Gingival Plasma Cell Granuloma: A case Report of Multiple Lesions.

BACKGROUND: Plasma cell granuloma (PCG) is a rare benign pseudotumorous proliferation of unclear etiology that is mainly situated in the lungs. Gingival PCG is an even more peculiar lesion that usually occurs in middle-aged or elderly individuals and clinically manifests as a solitary entity. CASE REPORT: A 15-year-old male with no underlying medical conditions presented with multiple gingival masses in the right maxilla, which were initially thought to be epulis. The lesions were resected completely and the excisional biopsies sent for histological examination. Immunohistochemical (IHC) stain revealed dense polyclonal plasma cell infiltration with positive expression of both kappa and lambda light chains, confirming a diagnosis of gingival PCG. Subsequently, the affected gingiva healed uneventfully, with no sign of recurrence over 2 years of follow-up. CONCLUSIONS: The present report depicts an extremely unusual case of gingival PCG occurring in a juvenile with multiple lesions, which is worth attention in clinical pediatric dentistry. Excisional-biopsy and histological investigations are imperative for a confirmative diagnosis and to exclude potential aggressive conditions. Complete resection of lesions seems to be a valid treatment, while long-term clinical follow-up is still needed.

Causes of Emergency Bleeding after Nonsurgical Periodontal Therapy in Adult Periodontitis Patients: A Retrospective Analysis.

Background: Emergency gingival uncontrollable bleeding after nonsurgical periodontal therapy (NSPT) could be caused by a variety of factors; local oral factors are the main cause of gingival bleeding in most patients. Because the doctor will do a good job of evaluating the patient's physical condition before nonsurgical periodontal therapy. This study is subjected to evaluate the possible factors associated with emergency uncontrollable bleeding within 24-48 hours after NSPT. Material and Methods. A total of fifty-eight patients with emergency bleeding after NSPT in the past four years were enrolled. The related factors in patients, such as age, gender, clotting function, systemic diseases, and baseline periodontitis severity, were analyzed. The site-related factors, such as tooth type, tooth distribution, and alveolar bone resorption at the bleeding site, were compared. The possible relationship of the parameters to the causes of emergency bleeding with NSPT was also evaluated. Results: Gingival bleeding after NSPT was registered. In this retrospective study, a total of 58 patients were selected. There were 29 males and 29 females, aged from 20 to 67 years old, with an average age of 35.21 ± 10.09 years. Among them, 8.6% were over 50 years old, and 91.4% were under 50 years old. Completed evaluations were performed in 15.5% gingivitis and 84.5% periodontitis. The causes of emergency bleeding after nonsurgical periodontal therapy in this study were residual subgingival calculus or granulation tissue in 63.79% of cases: severe gingival inflammation, 29.32%; gum trauma, 3.45%; and poor compliance, 3.45%. The therapy method before bleeding includes supragingival scaling accounted for 72.4% and subgingival scaling accounted for 27.6%. 23 cases of horizontal absorption at the bleeding site accounted for 39.66%, and 35 cases of angular absorption accounted for 60.34%. Bleeding of maxillary posterior teeth accounted for 34.48%; mandibular anterior teeth accounted for 15.52%; mandibular anterior teeth accounted for 8.62%; and mandibular posterior teeth accounted for 18.97%; multiple sites accounted for 22.41%; eliminating residual subgingival calculus and granulation tissue were the main and most effective hemostatic methods, 86.21%. Conclusion: Residual subgingival calculus or granulation tissue and severe gingival inflammation were the main causes of emergency gingival bleeding after nonsurgical periodontal therapy. Severe gingival inflammation causing emergency bleeding was more common in maxillary posterior teeth areas. Angular alveolar bone resorption was more likely to cause bleeding than horizontal resorption. Careful debridement of residual subgingival calculus and granulation tissue was the main hemostatic method.

Short-term microbiological effects of scaling and root planing and essential-oils mouthwash in Chinese adults.

OBJECTIVE: To assess the short-term effect of scaling and root planing (SRP) and essential-oils mouthwash on the levels of specific bacteria in Chinese adults. METHODS: Fifty Chinese adults with chronic periodontitis were randomly assigned to full-mouth SRP or a 7-d essential-oils mouthwash regimen. In addition, 22 periodontally healthy adults used essential-oils mouthwash for 7 d. Clinical examination and plaque/saliva sampling were performed at baseline and on Day 7. Quantitative real-time polymerase chain reaction (PCR) was used to measure Aggregatibacter actinomycetemcomitans (Aa), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), and total bacterial loads in saliva, supra- and sub-gingival plaque samples. RESULTS: The detection frequencies of four tested species remained unchanged after either treatment. However, the bacterial loads of Fn, Pg, and Pi were significantly reduced by SRP; the mean reduction of bacterial counts in saliva ranged from 52.2% to 62.5% (p<0.01), in supragingival plaque from 68.2% to 81.0% (p<0.05), and in subgingival plaque from 67.9% to 93.0% (p<0.01). Total bacterial loads were reduced after SRP in supra- and sub-gingival plaque (p<0.05). Essential-oils mouthwash reduced Fn levels in supragingival plaque by a mean of 53.2%, and reduced total bacterial loads in supra- and sub-gingival plaque (p<0.01). In subgingival plaque from periodontal patients, Pg and Pi reductions were high after SRP compared to essential-oils mouthwash (93.0% vs. 37.7% and 87.0% vs. 21.0%, p<0.05). No significant bacterial reduction was observed in periodontally healthy subjects using essential-oils mouthwash. CONCLUSIONS: SRP and essential-oils mouthwash both have an impact on saliva and gingival plaque flora in Chinese periodontitis patients in 7 d, with greater microbiological improvement by SRP.

[A study of 202 periodontitis subjects in Chengdu].

OBJECTIVE: To study the severity of periodontitis and risk factors in Chengdu. METHODS: 202 periodontitis patients (65 male, 137 female), aged from 25 to 60, were requested to fill a questionnaire. Probing depth (PD), clinical attachment level (CAL), gingival recession and bleeding on probing (BOP) on 6 sites of each tooth were measured and recorded. RESULTS: The mean PD, AL, gingival recession and BOP% of 202 subjects was (3.2 +/- 0.31) mm, (3.5 +/- 0.37) mm, (0.3 +/- 0.02) mm and 21.16%. 59% of subjects missed at least one tooth. 129 subjects suffered with initial to moderate periodontitis. 73 subject suffered with advanced periodontitis. 40, 86, 55 and 21 subjects had received college education, high school education, middle school education and primary school education. 18% of subjects had smoking history, 67% subjects had tea/coffee history, 66% of subjects had psychosocial problem, and only 8% of subjects had received regular periodontal treatment. There is no relationship between the severity of periodontitis and education. CONCLUSION: It is very important to develop an education program on oral healthy for people in Chengdu.