Treatment Of Desquamative Gingivitis Research Articles

Clinical effect of equol supplementation in the treatment of desquamative gingivitis with 1-year follow-up.

Desquamative gingivitis (DG) is characterized by desquamative erosion, edematous erythema, and vesicle formation on the gingiva. Because of its prevalence in women during the pre- and postmenopausal period, its potential association with female hormones has been suggested. Equol is a soy isoflavone metabolite with a chemical structure similar to estrogen. Scientific evidence suggests that equol helps in alleviating menopausal symptoms. This study evaluated the clinical effect of a 12-month equol supplementation as a substitute for estrogen to alleviate DG symptoms. The study enrolled 16 women with DG who regularly visited Nihon University School of Dentistry Dental Hospital. Urinary equol levels, periodontal tissue examination, O'Leary's plaque control record, stimulated saliva flow rate, and gingival pain-related questionnaires were evaluated before and after the 12-month daily intake of 10 mg equol supplement. Equol supplementation led to a statistically significant improvement in bleeding on probing, visual findings, and reductions in the frequency and severity of gingival pain. Urinary equol testing and equol supplementation may be novel treatment options for female patients with DG.

Desquamative gingivitis treatment with topical tacrolimus applied to a custom tray: an open trial regarding its efficacy on patients’ symptoms

To evaluate the efficacy of topical tacrolimus offered on a custom tray to treat desquamative gingivitis (DG). Eighteen patients with symptomatic DG related to oral lichen planus (OLP) or mucous membrane pemphigoid (MMP) were selected, of which 13 completed the study. Periodontal treatment was followed by the fabrication of a custom silicone tray to apply a tacrolimus gel formulation (0.1%). Clinical evaluation (complaint of pain and burning - visual analog scale from 0 to 10; and the presence of erythema, desquamation, vesicle/blister, erosion, ulcer, and bleeding) was performed by the same examiner on day 1, and every 15 days for 90 days. Total remission was found in 4 patients (30.76%). Partial remission was found in 69.24% of the patients, classified with an excellent (30.76%), good (30.76%), and regular (7.69%) recovery, respectively. There was a reduction of about 60% in pain and 65% in burning sensation complaints. Wilcoxon test revealed significant differences between pre- and post-treatment pain and burning sensation symptoms (P < .01). Topical application of 0.1% tacrolimus gel was effective in the treatment of DG in controlling pain and burning sensation, leading to the clinical remission of gingival lesions in patients with OLP and MMP.

Complicated clinical variants of mucoperiodontal lesions: desquamative gingivitis

Objective. To study the frequency, clinical and topographic features, risk factors for development, quality of primary diagnosis and treatment of desquamative gingivitis in patients with chronic pathology of the oral mucosa.&#x0D; Materials and methods. A cohort cross-sectional clinical study with elements of sociological analysis of patients (n = 314; 99 males and 215 females aged 18 to 62 years), who visited the medical advisory center for oral mucosal diseases (OMD) was conducted. According to the results of clinical and laboratory studies, the diagnosis of the main oral mucosal disease was formulated, and patients with desquamative gingivitis were isolated into a separate group. Hygienic (OHI-S) and periodontal (PMA, BoP, PBI, CPITN) indices were evaluated, and impact of oral pathology on the patients quality of life using OHIP-49-RU index was assessed for objectification of periodontal status.&#x0D; Results. High (17.8 %) incidence of desquamative gingivitis was found in patients with chronic oral mucosal diseases of predominantly autoimmune origin (lichen planus, pemphigus vulgaris, erythema multiforme, psoriasis). Desquamative gingivitis develops significantly more often (60.7 %) in women and affects the vestibular surfaces of the anterior-upper dentogingival segment, manifests clinically apparent edema, pain, hemorrhagic and sensory-paresthetic symptoms, which limit the functionality of the patient (chewing, speech, oral hygiene, social communication and professional realization), that significantly reduces the key parameters of patients quality of life.&#x0D; Conclusions. The main reasons for chronization of desquamative gingivitis and low effectiveness of its treatment are the following: low level of polyclinic diagnostics, problems of differential diagnosis, the predominant use of irrational, pathogenetically unjustified means and methods of treatment, as well as the lack of interdisciplinary approaches to the planning of complex therapy.

