Severe Gingival Enlargement with Coexisting Erosive Lichen Planus in Severe Chronic Periodontitis Patient

Abstract

Plaque induced gingival enlargement is most commonly seen and when encountered simultaneously with erosive lichen planus poses a challenge to the treating dentist. Prognosis of one condition may influence the prognosis of another condition. The presented case highlights the significance of proper diagnosis and the management of simultaneously occurring gingival lesions. A 49-year-old hypertensive female presented with painful enlarged bleeding and suppurating gums with burning sensation on eating food along with long-term usage of antihypertensive drug amlodipine known for its gingival enlargement effect. All these multiple factors led to diagnostic dilemma. Effective management of the gingival enlargement was done by using electrocautery to rehabilitate the functions and esthetics of the patient. Gingival condition was also complicated by the presence of coexisting lichen planus which was predominantly erosive for which topical corticosteroid, antifungal, and antimicrobial agents were prescribed. Eight-month follow-up did not show recurrence of gingival enlargement. Electrocautery is an effective tool for the gingivectomy in severe inflammatory type of gingival enlargement because of rapid postoperative hemostasis. For the management of erosive lichen planus, long-term use of topical corticosteroids is an effective approach. Maintenance of oral hygiene and regular follow-ups are essential for these conditions.

Interest of periodontal maintenance in improving autoimmune diseases: about an oral lichen planus case report

“…Despite the use of multiple medical treatments, no improvement could be observed. This may be firstly explained by the use of local corticosteroids to treat the OLP, but resulting in a decrease in local immune defences that may favour opportunistic infections [1]. Secondly, this patient's periodontal disease probably played an aggravating role in the aetiology of this OLP.…”

“…Oral Lichen Planus (OLP) is an autoimmune inflammatory disease affecting 1-2% of the population, the mechanisms of which are still poorly understood. Yet this pathology is clinically and histologically well-known [1]. The Lichen Planus can take many forms: reticulated, flat, patchy, erythematous, erosive, then atrophic.…”