ETIOLOGICAL FACTORS, CLINICAL AND IMMUNOLOGICAL CHARACTERISTICS OF DESQUAMATIVE GINGIVITIS

Abstract

Desquamative gingivitis is characterized by increased desquamation of the epithelium. It is a clinical term to describe red, painful, glazed and friable gingivae which may be a manifestation of some dermatoses with an autoimmune component. Purpose of the study. To define etiological factors and diagnostic attributes of desquamative gingivitis. Methods. 42 patients (7 men, 35 women) at the age of 19-68 years with desquamative gingivitis were examined. Clinical, radiological and immunological study were conducted. Results. It is established that desquamative gingivitis in 5 patients of young age was an independent periodontal disease, and in 37 patients (88,1%) occured – as a symptom of a generalized periodontitis. Desquamative gingivitis is diagnosed for 19 women in the post-menopausal period (45,2%), for 11 patients (26,2%) with dermatosis with an autoimmune component (oral lichen planus – 6, mucous membrane pemphigoid – 2, pemphigus vulgaris – 1, scleroderma – 1, lupus erythematosus – 1), for 6 patients (14,3%) with diabetes mellitus, for 3 patients (7,1%) with hypothyroidism, for 7 patients (16,7%) as allergic reaction (the contact gingivostomatitis). Increase of the immunoregulatory index CD4/CD8 (2,87±0,24) and a high content of low molecular weight circulating immune complexes in the blood of women with desquamative gingivitis in the post-menopausal period indicates possible development of an autoimmune syndrome. Conclusions. The main etiological factors of desquamative gingivitis are endocrine disturbances (gipoestrogenemiya, hypothyroidism, diabetes) and dermatosis with an autoimmune component. Confirmation of the desquamative gingivitis diagnosis in the presence of strong clinical symptoms requires immunological study and histopathological examination of tissue biopsies.