Abstract
BackgroundChronic erosive gingivitis, also called desquamative gingivitis, defines a clinical picture that can be generated by several inflammatory and immune diseases. Pathology is therefore essential for the differential diagnosis. However, when the gingival lesion is initial, exclusive or predominant, selecting the biopsy site and protocol may be problematic due to tissue fragility. Especially since there are few studies on the subject, the aim of our study was to assess the protocol, diagnostic relevance and tolerance of an original protocol using interdental papilla biopsy.MethodsWe conducted a retrospective bicentric study, from October 2011 to July 2019, including all patients with a chronic erosive gingivitis who had received, for diagnostic purposes, a interdental papilla biopsy.ResultsThe contribution levels for the two hospital departments were 94.7% and 97.1%, respectively. No postoperative complication was recorded in the short or long term.ConclusionThe interdental papilla biopsy protocol is perfectly adapted to the anatomopathological examinations required to establish differential diagnosis of chronic erosive gingivitis. This surgical protocol is simple to perform, non iatrogenic with a very good tolerance and and accessible to all clinicians. It is highly efficient with an excellent contribution level.ClinicalTrials NCT04293718 (March 3, 2020). Health Data Hub N° F20201109083211 (November 9, 2020).
Highlights
Chronic erosive gingivitis, called desquamative gingivitis, defines a clinical picture that can be generated by several inflammatory and immune diseases
One essential for a standard histological examination, and the other for direct immunofluorescence, are recommended in case of atypical, severe, long-standing chronic erosive gingivitis or chronic erosive gingivitis associated with blisters or pseudomembranes
For 47 other patients (47%), only 1 biopsy was performed for histological examination, and for the remaining 5 patients (5%), only 1 biopsy for direct immunofluorescence because histological examination had already been prescribed by the dental clinician or by the referring doctor
Summary
Called desquamative gingivitis, defines a clinical picture that can be generated by several inflammatory and immune diseases. The term of «desquamative gingivitis» is often used to define it This definition is inappropriate because the physiopathological process that leads to this gingival disease does not induce desquamation but a loss of tissue, i.e. erosion, involving all or part of the oral gingival epithelium. Desquamation of the buccal gingival epithelium results in the spontaneous elimination of the keratinized layer which is counterbalanced by cell divisions within the basal lamina, avoiding altering tissue continuity. This type of gingivitis evolves in phases of variable duration.
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