Viral etiology of gingival recession. A case report.
Herpes simplex virus-type I (HSV-1) is responsible for both primary and recurrent infections of the oral mucosa. The aim of this case report is to show how HSV-1 may cause periodontal damage such as gingival recession. A 26-year-old male patient presented in a private office for the treatment of gingival recessions. He reported that the recessions had appeared suddenly with marginal inflammation of the gingiva and vesicle formation; within a few hours, the gingival tissue had been completely destroyed. The lesions were accompanied by pain, fever, and regional lymphadenopathy. Two weeks later, the patient returned complaining of a recurrence accompanied by pain and lymphadenopathy. The following day, the patient's condition had worsened and the depth of the recession had increased. A biopsy was taken for histological examination. A free epithelial-connective tissue graft was performed. Histological and direct immunofluorescence examinations confirmed the herpetic origin of the lesion. Eight months after surgery, a new herpetic lesion was detected in correspondence to the gingival margin of the first lower right premolar; therefore, acyclovir was prescribed. After 1 week, the antiviral therapy was completely successful; the gingival lesion disappeared, and no recession of the soft tissue margin was observed. Based on these clinical features, diagnosis of gingival recession induced by HSV-1 must be carried out at an early stage to establish a successful therapy.
Prato
G Pini
GP
School of Dentistry, University of Florence, Italy. gpinipr@tin.it
Rotundo
R
R
Magnani
C
C
Ficarra
G
G
D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D003238:Connective Tissue / Q000637:transplantation; D004848:Epithelium / Q000637:transplantation; D019085:Fluorescent Antibody Technique, Direct; D005881:Gingiva / Q000637:transplantation; D005889:Gingival Recession / Q000821:virology*; D005891:Gingivitis / Q000821:virology; D006801:Humans; D008297:Male; D012008:Recurrence; D013283:Stomatitis, Herpetic / Q000175:diagnosis*
D000998:Antiviral Agents; D000212:Acyclovir