Desquamative gingivitis: a systematic review of possible treatments

Abstract

The occurrence of epithelial desquamation, erythema, and erosions on the gingival tissue could bedescribed in literature as “desquamative gingivitis” (DG), mostly due to a wide range of autoimmune/dermatological disorders. The objective of this systematic review was to assess the efficiency of thedifferent treatments for DG. The research was conducted using the following databases: PubMed, GoogleScholar, NIH (National Institute of Health), Up to Date, Scopus, Cochrane Library, Web of Science.The P.I.C.O. (Patient, Intervention, Control, Outcome) question was as follows: human patients withclinical-pathological diagnosis of DG (Patients); any topic, systemic medication, photobiomodulationor periodontal treatments (Intervention); no treatment, placebo or other drug (Comparison); andeffectiveness in terms of improvement of symptoms (primary Outcome) and signs (secondary Outcome).The PROSPERO record is number CRD42018084531. A total of 2,174 potential results were acquiredfrom the various databases, of which 998 were duplicates; the remaining 1,176 studies were submittedto a first reading of title and abstract: 1,137 articles had to be excluded, with 994 not being inherent tothe purposes of this review, and 143 being published in languages other than English. The remaining39 articles were subjected to full reading; 4 randomized controlled trials were considered eligible butonly 2 finally analysed. To date, 0.05% clobetasol propionate ointment compared with placebo, in themanagement of signs and symptoms of DG, showed no statistically significant differences. Differently, astructured plaque control appeared to be successful in reducing plaque and improving signs and relatedpain, with statistically significant differences regarding related symptoms, plaque index and mucosaldisease score. Regarding the clinical relevance based on our results, it is actually not possible to drawcertain and positive conclusions as to the best management modalities for DG. Future research shouldbe conducted in order to establish a proper therapy for this condition, primarily considering that it ismainly a characteristic clinical representation of dissimilar autoimmune bullous diseases. A promisingfield could be that of periodontal therapy, however, more data are needed.