, Morser J, Semeraro N. Thrombin activatable fibrinolysis inhibitor (TAFI) does not inhibit in vitro thrombolysis by pharmacological concentrations of t-PA. Thromb Haemost 2001;85(4):661-6.
  • 7. Frimodt-Moller J. Conjunctivitis ligneosa combined with a dental affection. Report of a case. Acta Ophthalmol (Copenh) 1973;51(1):34-8.
  • 8. Sivolella S, De Biagi M, Sartori MT, Berengo M, Bressan E. Destructive membranous periodontal disease (ligneous gingivitis): a literature review. J Periodontol 2012;83(4):465-76.
  • 9. Chi AC, Prichard E, Richardson MS, Rasenberger KP, Weathers DR, Neville BW. Pseudomembranous disease (ligneous inflammation) of the female genital tract, peritoneum, gingiva, and paranasal sinuses associated with plasminogen deficiency. Ann Diagn Pathol 2009;13(2):132-9.
  • 10. Gunhan O, Gunhan M, Berker E, Gurgan CA, Yildirim H. Destructive membranous periodontal disease (ligneous periodontitis). J Periodontol 1999;70(8):919-25.
  • 11. Kurtulus I, Kazmi B, Lewis MP, Solakoglu S, Schuster V, Scully C, et al. Altered functional activity patterns of fibroblasts related to periodontitis by systemic plasminogen deficiency (ligneous periodontitis). Quintessence Int 2011;42(7):601-9.
  • 12. Baltacioglu E, Akalin FA, Topaloglu E, Sukuroglu E, Cobanoglu U. Ligneous periodontitis and gingival antioxidant status: report of two cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104(6):803-8.
  • 13. Baykul T, Bozkurt Y. Destructive membranous periodontal disease (ligneous periodontitis): a case report and 3 years follow-up. Br Dent J 2004;197(8):467-8.
There are 13 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Hasan Gündoğar This is me

Kemal Üstün This is me

Ufuk Sezer This is me

Kamile Erciyas This is me

Publication Date March 1, 2013
Published in Issue Year 2013 Volume: 19 Issue: 2

Cite

APA Gündoğar, H., Üstün, K., Sezer, U., Erciyas, K. (2013). Lignöz gingivitis: Olgu sunumu. Gaziantep Medical Journal, 19(2), 128-130.
AMA Gündoğar H, Üstün K, Sezer U, Erciyas K. Lignöz gingivitis: Olgu sunumu. Gaziantep Medical Journal. March 2013;19(2):128-130.
Chicago Gündoğar, Hasan, Kemal Üstün, Ufuk Sezer, and Kamile Erciyas. “Lignöz Gingivitis: Olgu Sunumu”. Gaziantep Medical Journal 19, no. 2 (March 2013): 128-30.
EndNote Gündoğar H, Üstün K, Sezer U, Erciyas K (March 1, 2013) Lignöz gingivitis: Olgu sunumu. Gaziantep Medical Journal 19 2 128–130.
IEEE H. Gündoğar, K. Üstün, U. Sezer, and K. Erciyas, “Lignöz gingivitis: Olgu sunumu”, Gaziantep Medical Journal, vol. 19, no. 2, pp. 128–130, 2013.
ISNAD Gündoğar, Hasan et al. “Lignöz Gingivitis: Olgu Sunumu”. Gaziantep Medical Journal 19/2 (March 2013), 128-130.
JAMA Gündoğar H, Üstün K, Sezer U, Erciyas K. Lignöz gingivitis: Olgu sunumu. Gaziantep Medical Journal. 2013;19:128–130.
MLA Gündoğar, Hasan et al. “Lignöz Gingivitis: Olgu Sunumu”. Gaziantep Medical Journal, vol. 19, no. 2, 2013, pp. 128-30.
Vancouver Gündoğar H, Üstün K, Sezer U, Erciyas K. Lignöz gingivitis: Olgu sunumu. Gaziantep Medical Journal. 2013;19(2):128-30.