Destructive Membranous Periodontal Disease (Ligneous Periodontitis)

Abstract

Generalized membranous gingival enlargement due to accumulation of amyloid or fibrin-like material is a rare, destructive and poorly defined disease entity. Some patients also show extraoral manifestations. The lesion is an involvement of periodontal tissues caused by the same process as ligneous conjunctivitis. In this report, 3 new cases, two of whom are siblings, are presented. Defective fibrinolysis and abnormal wound healing seem to be the main pathogenetic mechanism of this unusual disease, which should be evaluated systemically considering other mucosal involvement.

Destructive membranous periodontal disease (ligneous periodontitis): a case report and 3 years follow-up

“…3 Scully et al stated that the reported cases might fall within a spectrum of disorders related to plasminogen deficiency and very closely related with ligneous conjunctivitis, but distinct from it, because few patients had lesions of other mucosae and the gingival deposits had different staining characteristics. 4 The gingival lesions reported in association with this entity reveal that they were progressive and usually end with loss of teeth.…”

“…4 The gingival lesions reported in association with this entity reveal that they were progressive and usually end with loss of teeth. [2][3][4]6 Several surgical and periodontal treatment efforts were unsuccessful in all the reported oral lesions. [2][3][4]6 In some cases, gingival lesions show regression or disappear following tooth loss, 3 but there is not any reported period for the regression of the lesions in the literature.…”

“…3 Scully et al reported that therapy with topical heparin or intravenous purified plasminogen concentrate will effectively control the gingival lesions. This remains to be established, as plasminogen concentrate is not yet widely available.…”

“…2 Destructive membranous periodontal disease (ligneous periodontitis) is a rare, poorly defined entity characterised by gingival enlargement and periodontal tissue destruction. 3 The cause of this condition is due to plasminogen deficiency and resultant fibrin deposition. 2,4 The periodontal lesions are produced by the same process that causes ligneous conjunctivitis.…”

“…However, only a few of the reported cases of ligneous conjunctivitis have coexisted with oral and dermatological lesions. 3,4,6 Therefore, patients with destructive membranous lesions of the periodontal tissues should always be systemically evaluated and should be thoroughly examined for possible involvement of the skin and other mucosal surfaces. In the reported case, oral and eyelid lesions were seen together but there were not any dermatological lesions related with the disease.…”