Prevalence and Incidence of Desquamative Gingivitis among Patients Visiting a Private Teaching Hospital in Chennai, India

Desquamative gingivitis (DG) is a term indicating epithelial desquamation, erythema, erosion and/orvesiculobullous lesion of the attached and marginal gingiva. The lesions of DG mainly involve the buccalaspect of the gingiva. The term desquamative gingivitis is not a specific diagnosis , but describe severalmucocutaneous disorders major of which are oral lichen planus (OLP), mucous membrane pemphigoid(MMP), pemphigus vulgaris (PV). The aim of the study was to assess the prevalence and incidence ofdesquamative gingivitis among the patients visiting the outpatient department of periodontics at a privateteaching hospital , Chennai, India. This is a descriptive study which was performed under a universitysetting in which the data of patients who were diagnosed with desquamative gingivitis in the departmentof Periodontics at a private teaching hospital, Chennai from June 2019 to March 2020 was collected byreviewing patients records and the analysis of data of 86000 patients was done. The collected data wascompiled , reviewed, tabulated and imported to SPSS software (version 22.0) for statistical analysis. Theprevalence of desquamative gingivitis was found to be less 0.1% and had a female predilection (67%) andpatients between 50 to 60 years of age were more commonly affected by DG. Most cases of DG presentedwith burning sensation in the mandibular gingiva (50%) . The most common treatment of DG was foundto be pharmacotherapy mainly corticosteroids (50%) . Thus the knowledge of prevalence of desquamativegingivitis and correlation with various parameters is essential in dental practice for clinical implementation.

Desquamative Diseases and Periodontal Health/Treatment

The purpose of the present review is to answer the following focused question: “What are the most relevant findings about the diagnosis and subsequent treatment of desquamative gingivitis (DG)?” Topical corticosteroids in the form of gel should be the first-line medical treatment and may be sufficient for some moderate or mild forms of DG. When patients continue to experience erosions and pain despite topical therapy, treatment with systemic therapy is indicated. A tailored plaque control program is effective in reducing gingival manifestations of DG in terms of related symptoms, plaque index, mucosal disease score, gingival crevicular fluid volume, matrix metalloproteinase (MMP)-1, and MMP-9. The painful symptoms and clinical features in gingiva are improved by non-traumatic oral hygiene procedures, but the underlying causes of DG cannot be eliminated by plaque control alone. Thus, the cooperation with dermatologists/oral pathologists is always required. New technologies for home oral hygiene may improve patients’ quality of life.

A novel formulation of Folic acid gel in the treatment of Desquamative Gingivitis

Abstract not available&#x0D; Bangladesh Journal of Medical Science Vol.19(2) 2020 p.187-188

Diagnosis and treatment of skin diseases manifesting as desquamative gingivitis

Skin diseases manifesting as desquamative gingivitis (DG) can be divided into recurrent DG- and chronic DG-related skin diseases, including oral lichen planus, mucosal pemphigoid, pemphigus vulgaris and so on. A thorough medical history, detailed oral and histopathological examinations and serum immunological tests can be helpful for correct diagnosis of DG-related skin diseases. The treatment of DG-related skin diseases includes topical and systemic therapies. It is necessary to individualize treatment protocols due to treatment response. During the treatment of DG, oral hygiene should be strengthened, secondary fungal and bacterial infections should be avoided, and attention should be paid to the protection of oral cavity and periodontal tissues. Key words: Gingivitis; Lichen planus, oral; Pemphigus; Pemphigoid, benign mucous membrane; Epidermolysis bullosa acquisita

