Conservative Treatment of Localized Juvenile Spongiotic Gingival Hyperplasia

Abstract

Introduction: Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a recently described uncommon and distinctive form of inflammatory hyperplasia. Treatment of this condition has varied from surgical excision to no treatment followed by spontaneous remission. This case report demonstrates successful management of the lesion using a conservative treatment approach. Case Presentation: A 14‐year‐old male with negative medical and dental histories presented with LJSGH. The vivid red lesions involved the papillary and marginal gingiva of all maxillary anterior teeth. Initially, the lesion developed as a single red patch‐like area involving the maxillary left cuspid. Subsequently, the lesion displayed a linear pattern of spread to involve successively more teeth in the anterior sextant. Biopsy revealed hyperplastic elongated epithelial rete pegs, atrophy of the overlying stratified squamous epithelium with mild spongiosis, neutrophilic exocytosis, and a highly vascular connective tissue with a dominant infiltrate of chronic inflammatory cells. The lesion responded to treatment consisting of a mild surface cauterization followed by topical application of a 0.05% clobetasol ointment four times per day for a period of 4 weeks. Conclusion: This case report demonstrates that LJSGH can be successfully managed by conservative therapy, thereby avoiding potential gingival margin defects that may result from a surgical ablation of the lesion.