Gingival inflammation is usually attributed to bacterial-induced gingivitis and/or periodontitis. Although bleeding is most often caused by this etiology, there can be other systemic issues at work. The most common of these entities are the diseases listed under the category desquamative gingivitis. Desquamative gingivitis is a clinical term used to characterize attached and/or free (marginal) gingiva that demonstrates epithelial erythema and erosion. Desquamative gingivitis can be seen alone or with focal areas of ulceration. When a patient presents with desquamative gingivitis, the most common diseases or disorders that may be causing the problem are 1. (benign) mucous membrane pemphigoid, 2. erosive lichen planus, 3. lichenoid mucositis, and, less frequently, 4. pemphigus vulgaris. There are other diseases such as lupus erythematosus and erythema multiforme that under certain instances could be considered, but for our purposes we will address the most common entities.
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