Desquamative gingivitis as a manifestation of chronic mucocutaneous disease

Desquamative gingivitis (DG) is a clinical descriptive term indicating "peeling gums". DG is usually the result of a disease process that causes separation of the epithelium from the underlying connective tissue in the oral masticatory mucosa. DG may be a manifestation of several mucocutaneous diseases, most commonly cicatricial pemphigoid, pemphigus vulgaris and lichen planus. Correct diagnosis of the underlying disease in DG patients requires careful clinical observation, detailed examination of medical history, biopsy and histopathological examination of the lesions as well as more specialized tests such as direct and indirect immunofluorescence. Treatment of DG consists of treating the underlying disease and often requires the use of immunosuppressive agents, such as corticosteroids. Elimination of local gingival irritants, such as dental plaque and calculus, can significantly improve the treatment outcome.

Treatment of desquamative gingivitis with free gingival graft: a case report.

Recalcitrant gingival erythematous lichen planus lesions comprise a considerable therapeutic problem. This case of chronic desquamative gingivitis in a 25-year-old woman with erosive oral lichen planus was treated with topical and systemic corti-costeroid administration, followed by placement of a free gingival graft on right upper quadrant. Although recurrence of the lesions was observed following both treatment modalities, free gingival graft despite being an aggressive therapy, proved more effective and with fewer side effects compared with topical or systemic steroid therapy, and seems to be a promising treatment modality with the benefit of more stable results, among others.

Disease Progression From Mucosal to Mucocutaneous Involvement in a Patient With Desquamative Gingivitis Associated With Pemphigus Vulgaris

Pemphigus vulgaris (PV) frequently begins with oral lesions and progresses to skin lesions. A patient is described who developed skin lesions during follow-up and whose only initial symptom was desquamative gingivitis (DG). A 31-year-old woman presented with a 2-month history of painful gingiva. The diagnosis of PV was made according to clinical, histopathological, and immunofluorescent criteria. Topical corticosteroid (0.1% triamcinolone acetonide) was provided for the treatment of DG. Evaluation of the circulating autoantibody titers to desmoglein (Dsg)1 and Dsg3 was conducted by enzyme-linked immunosorbent assay (ELISA). The gingival PV lesions went into remission with the use of topical corticosteroid, although the patient experienced occasional recurrent oral lesions that required retreatment. She had regular follow-ups and remained relatively stable for several months. However, relapse and worsening of the oral lesions and the onset of skin lesions occurred after 26 months. Using ELISA, a change in the autoantibody profile corresponding to the transition from mucosal PV to mucocutaneous PV was confirmed. In all ELISA studies conducted throughout the course of the patient's disease, the Dsg3 ELISA was consistently high ranging from 150 to 200. However, the Dsg1 ELISA remained low, ranging from 10 to 30. After 26 months, Dsg3 (index value of 150) and Dsg1 (index value of 114) ELISA levels were elevated, consistent with the transition to mucocutaneous PV. In cases in which the lesions are limited to the oral cavity, PV sometimes may be managed successfully using only topical corticosteroids. However, it may not be possible to reduce the circulating Dsg autoantibody titers without systemic immunosuppression. The sustained high Dsg3 antibody level may cause "epitope spreading" and induce skin lesions. It may be prudent to determine post-treatment levels of Dsg using ELISA and, in consultation with the physician, recommend the addition of systemic therapy if Dsg3 levels remain elevated.

Comparison of topical tacrolimus 0.1 % in pectin ointment with clobetasol 0.5% ointment in adults with moderate to severe desquamative gingivitis: A 4-week, randomized, double-blind clinical trial

