PMC6533965_01
First week of ICU admission (marginal and attached gingiva
necrosis).
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After a few days of hospitalization, the entire length of the marginal and attached gingiva, both on the buccal and palatal sides, showed white coloration suggestive of necrosis (Figure 1).
Aspect of the upper arch after the first cycle of systemic antibiotic
therapy (elimination of gingival necrosis)
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A hard tissue with bone appearance was present in the remaining normal gingiva, but presented as a fragile structure (Figure 2). There was clinical insertion loss but without periodontal pockets (Figure 2).
Panoramic radiograph showing bone loss, especially between permanent
incisors and molars.
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Pathological tooth mobility was present as well as bone loss especially between the first permanent molars and incisors both in the upper and lower jaws (Figure 3).
Appearance after supragingival scraping, use of 0.12% chlorhexidine
and second cycle of systemic antibiotic therapy.
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After biopsy of the gingival tissue and the exposed hard tissue, the presence of inflammatory hyperplastic gingivitis was confirmed and the hard tissue was confirmed as bone tissue (Figures 4 and 5).
Bone alterations.
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After biopsy of the gingival tissue and the exposed hard tissue, the presence of inflammatory hyperplastic gingivitis was confirmed and the hard tissue was confirmed as bone tissue (Figures 4 and 5).
Bone lesion and loose teeth surgically removed.
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The collected material was sent for histopathology and culture examinations (Figure 6).
Appearance 15 days after surgery.
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Fifteen days later, the patient had significant oral health improvement (Figure 7).