A case of juvenile spongiotic gingivitis

Introduction

Juvenile Spongiotic Gingivitis (JSG) is an uncommon clinicopathologic entity, described for the first time in 2007 (Darling et al.). JSG clinical presentation is characterized by bright red patches, with granular, pebbly or velvety surface, involving attached gingiva. The lesions are generally multifocal, painless and sometimes associated with bleeding during brushing in approximately 20% of cases. JSG is most commonly localized at the maxillary and mandibular labial gingiva, not necessary involving marginal gingiva. Histologically, JSG is characterized by the loss of keratinization, that makes the tissue gingiva similar to junctional epithelium with a decrease of defense against oral pathogens and trauma. The age of affected patients ranges from five to twenty years. No specific treatment is at the moment available.

Case details

We present the case of a 11-year-old female that came to our attention for a gingival lesion. Intraoral clinical examination showed three bright red lesions, slightly detected, of soft consistency, on the vestibular attached gingiva in the area of 11, 12 and 23. The lesions were asymptomatic. During first examination it was decided to follow up the patient and 1% chlorexidine gel was prescribed.

Conclusions

JSG incidence and pathogenesis remain unknown. The lack of response to periodontal treatment and the lack of association with plaque excluded a role of local bacteria in the etiology of this condition. Juvenile Spongiotic Gingivitis treatment is still controversial and the surgical excision showed high recurrence frequency about 25% of cases.