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Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Background: Ligneous periodontitis is a rare periodontal condition characterized by pseudomembranous enlargement of gingiva with marked impairment in fibrinolysis. The term ligneous is defined as made of, consisting of, or resembling wood; woody. Few cases of ligneous disease have been described in the literature., Case Description: The authors describe the case of a 32-year-old woman with autism spectrum disorder who had multiple, ulcerated, erythematous, nodular enlargements of the maxillary and mandibular anterior gingiva. Histopathologic examination revealed extensive fibrinous deposits in the submucosa. The patient's laboratory test results showed plasminogen activity of less than 5%. The patient received a final diagnosis of ligneous periodontitis on the basis of histopathologic features and laboratory findings. Recurrence was not noted until 3 months after excision., Practical Implications: Autism spectrum disorders can be associated with ligneous diseases. Because ligneous disease is a lifelong systemic disease affecting multiple systems, early diagnosis is essential to prevent infections and additional periodontal destruction., (Copyright © 2023 American Dental Association. Published by Elsevier Inc. All rights reserved.)