Periodontology Part 2: Localised Juvenile Spongiotic Gingival Hyperplasia: histopathological and clinical features

Localised juvenile spongiotic gingival hyperplasia (LJSGH) is a poorly understood but distinctive inflammatory hyperplasia. It is an exophytic lesion lined with non keratinised hyperplastic stratified squamous epithelium characterised by acanthosis, papillomatosis and spongiosis. Despite the name, it is not limited to juveniles but it can affect also adults. Its aetiology is unknown and the pathogenesis is controversial. Histological and immunophenotypic similarities suggest that LJSGH may result from a less keratinised junctional or sulcular epithelium. The excisional biopsy was considered the treatment of choice for a very long time. However, new evidence has suggested the efficacy of a conservative approach as it was seen that spontaneous remission of the lesion was possible. Even if LJSGH is not a plaque-induced lesion, the wait-and-see approach involves recall visits to evaluate the periodontal health and to reinforce oral hygiene instructions.