Abstract
Periodontitis and gingivitis are highly prevalent inflammatory diseases of the oral cavity, and typically are characterised by the presence of dental plaque. However, other causes of oral inflammation exist, which can resemble plaque-induced gingivitis and periodontitis, and may thus first be seen by a dental practitioner. This paper aims to provide dentists with an understanding of the manifestations of systemic diseases to the periodontium and highlights anamnestic and clinical clues important for distinguishing between plaque-induced and non plaque-induced lesions. In the first part of this series immune-mediated and hereditary conditions as causes of gingival lesions were discussed; this second part highlights cancer-related gingival lesions as well as those caused by specific pathogens, medication or malnutrition. A clear clinical, epidemiological and visual overview of the different conditions is provided. Early diagnosis of non plaque-related causes of gingival lesions can be vital for affected patients. Therefore, dental practitioners should be aware of the various manifestations of systemic diseases to the periodontium.
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Acknowledgements
The authors would like to thank Dr Elisabeth Reichardt at the Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Switzerland (formerly at the Department of Orthodontics, Dentofacial Orthopedics and Paedodontics at Charité, Berlin, Germany); Dr Pravesh Kumar Jhingta at the Department of Periodontology, Himachal Pradesh Government Dental College and Hospital, Shimla, India and Dr Rajiv S. Desai at the Department of Oral Pathology, Nair Hospital Dental College, Mumbai, India for their permission to use clinical photographs. We further thank our patients for their consent to use their clinical photographs for this publication.
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JH (Josefine Hirschfeld) and JH (Jon Higham) contributed equally to writing the mansucript and gathering demographic data for the table. JH (Josefine Hirschfeld) finalised the manuscript. FB, AR and ILC provided guidance and clinical photographs. All authors provided critical feedback.
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Hirschfeld, J., Higham, J., Blair, F. et al. Systemic disease or periodontal disease? Distinguishing causes of gingival inflammation: a guide for dental practitioners. Part 2: cancer related, infective, and other causes of gingival pathology. Br Dent J 227, 1029–1034 (2019). https://doi.org/10.1038/s41415-019-1053-5
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DOI: https://doi.org/10.1038/s41415-019-1053-5
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