Background: Desquamative gingivitis (DG) is a clinical condition characterized by red, painful, glazed, and friable gingiva, which might be a manifestation of some autoimmune mucocutaneous diseases. The time from the development of initial signs of DG to diagnosis can vary from months to years. Based on a literature search, no data concerning patients with DG without signs of autoimmune disease were available. Objective: The aim of this trial was to compare the efficacy and tolerability of monotherapy with topical tacrolimus 0.1% in pectin ointment versus clobetasol propionate 0.5% ointment in adults affected by DG. Methods: This randomized, double-blind clinical trial was conducted at the Dipartimento di Medicina Clinica e Sperimentale, Universita di Verona, Verona, Italy. Patients aged ≥18 years were selected using the department's electronic medical records based on a clinical diagnosis of moderate to severe DG. After a 2-week washout period, patients were randomly assigned to receive 2 mL of tacrolimus 0.1% in pectin (equivalent to 0.2 mg of tacrolimus) or 2 mL of clobetasol propionate 0.5% ointment (equivalent to 1 mg of clobetasol) QD for 4 weeks. Evaluations were performed before treatment (baseline), after the treatment period (week 4), and at 2 follow-up visits at weeks 6 and 8. The signs of DG (ie, erythema [atrophy] and desquamation [erosions/ulceration]) were quantified by a blinded investigator using a calculated score based on their surface extension, using a drawing in which the areas of various zones of the mouth were indicated as a percentage of the whole oral mucosa. Severity of erythema and desquamation was rated on a 4-point scale (0 = absent; ' = involvement of <5% of surface [mild]; 2 = 5%-15% [moderate]; and 3 = >15% [severe]). The primary end point was the number of patients who achieved remission (severity score of 0) in either sign; the secondary end point was the proportions of patients achieving improvement (severity score of 0 or 1) in either sign. Before and after treatment, we measured the serum concentrations of tacrolimus and its metabolites with an immunoenzymatic assay kit. Tolerability was assessed using hematology, biochemistry, urinalysis, measurements of systolic/diastolic blood pressure and heart rate, patient interview, and spontaneous reporting. Results: A total of 24 patients (18 women, 6 men; all white of Italian origin; age range, 21–65 years; 12 patients per treatment group) were enrolled in the study. In the tacrolimus group, 11 (91.7%) patients achieved remission of erythema and/or desquamation at weeks 4 and 6; at week 8, these rates were 9 (75.0%) and 8 (66.7%), respectively; none of the patients in the clobetasol group achieved remission of either sign at any time point (all, P < 0.001). At weeks 4, 6, and 8, significantly greater proportions of patients treated with tacrolimus had improved erythema and desquamation compared with those treated with clobetasol (all, P < 0.001). At week 4, all patients had undetectable serum tacrolimus concentrations (<1.5 μg/L). Six (50.0%) patients in the tacrolimus group reported a mild oral burning sensation, and 6 (50.0%) patients in the clobetasol group reported mild mouth dryness. No other adverse events were reported. Conclusions: The results of this small study suggest that topical tacrolimus 0.1 % in pectin was more effective compared with clobetasol propionate 0.5% ointment in the treatment of DG. Both treatments were generally well tolerated in the population studied.

Labial Veneers in the Management of Desquamative Gingivitis: Report of a Case

Desquamative gingivitis is a condition characterized by intense erythema, ulceration, and desquamation of the free and attached gingiva. Approximately 50% of desquamative gingivitis cases occur on the gingival tissues though it is not uncommon at other intraoral and extraoral sites. Though topical corticosteroids are considered the mainstays in the treatment of desquamative gingivitis, the inability of these medicaments to be in contact with the affected sites for longer duration has been implicated as a factor in reducing the efficacy of this mode of treatment. The case presented here is of a 24-year old male with desquamative gingivitis of 3 years duration. Topical corticosteroid therapy using custom-made acrylic veneers was utilized in the patient with remarkable results. This paper highlights the use of acrylic labial veneers over the gingival tissue as a vehicle for delivering medication and as a way to improve aesthetics.

Treatment of desquamative gingivitis: report of case

Technics of cytology were used in the evaluation and treatment of six patients with chronic desquamative gingivitis.

Treatment of desquamative gingivitis: Report of a case

Treatment of desquamative gingivitis: Report of a case

The treatment of desquamative gingivitis

The treatment of desquamative gingivitis