Non-plaque related periodontal lesions. An overview of some common and uncommon lesions

An overview is presented of some common and uncommon non-plaque-related lesions and conditions of the periodontal tissues. Erosive lesions of the gingiva, such as lichen planus, may clinically be misdiagnosed as being the result of inflammation. Likewise, local and generalized gingival swelling may be based on non-plaque-related lesions and conditions. True leukoplakia of the gingiva is rare, but should be looked upon with suspicion. The reasons for pigmentation of the gingiva are many-fold. Especially in the maxilla, the clinician should be alert for an early malignant melanoma. A large variety of lesions may affect the periodontal bone structures, ranging from the common periapical granuloma to the rare, sometimes sclerosing, osteosarcoma. Irregular widening of the periodontal ligament and loss of the lamina dura are ominous radiographic signs.