PMC4295159_01
Generalized gingival swelling and redness with desquamation of necrotic tissue is observed (arrow).
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Incisional biopsy was done to differentiate gingival infection or metastatic lesion (Figure 1).
(a) Necrotic tissue with chronic nonspecific inflammation (H-E stain, x100). (b) PAS stain reveals candida hyphae (periodic acid-Schiff stain, x200).
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fig2
The pathologic finding revealed necrotic tissue with candidiasis (Figure 2).
An apparent improvement, with a decreased swelling and necrotic tissue, is observed after a two-week antifungal therapy.
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fig3
When he visited outpatient clinic two weeks later, the apparent gingival lesion nearly disappeared (Figure 3).
(a) Initial panoramic view (September 2, 2009). The dotted line denotes the marginal bone level. (b), (c) Panoramic and periapical view 2 months after treatment (November 19, 2009). Note the marginal bone loss and the sequestrum at the lower anterior teeth area (arrow). Also note that the radices of the second right lower molar have been removed.
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fig4
Two months later, the gingival lesion was nearly healed, but the radiographic examinations revealed severe marginal bone loss at upper and lower incisor due to destructive change by the previous inflammation (Figure 4).
Summary of patient progress.
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fig5
He expired due to disease progression on 13th February, 2010 (Figure 5).