Localized Juvenile Spongiotic Gingival Inflammation: A Report on 3 Cases

A new pathological entity with distinct clinicopathological features has been recently described and termed as juvenile spongiotic gingivitis. Histopathological associated features are unique and characterized by prominent intercellular edema (spongiosis) and neutrophil infiltrate. The aims of this paper were to: introduce juvenile spongiotic gingivitis to the dental and pediatric communities, to report three cases based on clinical and histopathological findings, and to discuss the most common clinical differential diagnoses. The cases were documented at baseline and follow-ups. The clinical appearance of the lesions described in this paper correspond to the pattern described by the literature: 1) localized lesions as bright red slightly raised overgrowths, most often with a subtle papillary or finely granular surface; or 2) multifocal masses or raised papular lesions with a pebbly texture. The first intention treatment approach was personal and professional plaque control. Because of the lack of a good clinical response to conventional therapy, excisional biopsies were performed, which helped establish the diagnosis. The plaque control was reinforced and additional antiseptic local treatment was administered. A real improvement in the local gingival conditions was recorded for all the patients. However, because of the persistence of some bright reddish gingival masses in one of the patients these lesions were treated by surgical excision. The overall clinical outcome was good and stable after one year.

The presented cases might raise awareness of this condition among orthodontic specialists because orthodontic treatment could not be applied until the gingival gum disease was resolved.