Lauren, Shanae and Monica

NON - PLAQUE-INDUCED GINGIVAL LESIONS
  • Gingival diseases of fungal origin – are relatively uncommon in healthy individuals but occur more frequently in immunocompromised individuals and those with normal oral flora disturbed by the long term use of broad spectrum antibiotics.
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  • Candida species infections: generalized gingival candidiasis- There are four types of gingival candidiasis that consist of pseudomembranous, erythematous, hyperplastic candidiasis and angular cheilitis.
    • What this type of gingival disease would look like clinically?
      • Pseudomembranous also known as Thrush is painless yellow white curdlike lesion that can be wiped off. Most commonly seen on the hard and soft palate, the buccal and labial mucosa and may occur in the oral mucosa.
      • Erythematous- Painful and appears red patches on the buccal or palate and depapillation of the tongue.
      • Hyperplastic candidiasis is the least common appears as a white lesion that does not wipe off
      • Angular Cheilitis- Appears as erythema and fissuring of the labia commisures.
      • What this type of gingival disease would look like radiographically? Cannot be seen radiographically.
    • Specific organism assoicated with the gingival disease? About 85 to 95% of oral infections are associated with Candida albicans.
    • How would you diagnosis this- what would your differential diagnosis be?
Candida is part of the oral microflora in individuals so a brush biopsy will be needed to diagnose candidiasis and should resolve
with an antifungal treatment. Also a thorough medical history review because patient that are immunocompromised have the ability
to over develop candida albicans. Candidiasis will be persistent and re occur.
  • Differential diagnosis: Candidiasis, frictional keratosis, reticular linchen planus.






  • Linear gingival erythema (LGE) - Is a Candidal infection that presents as erythema of the attached gingiva.
    • What this type of gingival disease would look like clinically? Looks linear, presents with spontaneous bleeding, petcechia like lesions on the attached gingiva and alveolar mucosa, and erythematous. Seen mostly in HIV-positive patients, but also in those who immune system has become deficient. It may be localized or generalized, it may be limited to marginal tissue, may extend into attached gingival, and may extend into alveolar mucosa
    • What this type of gingival disease would look like radiographically? Unable to see on radiographs.
    • Specific organism associated with the gingival disease? Candidial species and thought to be Candida dubliniensis
    • How would you diagnosis this- what would your differential diagnosis be? LGE is unlike typical gingivitis, it’s characterized by spontaneous bleeding and erythema. Also, typical gingivitis responds within a few days to 1 week of scaling, root planning, and improvement of the patient’s oral hygiene. LGE occurs independently of the patient’s oral hygiene status.
Differential Diagnosis: Linear gingival erythema, desquamative gingivitis, and necrotizing ulcerative gingivitis.
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  • Histoplasmosis- a fungal infection that enters the body through the lungs. 1. What this type of gingival disease would look like clinically?
    - ulcerated lesions in the oral cavity which can appear on the buccal mucosa, tongue, lips, palate, or gums.
    2.What this type of gingival disease would look like radiographically?
    - This disease would not be seen radiographically
    3. Specific organism assoicated with the gingival disease
    -histoplasma capsulatum
    4. How would you diagnosis this- what would your differential diagnosis be?
    Histoplasmosis can be diagnosed by skin biopsy, chest xray, blood test, urine test, sputum test, or spinal tap.
    Differential Diagnosis: Herpes Simplex 1, desquamative gingivitis, ANUG, aphthous ulcer.



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