Plasma cell gingivitis

Pathophysiology

Plasma cell gingivitis is a chronic inflammatory disease of the gingiva that is characterized by the presence of numerous plasma cells in the connective tissue. The exact cause of plasma cell gingivitis is unknown, but it is thought to be related to an immune response to bacterial plaque. The bacteria in plaque produce toxins that damage the gingival tissue, and the immune system responds by sending plasma cells to the area. The plasma cells produce antibodies that help to neutralize the toxins and kill the bacteria. However, the inflammation can also damage the gingival tissue, and if it is not treated, it can lead to gingivitis and periodontitis.

Clinical Presentation

Plasma cell gingivitis is generally localized but may be generalized, most often affecting the anterior mandibular and maxillary gingiva. It is characterized by a shiny, smooth surface that appears erythematous and edematous. The gingiva is firm and there is no bleeding on probing. The teeth are usually firm with no mobility and there is no attachment loss.

Differential Diagnosis

Differential diagnosis of plasma cell gingivitis should include chronic hyperplastic candidiasis, erythema multiforme, bullous pemphigoid, lichen planus, and psoriasis. A thorough medical and dental history, along with clinical examination and biopsy if necessary, is crucial for an accurate diagnosis and appropriate treatment plan.

Treatment

Treatment for plasma cell gingivitis involves addressing the underlying cause, which may include addressing systemic health conditions, optimizing oral hygiene practices, and professional dental cleanings. Medications such as corticosteroids or antibiotics may be prescribed to reduce inflammation and control infection. In some cases, surgical intervention may be necessary to remove severely inflamed tissue or treat associated periodontal disease.

Prognosis

The prognosis of plasma cell gingivitis is generally good. With proper oral hygiene and dental care, the condition can be managed and controlled. However, if left untreated, plasma cell gingivitis can lead to more severe periodontal disease, including periodontitis, which can result in tooth loss and other complications. Regular dental check-ups and professional cleanings are essential for maintaining periodontal health and preventing the progression of plasma cell gingivitis.

Complications

Plasma cell gingivitis is a chronic inflammatory disease of the gingiva that is characterized by the presence of plasma cells in the gingival infiltrate. The complications of plasma cell gingivitis include:

• Gingival recession
• Periodontal attachment loss
• Tooth mobility
• Tooth loss

Etiology

The exact cause of plasma cell gingivitis is unknown, but it is thought to be an autoimmune disorder in which the body's immune system attacks the soft tissues of the gums. This inflammation leads to the accumulation of plasma cells, a type of white blood cell that is responsible for producing antibodies. The antibodies produced by these plasma cells target the proteins in the gums, causing them to break down and leading to the symptoms of plasma cell gingivitis.

Epidemiology

Plasma cell gingivitis is a rare condition, with an estimated prevalence of less than 1% in the general population. It is more common in certain groups of individuals, such as those with a history of smoking, HIV infection, or immunosuppression. The exact etiology of plasma cell gingivitis is unknown, but it is thought to be related to an excessive immune response to local factors, such as plaque and calculus.

Histology

Plasma cell gingivitis is characterized histologically by the presence of a dense infiltrate of plasma cells in the gingival tissue. These plasma cells are typically seen in the superficial subepithelial connective tissue, and they may also be present in the epithelium. The infiltrate may be accompanied by other inflammatory cells, such as lymphocytes, neutrophils, and mast cells. The epithelium may show signs of hyperplasia or atrophy, and the connective tissue may be edematous or fibrotic.