PMC3357015_01
Preoperative facial view
JISP-16-104-g001.jpg
PMC3357015_01_JISP-16-104-g001.jpg
F1
Intraoral examination revealed moderate gingival inflammation [Figure 1] with clinical attachment loss of approximately 4 mm (buccally) in relation to 45, 46, 47, and 48.
Preoperative view of the lesion
JISP-16-104-g002.jpg
PMC3357015_01_JISP-16-104-g002.jpg
F2
Whole of the buccal gingiva in the 4th quadrant was bright red in appearance [Figure 2] .
Intraoral periapical radiograph
JISP-16-104-g003.jpg
PMC3357015_01_JISP-16-104-g003.jpg
F3
Patient was advised intraoral periapical radiograph [Figure 3] initially, followed by an orthopantomogram [Figure 4] which showed no bony involvement.
Orthopantomogram
JISP-16-104-g004.jpg
PMC3357015_01_JISP-16-104-g004.jpg
F4
Patient was advised intraoral periapical radiograph [Figure 3] initially, followed by an orthopantomogram [Figure 4] which showed no bony involvement.
Post preliminary therapy
JISP-16-104-g005.jpg
PMC3357015_01_JISP-16-104-g005.jpg
F5
Hexi-M gel 3-4 times daily for 1 week. However, healing was not satisfactory after 1 week recall [Figure 5].
Post biopsy
JISP-16-104-g006.jpg
PMC3357015_01_JISP-16-104-g006.jpg
F6
HbsAg which was reactive. Hence, excisional biopsy of the lesion was performed and the patient was put on amoxicillin 250 mg + clavulanic acid 125 mg t.i.d. for 5 days post biopsy [Figure 6].
Histopathologic section: Dashed arrow denotes attempted keratin pearl formation, black colored arrow denotes absence of epithelial rete pegs, and red colored arrow denotes altered nuclear/cytoplasmic ratio
JISP-16-104-g007.jpg
PMC3357015_01_JISP-16-104-g007.jpg
F7
The surface epithelium showed normal stratification with absence of rete ridges [Figure 7].
Chest radiograph
JISP-16-104-g008.jpg
PMC3357015_01_JISP-16-104-g008.jpg
F8
To rule out secondaries from lung, chest X-ray was taken [Figure 8] and was found to be clear.