Periodontal Management of Cyclosporin A-Induced Gingival Overgrowth: A Nonsurgical Approach.

Gingival overgrowth is a major and frequent unwanted effect accompanying the chronic usage of antihypertensive, anticonvulsant, and immunosuppressant drugs. The expression and the severity of this tissue-specific condition are influenced by a variety of factors, mainly drug and periodontal variables. Such increased volume of gingiva may compromise normal oral functions, aesthetics in addition to the patients' ability to practice optimal oral hygiene. The management of gingival overgrowth includes nonsurgical approach, surgical approach, or both of them for severe cases of gingival overgrowth as well as drug withdrawal. This case report illustrates a successful nonsurgical management of a 21-year-old patient with cyclosporin A-induced gingival overgrowth who experienced a total regression of the gingival enlargement without any surgical procedure or drug substitution. And it highlights therefore the key role of supportive periodontal therapy in maintaining good and stable outcomes over 2 years of follow-up.

Necrotizing Ulcerative Gingivitis.

Necrotizing ulcerative gingivitis (NUG) is a typical form of periodontal diseases. It has an acute clinical presentation with the distinctive characteristics of rapid onset of interdental gingival necrosis, gingival pain, bleeding, and halitosis. Systemic symptoms such as lymphadenopathy and malaise could be also found. There are various predisposing factors such as stress, nutritional deficiencies, and immune system dysfunctions, especially, HIV infection that seems to play a major role in the pathogenesis of NUG. The treatment of NUG is organized in successive stages: first, the treatment of the acute phase that should be provided immediately to stop disease progression and to control patient's feeling of discomfort and pain; second, the treatment of the preexisting condition such as chronic gingivitis; then, the surgical correction of the disease sequelae like craters. Moreover, finally, maintenance phase that allows stable outcomes. This case report describes the diagnosis approach and the conservative management with a good outcome of NUG in a 21-year-old male patient with no systemic disease and probable mechanism of pathogenesis of two predisposing factors involved.