Objectives: Gingival hyperplasia is a volumetric augmentation, related to a local or systemic pathology, or drug assumption. Gingival hyperplasia with plasminogen deficit is a rare condition caused by fibrin depositing on connective tissue. This paper de- scribes a case of gingival hyperplasia, related at hyper expression of PAI-1, with normal plasminogen level. Clinical case: S.N., female, aged 18, was admitted presenting diffuse gingival hyperplasia with absence of major risk factors. Anamnesis revealed a total relapse after a previous complete gingivectomy performed 2 years before. Clinical and radiolog- ical evaluation confirmed the absence of periodontal disease. Hematochemical-serological-genetic set-up revealed the follow- ing: PLT 132 E+09/L, RDW 12.9%, P-PT 1.25 INR, P-APTT 1.33, vWF 43%, RISTOCETINIC CO-FACTOR 34%, desmo- pressin test: positive, homozygosis 4G for PAI-1 gene, heterozy- gosis for VLF and for XIIIF (Val34Leu) and for MTHFR (C677T and A1298C), absence of polymorphism in GpIIIa (Leu33Pro). Histological evaluation showed evidence of gingival tissue with a severe fibrin depositing and chronic inflammation. Therapy protocol included: a full mouth gingivectomy and gin- givoplasty in local anaesthesia, professional dental care every 3 months, a soft diet. After a five years follow up no evidence of relapse is observed. Conclusions: Recurrent gingival hyperplasia, related to altered blood PAI-1 level, is a rare condition, still to be properly de- fined. The action mechanism is referred to a genetic set up (homozygosis 4G for PAI-1 gene) that, arising PAI-I blood levels, inhibits plasminogen activation and so fibrin degradation. Fibrin is produced where tissue is affected by inflammation and regeneration, like in gingival mucosa while chewing

Gingival Hyperplasia and PAI-1: a case report / Massimo, Albanese; Acquilini, S.; Toller, N.; Bertossi, D.; Corrocher, G.; Anesi, Alexandre; Nocini, P. F.. - In: JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY. - ISSN 1010-5182. - STAMPA. - 36, suppl.1:(2008), pp. 48-48. (Intervento presentato al convegno XIX Congress of EACMF tenutosi a Bologna nel 2008) [10.1016/S1010-5182(08)71443-4].

Gingival Hyperplasia and PAI-1: a case report

ANESI, Alexandre;
2008

Abstract

Objectives: Gingival hyperplasia is a volumetric augmentation, related to a local or systemic pathology, or drug assumption. Gingival hyperplasia with plasminogen deficit is a rare condition caused by fibrin depositing on connective tissue. This paper de- scribes a case of gingival hyperplasia, related at hyper expression of PAI-1, with normal plasminogen level. Clinical case: S.N., female, aged 18, was admitted presenting diffuse gingival hyperplasia with absence of major risk factors. Anamnesis revealed a total relapse after a previous complete gingivectomy performed 2 years before. Clinical and radiolog- ical evaluation confirmed the absence of periodontal disease. Hematochemical-serological-genetic set-up revealed the follow- ing: PLT 132 E+09/L, RDW 12.9%, P-PT 1.25 INR, P-APTT 1.33, vWF 43%, RISTOCETINIC CO-FACTOR 34%, desmo- pressin test: positive, homozygosis 4G for PAI-1 gene, heterozy- gosis for VLF and for XIIIF (Val34Leu) and for MTHFR (C677T and A1298C), absence of polymorphism in GpIIIa (Leu33Pro). Histological evaluation showed evidence of gingival tissue with a severe fibrin depositing and chronic inflammation. Therapy protocol included: a full mouth gingivectomy and gin- givoplasty in local anaesthesia, professional dental care every 3 months, a soft diet. After a five years follow up no evidence of relapse is observed. Conclusions: Recurrent gingival hyperplasia, related to altered blood PAI-1 level, is a rare condition, still to be properly de- fined. The action mechanism is referred to a genetic set up (homozygosis 4G for PAI-1 gene) that, arising PAI-I blood levels, inhibits plasminogen activation and so fibrin degradation. Fibrin is produced where tissue is affected by inflammation and regeneration, like in gingival mucosa while chewing
2008
36, suppl.1
48
48
Massimo, Albanese; Acquilini, S.; Toller, N.; Bertossi, D.; Corrocher, G.; Anesi, Alexandre; Nocini, P. F.
Gingival Hyperplasia and PAI-1: a case report / Massimo, Albanese; Acquilini, S.; Toller, N.; Bertossi, D.; Corrocher, G.; Anesi, Alexandre; Nocini, P. F.. - In: JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY. - ISSN 1010-5182. - STAMPA. - 36, suppl.1:(2008), pp. 48-48. (Intervento presentato al convegno XIX Congress of EACMF tenutosi a Bologna nel 2008) [10.1016/S1010-5182(08)71443-4].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/622621
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