2025, Number 3
Oral pathologies related to orthodontics: a case report
Full text
10.35366/121714
Language: English
References: 6
Page: 106-108
PDF size: 1717.79 Kb.
ABSTRACT
Introduction: localized spongiotic gingival hyperplasia (LSGH) is a benign gingival condition of uncertain etiology that may arise during orthodontic treatment. Although often self-limiting, some cases require surgical intervention. Case report: a 14-year-old female undergoing orthodontic treatment presented with a persistent, asymptomatic gingival lesion adjacent to tooth 1.3. The lesion, initially observed when the tooth was in an ectopic vestibular position, persisted for several months and showed enlargement with central color changes. Clinical examination revealed a well-defined, sessile, erythematous lesion (8 × 3 mm). Excisional biopsy confirmed LSGH. Healing was uneventful, with no recurrence observed at follow-up. Conclusion: pathological mucosal lesions can develop during orthodontic care. Regular follow-up appointments are essential for early detection. Any lesion persisting beyond 15 days should be referred for oral pathology evaluation. Interdisciplinary collaboration between orthodontists and oral surgeons/pathologists ensures timely diagnosis and appropriate management.ABBREVIATION:
- LSGH = localized spongiotic gingival hyperplasia.
INTRODUCTION
Localized spongiotic gingival hyperplasia (LSGH) is a benign lesion characterized by erythematous, papillary gingival overgrowth. Although it was originally described in adolescents, more recent reports indicate that it occurs in a wider age range.1 Given its uncertain etiology, potential for spontaneous regression, and poor response to conventional hygiene measures, recognition and histopathological confirmation are crucial. For orthodontic patients, routine control appointments provide an important opportunity for early detection and timely referral.
This report describes a case of LSGH in a young patient undergoing orthodontic treatment and highlights the importance of collaboration between orthodontists and oral pathologists/surgeons.
CASE REPORT
A 14-year-old female was referred by her orthodontist due to a persistent gingival lesion adjacent to the upper right canine (tooth 1.3) (Figures 1, 2, 3 and 4). The lesion was first noted when the tooth was ectopically positioned at the start of orthodontic treatment. Despite reinforcement of oral hygiene, the lesion persisted and progressively enlarged.
The patient's medical history included multiple allergies and cardiological evaluation for prolonged QTc interval. Clinical examination revealed a sessile, erythematous, asymptomatic lesion on the free vestibular gingiva of tooth 1.3, measuring approximately 8 × 3 mm and had well-defined margins with no bleeding.
An excisional biopsy was performed under outpatient conditions. Histopathological analysis confirmed localized spongiotic gingival hyperplasia, showing stratified squamous epithelium with marked spongiosis, acanthosis, and mild inflammatory infiltrate (Figures 5 and 6).
At one-week follow-up, healing was complete without complications. No recurrence was observed.
DISCUSSION
LSGH is an uncommon gingival lesion, clinically presenting as erythematous, nontender gingival overgrowth, often mistaken for reactive or inflammatory lesions. Its immunohistochemical profile, particularly CK19 expression, suggests that it originates from the junctional epithelium.2,3
Management varies from observation to excision. Although spontaneous regression has been documented,4 surgical removal ensures definitive diagnosis and rapid resolution. Recurrence is rare, with both excision and cryotherapy considered effective approaches.5,6
In orthodontic patients, routine checkups represent an invaluable opportunity for mucosal surveillance. Persistent lesions require biopsy to rule out other pathologies, including reactive gingival growths and early neoplastic changes. Oral and maxillofacial surgeons play a central role in the surgical management and histopathological assessment of these cases.
This case highlights the importance of interdisciplinary collaboration. The orthodontist's vigilance resulted in a timely referral, diagnosis, and treatment, which prevented unnecessary complications.
CONCLUSIONS
- 1. Gingival lesions such as LSGH can appear during orthodontic treatment.
- 2. Lesions persisting beyond 15 days should be referred for oral pathology evaluation.
- 3. Surgical excision remains a safe and effective option when spontaneous regression does not occur.
- 4. Collaboration between orthodontists and oral/maxillofacial specialists is key to optimal patient outcomes.
ACKNOWLEDGMENTS
The authors would like to thank Dr. Catalina Troncoso Escudero for her role in case detection and referral.
REFERENCES
AFFILIATIONS
1 Oral Pathology, Hospital San Camilo, San Felipe, Chile.
2 Orthodontics, Pontifical Catholic University of Chile, Chile.
3 DDS, Universidad del Desarrollo, Santiago, Chile.
4 DDS, CESFAM Cordillera Andina, Los Andes, Chile.
5 DDS, Universidad de Chile, Santiago, Chile.
6 DDS, Universidad de Valparaíso, Valparaíso, Chile.
CORRESPONDENCE
Fernanda Marcela Torrealba Mancilla. E-mail: dratorrealbamancilla@gmail.comReceived: 05/05/2025. Accepted: 24/09/2025.