title: A stab-and-roll biopsy technique to maintain gingival epithelium for desquamative gingivitis.
abstract: BACKGROUND
  Desquamative gingivitis (DG) is a clinical manifestation common to several diseases. It is known that most cases of DG are caused by mucous membrane pemphigoid (MMP), oral lichen planus (OLP), or pemphigus vulgaris (PV). Early recognition and treatment of these diseases can improve the prognosis, but diagnostic delays are common in patients with DG because obtaining a diagnostic biopsy is technically challenging. A biopsy technique designed to maintain the gingival epithelium for patients with DG was developed. The usefulness of this technique is discussed.
  
  
  METHODS
  This study is based on a retrospective review of 27 DG cases. A stab-and-roll technique was used to obtain gingival tissue. This technique is designed to reduce lateral forces on the epithelium during the procedure and to thereby prevent the inadvertent removal of the epithelium from the biopsy specimen. A total of 52 biopsies comprising 27 for hematoxylin and eosin (H&E)-stained samples and 25 for direct immunofluorescence (DIF) testing were reviewed.
  
  
  RESULTS
  Fifty-one of the 52 biopsies (98.1%) maintained the epithelium. Only one biopsy (1.9%) showed that the epithelium was totally absent. Therefore, H&E and DIF features of 51 biopsies were analyzed. Definitive diagnoses of the diseases causing DG included MMP (13 cases), PV (eight cases), and OLP (six cases).
  
  
  CONCLUSIONS
  A diagnostic biopsy was obtained from the gingiva of patients with DG using the stab-and-roll technique. The gingival epithelium was well maintained, and the relationship with the underlying connective tissue was diagnostic. In the future, this stab-and-roll biopsy technique may facilitate early diagnosis and treatment of diseases causing DG.
authors.affiliation: Department of Oral Diagnosis, Nihon University, School of Dentistry at Matsudo, Matsudo, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Endo
authors.forename: Terry D
authors.initials: TD
authors.lastname: Rees
authors.forename: Edward P
authors.initials: EP
authors.lastname: Allen
authors.forename: Kayo
authors.initials: K
authors.lastname: Kuyama
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Aoki
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Takanori
authors.initials: T
authors.lastname: Ito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000295:instrumentation / Q000379:methods*; D004396:Coloring Agents; D003176:Complement C3 / Q000032:analysis; D004848:Epithelium / Q000473:pathology; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D019085:Fluorescent Antibody Technique, Direct / Q000379:methods; D005456:Fluorescent Dyes; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology*; D005891:Gingivitis / Q000473:pathology*; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D017676:Lichen Planus, Oral / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010390:Pemphigoid, Benign Mucous Membrane / Q000473:pathology; D010392:Pemphigus / Q000473:pathology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D004396:Coloring Agents; D003176:Complement C3; D005456:Fluorescent Dyes; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005340:Fibrinogen
keywords: Biopsy; benign mucous membrane; gingival diseases; lichen planus; oral; pemphigoid; pemphigus