Linear Gingival Erythema (LGE) in HIV patients
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In adults HIV infection is related to a variety of periodontal lesions including necrotizing periodontal diseases and certain forms of gingivitis as well as due to possible exacerbation of pre-existing periodontal conditions. Risk Factors for periodontal diseases in HIV -infected individuals include age, smoking ,poor diet, poor oral hygiene, pre-existing gingivitis Previously, LGE was called HIV-G (HIV-associated gingivitis) y. But now, there are indications that HIV-G do occur in HIV-negative immunocompromised individuals and hence makes their original terms unsuitable and hence were renamed as LGE. HIV-associated periodontal diseases along with other oral infections, are considered as serious complications of HIV.

Linear Gingival Erythema (LGE) is a form of gingivitis characterized by distinct fiery red band along the margin of gingiva (EC-Clearinghouse, 1994) and is limited to the soft tissues of the periodontium. It is usually seen 2-3mm from the free gingival margin in anterior teeth, occasionally extending to the posterior teeth, presenting as a linear erythematous band. In some cases, it presents as petechia -like patches on free or attached gingiva causing bleeding and discomfort. There may be punctate erythema, which extends to the alveolar mucosa. Sometimes, these areas fuse, creating diffuse erythematous zones from the gingival margin to the vestibule.

Linear Gingival Erythema, marked by a marginal band of severe apical focal and/or diffuse areas of erythema, extending beyond the mucogingival line. It is associated with initial stages of HIV infection and CD4+ cell suppression. There are no pockets, ulceration or loss of attachment and is resistant to local treatment. The lesion may be localized generalized. Plaque that is commonly seen in conventional gingivitis is usually not associated with LGE. Bleeding on gentle probing is seen in the majority of cases of LGE. Presently, the aetiopathology of LGE and other HIV associated periodontal diseases have been associated with Candida species. The microflora of LGE resembles periodontitis than gingivitis.

LGE lesions undergo abrupt and quick remission and are often refractory to treatment. The treatment success relies on recognizing causative factors like tobacco, plaque, association with candida infection or existence of pathogenic bacteria consistent with those in conventional periodontitis . Treatment usually includes scaling and debridement by a dental professional, rinsing twice a day with 0.12% Chlorhexidine gluconate for 2 weeks and proper home care.

Source: http://ispub.com/IJDS/14/1/48158
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