From Volume 47, Issue 2, February 2020 | Pages 162-164
Localized juvenile spongiotic gingival hyperplasia is a relatively new histopathological diagnosis, presenting as a localized erythematous lesion of the anterior attached gingivae. Presenting in a peri-pubertal age, this condition is often misdiagnosed as ‘puberty gingivitis’. Here, two cases presenting to the Joint Paediatric-Oral Medicine clinic at the Eastman Dental Hospital are discussed.
Localized Juvenile Spongiotic Gingival Hyperplasia (LJSGH) is a relatively new histopathological diagnosis, being first described in 2007.1 Clinically, LJSGH distinctively presents as erythematous, raised papillary lesions affecting a discrete area of attached gingiva which, importantly for diagnostic purposes, is often independent of the unaffected adjacent marginal gingiva. These lesions are most commonly noted on the labial aspect of the anterior maxilla, as seen in approximately 81% of cases, however, anterior mandibular involvement has also been reported.2
Macroscopically, these exophytic lesions have a granular or ‘pebble-like’ appearance, and are often painless. Bleeding on brushing is the only reported symptom in approximately 20% of cases. Consequently, delayed clinical presentation is often a feature of this condition. LJSGH presents in a peri-pubescent age group, with a female predominance reported.3 Given this presentation, LJSGH is often erroneously diagnosed as ‘puberty gingivitis’. It is refractory to mechanical periodontal treatment, which differentiates it from other gingival conditions.4 Microscopically, the presence of acanthotic stratified squamous epithelium, with intercellular oedema and epithelial infiltration of inflammatory cells, namely neutrophils, is diagnostic. There is also marked differentiation from peri-lesional normal mucosa.5
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