Ligneous Gingivitis: A Systematic Review

Objective: Ligneous gingivitis (LG) is an uncommon disease caused by plasminogen deficiency with fibrin deposition, which affects principally the conjunctiva of the eyes. A systemic review of reported cases and case series was undertaken to evaluate this disease. Methods: Searches of detailed databases were performed. The variables were demographics, treatment, follow-up, location, histopathological findings, symptoms and plasminogen test results. Results: 49 cases were identified; LG was most frequently seen in white females (68.4%). The average age was 20.0 years, for males 17.1 years and for females was 20.9 years. The main symptom was pain with (40.8%), followed by painless presentation with (20.4%). The most common sign was bleeding (32.3%). Clinically, both upper and lower gingiva where most commonly evident in 49% of the cases, followed by the lower gingiva only with (18.4%). The mean size was 2.7cm. The presence of concurrent ligneous conjunctivitis was (69.4%). The average for plasminogen activity test was 24.7mg/mL. The recurrence was 59.2% and the mean follow-up was 18.9 months. Conclusion: The diagnosis was difficult to establish, there is not standard treatment, and recurrence is common. For the oral clinician this disease needs to be addressed in the differential diagnosis of gingival oral lesions.