ABSTRACT
Factitious disorders represent deliberately fabricated dissimulation of physical and psychological signs and symptoms seeking medical attention by the patient. Usually, they are ignorant of conventional treatment and consistently change their version of signs and symptoms. Due to various changes in the version, they do not respond to the treatment. They describe their signs and symptoms as dissimulated, imaginative, and exasperated, involving any part of the body. Gingivitis artefacta is an unusual and dramatic presentation with self-inflicted physical injury to the gingival tissues. We present an extremely rare case of frontal lobe glioma causing abnormal psychology of factitious disorder resulting in self-inflected injury to gingiva in an adult male. This case also highlights the management of the dental condition of multiple recessions with coronally advanced flaps with orthodontic buttons.
ABSTRACT
There are many etiological factors for nonplaque-induced gingival diseases, out of which physical trauma due to psychiatric reasons leading to self-infliction is less studied upon. This case report presents one such case which has been successfully treated stepwise where psychological counseling was done to restrain from habit followed by using an innovative laterally positioned periosteal pedicle graft for dehiscence coverage.
ABSTRACT
La gingivitis artefacta o autoinducida constituye una serie de recesiones gingivales caprichosas que, por lo general, son inducidas por el propio paciente. El objetivo de este artículo fue identificar la presencia de autolesiones gingivales en pacientes pediátricos para dar a conocer las causas que la propician, establecer el diagnóstico oportuno y el tratamiento adecuado que permita prevenir lesiones mayores. Se describe un paciente masculino de 10 años de edad en quien a la exploración clínica se observó la presencia de una hendidura vertical en la encía correspondiente al primer molar temporal inferior derecho. De acuerdo a los antecedentes se diagnosticó gingivitis artefacta o autoinducida. En razón al normal proceso de recambio de dentición como elemento básico para uin pronóstico favorable, como tratamiento específico para el caso se decidió hacer la extracción del órgano dental que presentaba una corona metálica y dejar en observación al paciente. Después de tres meses, la erupción del diente permanente concluyó sin alteración periodontal. Se considera de mucha importancia tener conocimientos sobre la prevalencia y la etiología de este tipo de lesiones, para poder prevenirlas con un enfoque multidisciplinario que permita darles el mejor tratamiento posible. Por esta razón se realiza el presente aporte a la literatura odontológica, mas exactamente a la literatura de la Odontopediatría.
Gingivitis artefacta is a series of capricious gingival recessions. Generally they are nominated self nducted lesions or artificial lesions. This paper presents the periodontal findings in a 10 years old boy who presents a vertical fissure on the right first lower temporal molar near to the gingival margin. This tooth presented a steel chromium crown and on the soft tissue had an unusual redness resilient to plaque control. Due to the gingival recession, the root surfaces were exposed. Treatment adopted was performing the tooth extraction. Three months after extraction, the eruption of permanent tooth concluded and there was not further periodontal alteration. Pedodontics should be aware of self induced gingival lesions to perform a better diagnosis and treatment. Preventive advice should include the study and control of children´ habits that could lead to hard and soft tissue dental lesions. Pedodontics should also work in conjunction with other dental specialists as a part of a multi-disciplinary team to offer the best professional decision to the patients´ needs.
