Gingivitis Clinical Trial
Official title:
Acquired Chronic Erosive Gingivitis: Clinical Relevance of Papillary Gingival Biopsy. Retrospective Bicentric Study of 148 Samples and Systematic Review of the Literature
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unpublished literature was also conducted.
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