Operating Microscope in the Analysis of Localized Juvenile Spongiotic Gingival Hyperplasia

The aim of this study was to describe the clinical microscopic features of localized juvenile spongiotic gingival hyperplasia (LJSGH) using an operating microscope (OM), a non-invasive technique rarely applied to oral mucosal lesions. An 18-year-old female presented with asymptomatic gingival redness and bleeding affecting the buccal gingiva of previously orthodontically treated maxillary canines. Conventional clinical examination revealed gingival recession, erythema, and edema. OM evaluation enabled detailed visualization of gingival surface irregularities, superficial vascular spots, exudation, and friable tissue that bled upon touch and probing. An incisional biopsy was performed. Histopathological analysis showed acanthosis, spongiosis, exocytosis, congested capillaries at the epithelium-connective tissue interface, and a dense inflammatory infiltrate in the lamina propria, confirming the diagnosis of LJSGH. In conclusion, OM allowed the identification of vascularity, exudation, surface irregularity, and tissue friability, features not apparent in conventional clinical examination. These findings suggest that OM is a valuable adjunct for evaluating and documenting gingival lesions.