Hemangioendothelioma of the gingiva. Histopathologic and therapeutic considerations.

The hemangioendothelioma is a benign neoplasm, rarely observed in the mouth. In the literature, reports on the treatment and on the therapeutic results are lacking. This type of gingival neoplasm was observed in a young adult male. It was located in the attached gingiva in the upper and in the lower jaw, covering almost the entire coronal part of the anterior teeth. An exhaustive internal and neurological examination revealed no associated general disease. The gingival biopsies displayed the typical characteristics of a hemangioendothelioma: proliferation of the blood vessels, with a reduced lumen surrounded by swollen endothelial cells. The treatment consisted of a meticulous mechanical plaque control, chlorhexidine rinses, gingivectomy procedures and a monthly professional prophylaxis. 3 years after the periodontal treatment, the gingival structures remained clinically healthy. In the biopsies, only a small amount of inflammatory cells could be detected. This report shows a case of benign gingival neoplasms of unknown etiology in which meticulous plaque control, combined with extensive gingivectomies and repeated professional prophylaxis may have prevented or, at least, retarded the recurrence of the lesion.

[Microbial aspects of periodontopathies and implications for antimicrobial treatment]. / Microbiële aspecten van de parodontopathieën en de gevolgen voor de antimicrobiële behandeling.

The development of periodontitis is always preceded by a gingivitis. Therefore, the studies of the etiological, histopathological, microbiological and therapeutic aspects of gingivitis form an essential contribution to the prevention of the major oral diseases. After 9-21 days without oral hygiene, in a previously healthy gingiva, a generalized mild gingivitis always develops. However, subclinical inflammation starts much earlier, obviously as a host reaction to the initial phases of plaque development. The development of gingivitis, and especially of peridontitis, is accompanied by a marked increase of anaerobic Gram-negative organisms and a decrease of aerobic Gram-positive organisms. However, their possible specific etiological role in the development of gingival inflammation is still unknown. On the other hand, the proliferation of the total mass of the original flora could be of importance, too. The actual treatment modalities of periodontal disease consist in a total non-specific elimination of the plaque, which imposes an intensive plaque control, independent of the individual tolerance level. Future bacteriological investigation will have to elucidate the pathogenic potential of specific micro-organisms.