Acquired Chronic Erosive Gingivitis: Clinical Relevance of Papillary Gingival Biopsy

NCT ID: NCT04293718

Last Updated: 2020-03-03

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 100 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2011-10-31
• Study Completion Date: 2019-07-31

Brief Summary

Chronic erosive gingivitis is a syndrome (CEGS) that combines severe gingival inflammation and gingival erosion. The term "desquamative gingivitis" is often used in the literature to define chronic erosive gingivitis. However, this definition is inappropriate because the pathophysiological process at the origin of this gingival disease does not induce a desquamation but rather a loss of gingival substance, namely erosion, concerned wholly or in part of the gingival epithelium. In most clinical situations, chronic erosive gingivitis is an oral manifestation of a general disease with immune dysfunction. The most frequently described diseases are gingival lichen and autoimmune bullous diseases (AIBD). In 2018, as part of a monocentric study, we were the first to detail an original papillary gingival biopsy protocol, non-iatrogenic, perfectly suited to the anatomopathological examinations necessary for the diagnosis of AIBD gingival expression. The CEGS early detection by odontologists avoid delayed diagnosis and allows patients to be referred to the closest AIBD reference center.

Hypothesis/Objective A bicentric study was conducted, to evaluate the clinical relevance of this protocol, including the differential diagnosis of the CEGS. Research was supplemented by carrying out a systematic review of the literature to compare the contributive capacity diagnostic of the papillary biopsy technique with other gingival sample methods (attached gingival tissue, mucosa).

Method A retrospective bicentric observational study was conducted from October 2011 to July 2019, in two departments of oral medicine of two public hospitals in Paris (University Hospital - Bretonneau in Paris and Henri Mondor in Créteil; France). These two departments are specialized in the diagnosis and management of oral pathology; that of the Henri Mondor hospital is an AIBD reference center.

The literature review was developed in accordance with PRISMA recommendations. It was conducted on Pubmed - MEDLINE and Cochrane Oral Health Group and included all existing publications from 1935 until August 2019. A manual search of publications from the unpublished literature was also conducted.

Conditions

Gingival Diseases; Gingivitis; Autoimmune Diseases; Oral Lichen Planus

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: RETROSPECTIVE

Study Groups

Acute erosive gingivitis

Patients presenting acute erosive gingivitis, isolated or predominant compared to other oral lesions, which required at least one papillary gingival biopsy for diagnostic purposes. Patients were included in the study regardless of age and general health.

papillary gum biopsies

Intervention Type: OTHER

1 or 2 papillary gum biopsies were performed simultaneously, 1 for histological examination and 1 for immunohistochemistry

Interventions

papillary gum biopsies

1 or 2 papillary gum biopsies were performed simultaneously, 1 for histological examination and 1 for immunohistochemistry

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Patients referred on an outpatient basis by the physician or the dental surgeon, suffering from an acute erosive gingivitis, regardless of age and general health.

Exclusion Criteria

• Patients referred on an outpatient basis by the physician or the dental surgeon, with a histological examination and immunofluorescence (DIF) already done previously, and patient under corticosteroid therapy which is skewing the immunofluorescence (DIF) data.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

References

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Reference Type: BACKGROUND

PMID: 14653403 (View on PubMed)

Cheng YS, Gould A, Kurago Z, Fantasia J, Muller S. Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Sep;122(3):332-54. doi: 10.1016/j.oooo.2016.05.004. Epub 2016 Jul 9.

Reference Type: BACKGROUND

PMID: 27401683 (View on PubMed)

Dridi SM, Bellakhdar F, Ortonne N, Bayet K, Ingen-Housz-Oro S, Gaultier F. [Autoimmune bullous diseases with gingival expression: A proposed non-iatrogenic gingival biopsy technique]. Ann Dermatol Venereol. 2018 Oct;145(10):572-577. doi: 10.1016/j.annder.2018.06.005. Epub 2018 Aug 22. French.

Reference Type: BACKGROUND

PMID: 30143321 (View on PubMed)

Lo Russo L, Fedele S, Guiglia R, Ciavarella D, Lo Muzio L, Gallo P, Di Liberto C, Campisi G. Diagnostic pathways and clinical significance of desquamative gingivitis. J Periodontol. 2008 Jan;79(1):4-24. doi: 10.1902/jop.2008.070231.

Reference Type: BACKGROUND

PMID: 18166088 (View on PubMed)

Rinaggio J, Crossland DM, Zeid MY. A determination of the range of oral conditions submitted for microscopic and direct immunofluorescence analysis. J Periodontol. 2007 Oct;78(10):1904-10. doi: 10.1902/jop.2007.070095.

Reference Type: BACKGROUND

PMID: 18062112 (View on PubMed)

van der Meij EH, van der Waal I. Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med. 2003 Oct;32(9):507-12. doi: 10.1034/j.1600-0714.2003.00125.x.

Reference Type: BACKGROUND

PMID: 12969224 (View on PubMed)

Gaultier F, Ejeil AL, Jungo S, Ingen-Housz-Oro S, de Clatigny FLP, Bruno G, Pirnay P, Bellakhdar F, Dridi SM. Clinical relevance of interdental papilla biopsy in chronic erosive gingivitis (desquamative gingivitis): retrospective bicentric study of 148 specimens. BMC Oral Health. 2021 Sep 17;21(1):452. doi: 10.1186/s12903-021-01820-9.

Reference Type: DERIVED

PMID: 34535102 (View on PubMed)

Other Identifiers

ODONT_APHP_HMN2019

Identifier Type: -

Identifier Source: org_study_id