17 February 2023

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Gingival swelling as a first sign of ligneous periodontitis in a patient with autism spectrum disorder

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Background

Ligneous periodontitis is a rare periodontal condition characterized by pseudomembranous enlargement of gingiva with marked impairment in fibrinolysis. The term ligneous is defined as made of, consisting of, or resembling wood. Few cases of ligneous disease have been described in the literature.

Case description

The authors describe the case of a 32-year-old woman with autism spectrum disorder who had multiple, ulcerated, erythematous, nodular enlargements of the maxillary and mandibular anterior gingiva. 

Histopathologic examination revealed extensive fibrinous deposits in the submucosa. The patient’s laboratory test results showed plasminogen activity of less than 5%. The patient received a final diagnosis of ligneous periodontitis based on histopathologic features and laboratory findings. Recurrence was not noted until three months after excision.

Practical implications

Autism spectrum disorders can be associated with ligneous diseases. Because ligneous disease is a lifelong systemic disease affecting multiple systems, early diagnosis is essential to prevent infections and additional periodontal destruction.

Reshma Poothakulath Krishnan, Pratibha Ramani, Deepak Pandiar, Dinesh Y. “Gingival swelling as a first sign of clinical presentation of ligneous periodontitis in a patient with autism spectrum disorder.” JADA. 23 January 2023. DOI: https://doi.org/10.1016/j.adaj.2022.12.005