The Management of Necrotizing Gingivitis in Paediatric Patients: A Scoping Review and Two Case Reports

Necrotizing gingivitis (NG) is an acute inflammatory process with an estimated prevalence of less than 1%. The treatment of choice is usually antibiotics in addition to periodontal treatment. This scoping review aims to detail extent and type of proof related to NG in paediatric patient; moreover, a decision tree protocol was developed to define NG management in paediatric patients based on the presence or absence of systemic compromission. In addition, we also propose the use of ozone treatment as an adjuvant therapy. Seven papers (3 case reports, 2 guidelines, and 2 reviews) were selected for evaluation by reading the full texts. This review outlines the lack of research on the treatment of NG in paediatric patients; we, however, demonstrate the efficacy of the decision tree protocol by describing two case reports in which patients were treated with antibiotics according to the presence or absence of systemic involvement through the implementation of an individualized therapeutic approach, with periodontal ozone therapy. Moreover, the supportive use of this molecule in the management of NG can be a valuable tool in the healing of gingival tissues.

Adjunct Use of Low-Level Laser Therapy on the Treatment of Necrotizing Ulcerative Gingivitis: A Case Report

Necrotizing ulcerative gingivitis (NUG) is a microbial disease of the gingiva in the context of an impaired host response. This form of gingivitis is relatively rare. NUG is an infection characterized by gingival necrosis presenting as "punched-out" papillae, spontaneous bleeding, pain, oral malodor, and pseudomembrane formation. The primary predisposing factors are bacterial plaque and an inadequate diet, but smoking and psychological stress may also affect the disease severity. NUG is associated with a characteristic bacterial flora, which includes fusiform bacteria, spirochetes, and Prevotella intermedia. Conventional treatment includes control of both the bacterial plaque and the secondary factors, as well as topical or systemic treatment biostimulative effect on wound healing, pain control, and inflammatory processes. Patients with NUG were treated using adjunct use of a diode laser (980 nm) for the control of pain and to accelerate the wound healing at day 2. 3. 5. 9, energy density was 9 J/cm² . After treatment, the patients' quality of life improved faster than with conventional treatment. These results suggest that low-level laser therapy (LLLT) is an effective treatment for the reduction of pain levels and healing times. As a result, our case report shows that LLTT has a positive effect in relieving the symptoms of NUG.

Necrotizing Periodontal Diseases in Children: A Literature Review and Adjustment of Treatment

Necrotizing ulcerative gingivitis, sometimes observed in young children, may lead to necrotizing stomatitis and noma. Therefore, its interception is a necessity and a challenge for the paediatric practitioners. First, this article aims to propose a systematic review of recent literature on the use of local antiseptic and antibiotic prescription in this particular periodontal condition. Then, a protocol is proposed to have a simple, costless and reproducible treatment on children.