PMC5426158_01
(a-c) Initial clinical views of Actinomyces-associated lesions from buccal and palatal aspects. The erythematous and desquamative appearances of gingival tissue are seen. (d) The panoramic image of the patient shows slight alveolar bone resorption
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F1
On intraoral examination, the erythematous appearance of gingival tissue, desquamation with pseudomembrane and bleeding on anterior and posterior vestibular/palatal aspects of the maxillary gingiva were observed [Figure 1].
Histopathologic examinations show exudate and active chronic inflammation with hematoxilen-eosine strain, (a) x40 and (b) x200. The arrows indicate Actinomyces colonies and sulfur granules with histochemical examinations in (c) Gomori's methenamine silver, x200 and (d) periodic acid-Schiff, x200
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F2
Actinomyces colonies and sulfur granules were defined in histochemical examinations which were performed in the separated subepithelial area with hematoxilen-eosine and periodic acid-Schiff strains [Figure 2]. Although Actinomyces was demonstrated in the histopathologic examination; tissue cultures did not yield Actinomyces spp.
(a-c) The appearance of gingival tissues after the treatment of Actinomyces-associated lesions
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F3
Following the treatment, the patient's complaints and all the symptoms related with gingival tissues were resolved totally [Figure 3].