牙龈粘膜交界处海绵状增生的独特表现

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology Pub Date : 2025-04-16 DOI:10.1016/j.ajoms.2025.04.008

Karanbir Sidhu , Kale Wudrich , Matheus de Castro Costa , Amanda Gruza , Marina Lara de Carli , Felipe Fornias Sperandio

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引用次数: 0

摘要

海绵状牙龈增生症（SGH），以前被称为局限性青少年海绵状牙龈增生症（LJSGH），由于其在所有年龄段的患者中表现出来，一直是命名争议的主题。SGH的特征是红斑，轻微凸起的斑块或结节，通常局限于边缘牙龈。本病例报告提出了粘膜牙龈交界处海绵状增生症（SHMJ）的独特临床表现，进一步阐明了SGH的临床变异性，特别关注其鉴别诊断和治疗，随后进行长期临床监测。病例报告：一名67岁女性，在21号和22号牙齿之间的粘膜交界处出现无症状的红斑斑块。临床及影像学检查未见牙周或牙髓感染/坏死征象。病变的切除活检显示明显的海绵状病变和弥漫性ck19阳性粘膜上皮的胞吐。组织学表现与海绵状增生一致。在9个月的随访中，病变完全愈合，无复发。结论：该病例是SHMJ的一个特殊病例，强调了提高临床对SGH非典型表现认识的必要性。手术切除仍然是治疗的选择，因为保守的牙周治疗是无效的。组织学和免疫组织化学分析有助于明确诊断；长期随访是排除复发的必要条件。

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A unique presentation of spongiotic hyperplasia at the mucogingival junction

Introduction

Spongiotic Gingival Hyperplasia (SGH), previously known as Localized Juvenile Spongiotic Gingival Hyperplasia (LJSGH), has been a subject of nomenclature debate due to its presentation in patients of all ages. SGH is characterized by erythematous, slightly raised plaques or nodules, often localized in the marginal gingiva. This case report presents a unique clinical presentation of Spongiotic Hyperplasia of the Mucogingival Junction (SHMJ), further elucidating SGH's clinical variability, with a particular focus on its differential diagnosis and management, followed by long-term clinical monitoring.

Case Report

A 67-year-old female presented with an asymptomatic, erythematous patch at the mucogingival junction between teeth #21 and #22. Clinical and radiographic examination revealed no signs of periodontal or pulpal infection/necrosis. An excisional biopsy of the lesion revealed marked spongiosis and exocytosis of a diffusely CK19-positive overlying mucosal epithelium. Histological findings were consistent with spongiotic hyperplasia. The lesion showed complete healing at a 9-month follow-up without recurrence.

Conclusion

This case represents a peculiar instance of SHMJ, highlighting the need for heightened clinical awareness of SGH’s atypical presentations. Surgical excision remains the treatment of choice, as conservative periodontal treatments are ineffective. Histological and immunohistochemical analysis aid in definitive diagnosis; long-term follow-up is essential to exclude recurrence.

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