Plasma Cell Gingivitis-two Case Reports

Plasma cell gingivitis, also known as plasma cell granuloma, plasmacell gingivostomatitis is a gingivitis hyperplasia. Happen in the mucousmembrane,distinguish it from other diseases by pathological examination.Since it was reported, there was little report about the disease in the world,the etiology is still unknown. In this paper, our hospital collected2clinical patients, and follow for3years.By reading the literature and theclinical manifestations, diagnostic criteria, antidiastole, treatment andetiology of the disease to analyze and summarize this disease.Plasma cell gingivitis is a inflammatory response. The exactlyreason of this disease is unknown, some scholars through stained lungtissue pathology plasma cell granuloma IgG4-positive plasma cellinfiltration can be observed under the microscope, so IgG4-relatedimmune pathological processes may be involved in mucosal lesionsplasma cells pathogenesis.IgG4-related disease caused.Genetic factors: human leukocyteantigen (HLA) a DRBI*0405and DQBl*0401, DQBl sequence of57points to heaven aspartate; bacterial infection: Helicobacter pyloriHelicobacter pylori α-carbonic anhydrase, Cox is Bumiti bacteria,Pseudomonas Gram-negative anaerobic bacteria Psittici possible bymolecular simulations of these bacterial components will cause thepatient’s own antibodies; autoimmunity: probably some unknownstimulus (such as chewing gum, herbal toothpaste and khat, etc.) causedthe immune response, allergic reaction.Plasma cell gingivitis mainly as follows: gum get red, swollen, softfriable, gums bleeding and occasionally accompanied by hyperplasia.Happened in a single one tooth or multiple teeth gums. Plasma cell hyperplasia can occur in the mucous membranes, genitals, and otheraerodigestive tract. Mainly occurs in the gums in the gingival margin, butalso up to attached gingiva, can also cause bone resorption. Pathologicaldiagnosis to prevail follows: epithelial parakeratosis, dense infiltration ofplasma cells clustered lesions, invasion was a large flake or lobulate.Systemic diseases (such as leukemia, HIV infection, discoid lupuserythematosus), Plasma cells epulis, disease of grow in quantity oflangerhans cells, puberty gingivitis, etc. is similarly with plasma cellgingivitis which happen in the gums, peripheral blood should be examedto differential diagnosis.Because the etiology is still unknown, the treatment is notsatisfactory else. Current clinical treatment is just to relieve symptomsand eliminate the damage. Plasma cell gingivitis management involvesperiodontal foundation treatment and periodontal surgery methods.Case1Patient, Mrs Wang, female,48years old.Due to "gum swelling a month" coming to our department fortreatment.2years ago the patient found gum red and swelling, treated inother the hospital forment, a month ago the swelling of the gumsrecurrence,then come to our hospital. The patient denied related diseasehistory. Specialist examination: oral hygiene is poor, there is debris,calculus Ⅰ°. Extensive swelling of the gums, dark, stippling addicted todisappear, gingival papilla blunt，BOP (+), PD:6-7mm, Al:2mm. Nosignificant loosening teeth. X-ray: Horizontal alveolar bone absorption.Take biopsy sent for pathological examination under a microscope to see:dense infiltration of plasma cells into a sheet gathered in the connectivetissue. Diagnosis: Plasma cell gingivitis. Treatment: Periodontal therapycombined with periodontal surgery. Periodontal therapy: After one month the gingival inflammation has been reduced, The attached gingiva werestill swelling. Periodontal surgery: with gums3surgery in2years. Now ayear after the third surgery, gum looks good,no recurrence.Case2Patient,Mrs Zhao,female,62years old.Due to "gum swelling six months" to our hospital. Patient use herbaltoothpaste two years ago, then found that the proliferation of gingivalswelling, six months ago exacerbation, come to our hospital. The patientwith coronary heart disease. Oral examination: mouth oral hygiene ispoor, debris, calculus Ⅱ°. Extensive swelling of the gums, texture brittle,gingival papilla blunt. BOP (+), PD:4-6mm, Al:5-7mm.11，13Looseteeth shift. Pathological examination: normal form dense infiltration ofplasma cells in the connective tissue. Diagnosis: Plasma cell gingivitis.Treatment: periodontal foundation treatment. Half year later the patientcouple back reduce swollen gums.