Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a rare gingival lesion predominantly affecting individuals aged <20 years. Although it has a distinct clinical presentation, its underlying pathogenesis remains poorly understood and standardized treatment guidelines are yet to be established. Surgical excision is the most common treatment; however, concerns regarding recurrence, aesthetic impact, and patient cooperation, particularly in pediatric cases, highlight the need for alternative approaches. Although spontaneous regression of LJSGH has been suggested, well-documented cases are rare. This report presents a case of LJSGH demonstrating spontaneous resolution without surgical intervention. A lesion on the mandibular anterior facial gingiva fully resolved over a 32-month period, further supporting the potential for natural resolution, and emphasizing the need for a conservative management approach.

Localized juvenile spongiotic gingival hyperplasia (LJSGH) is an exceedingly rare gingival disease. Most LJSGH occur in children, predominantly on the labial gingiva of the maxilla, and exhibit clinical manifestations similar to pyogenic granuloma or puberty gingivitis. This report presents a case of LJSGH. A 15-year-old male referred for evaluation of red lesions on the labial gingiva of the maxillary anterior teeth. Clinical examination revealed redness and swelling of the labial marginal gingiva, with no associated pain. After an incisional biopsy, the lesion was histopathologically diagnosed as LJSGH. We present this case to suggest that LJSGH should be considered in the differential diagnosis of patients presenting with painless gingival redness and swelling. We also report that we have obtained satisfactory aesthetic results by applying CO2 laser to LJSGH.