Generalized Aggressive Periodontitis Associated With a Plasma Cell Gingivitis Lesion: A Case Report and Non-Surgical Treatment

Introduction: Plasma cell gingivitis (PCG) is an unusual inflammatory condition characterized by dense, band-like polyclonal plasmacytic infiltration of the lamina propria. Clinically, it appears as gingival enlargement with erythema and swelling of the attached and free gingiva and is not associated with any loss of attachment. The aim of this report is to present a rare case of severe generalized aggressive periodontitis (GAgP) associated with a PCG lesion that was successfully treated and maintained non-surgically.

Case presentation: A 32-year-old white male with a non-contributory medical history presented with gingival enlargement with diffuse erythema and edematous swelling, predominantly around teeth #5 through #8. Clinical and radiographic examination revealed generalized severe periodontal breakdown. A complete blood count and biochemical tests were within normal limits. Histologic and immunohistochemical examination were consistent with PCG. A diagnosis of severe GAgP associated with a PCG lesion was assigned. Treatment included elimination of possible allergens and non-surgical periodontal treatment in combination with azithromycin. Clinical examination at reevaluation revealed complete resolution of gingival enlargement, erythema, and edema and localized residual probing depths of 5 mm. One year after treatment, the clinical condition was stable. Radiographs indicated improved bone levels and formation of crestal lamina dura.

Conclusion: This case report highlights the unusual coexistence of GAgP and PCG, in which non-surgical treatment with elimination of all possible causes in combination with antimicrobials resulted in elimination of the gingival enlargement and significant improvement of periodontal parameters.

Keywords: Aggressive periodontitis; gingival hyperplasia; gingivitis; plasma cells.