Case report of spongiotic gingivitis in an adult male treated with novel 9,300-nanometer carbon dioxide laser low-energy ablation.

BACKGROUND AND OVERVIEW: To date, only about 125 cases of juvenile or adult spongiotic gingivitis have been described in the literature, primarily from retrospective biopsy searches. Spongiotic gingivitis is a relatively new, often misdiagnosed, periodontal pathology that was originally attributed only to juveniles. This is the first case report to our knowledge on spongiotic gingivitis diagnosed in a middle-aged adult man and treated with a novel carbon dioxide (CO(2)) laser low-energy ablation therapy. CASE DESCRIPTION: A 56-year-old man sought treatment for a localized erythematous lesion on the facial gingiva of the maxillary left central incisor (tooth no. 9). Initial treatment was conventional excisional surgery and biopsy. Diagnosed as spongiotic gingivitis, it reoccurred in the same location within 4 months. It was then treated in 3 sessions using a novel 9,300-nm CO(2) laser low-energy ablation set at 0.4 W and 1.25-mm cut width for an irradiance of 33.3 W/cm(2) and energy density of 0.21 J/cm(2). The lesion was significantly reduced and has shown no hyperplastic reoccurrence to date. CONCLUSIONS AND PRACTICAL IMPLICATIONS: This case report brings to dental professionals' attention that acute spongiotic gingivitis may occur in older adults, not just juveniles. As such, spongiotic gingivitis may be underreported in adults with localized gingivitis, possibly attributed to toothpastes containing sodium laurel sulfate. 9,300-nm CO(2) laser therapy may successfully treat lesions such as acute spongiotic gingivitis without the need for anesthesia or additional medications. This report may also encourage further research on treatment modalities, biopsy of lesions resembling this entity, and improved reporting of adult spongiotic gingivitis to better understand this unique gingival pathology.