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1.
J Dent Child (Chic) ; 89(1): 41-45, 2022 Jan 15.
Article in English | MEDLINE | ID: mdl-35337399

ABSTRACT

Idiopathic gingival fibromatosis (IGF) is a rare, benign, slow-growing proliferation of the gingival tissues involving both maxillary and mandibular gingiva. It is exacerbated during the eruptive phase of both primary and permanent dentitions. The purpose of this article is to report the case of a 10-year-old boy who presented with IGF whose gingival enlargement covered the occlusal surfaces of many teeth and displaced the erupting dentition, compromising the patient's cosmetics, function, speech and development. The treatment involved gingivectomy and gingivoplasty, combining both surgical and laser methods. The case showed remarkable esthetic and functional im provement, without signs of recurrence one year post-treatment.


Subject(s)
Fibromatosis, Gingival , Gingival Overgrowth , Child , Fibromatosis, Gingival/diagnosis , Fibromatosis, Gingival/surgery , Gingiva , Gingival Overgrowth/surgery , Gingivectomy , Gingivoplasty , Humans , Male
2.
Cient. dent. (Ed. impr.) ; 17(2): 139-146, mayo-ago. 2020. tab
Article in Spanish | IBECS | ID: ibc-195102

ABSTRACT

Hablamos de sonrisa gingival cuando se altera la armonía establecida entre los dientes, labios y encía, exponiendo más allá de 2 mm de encía coronal a los incisivos maxilares, una circunstancia que, en ocasiones, genera un problema estético para algunos pacientes. La etiopatogenia de dicha condición se resume en tres facetas: dentoperiodontal (erupción pasiva alterada y erupción activa alterada), ósea (esquelética y/o dentoalveolar) y muscular (labio superior corto e hipermovilidad labial).Una condición multifactorial como la sonrisa gingival precisa un abordaje multidisciplinar: cirugía plástica periodontal, ortodoncia, cirugía ortognática, reposición labial, infiltración de toxina botulínica y tratamiento estético complementario


The excessive gingival display when a patient smiles (from 2 mm or more) is known as gummy smile. When the harmony established between the teeth, lips and gum is altered, exhibiting short clinical crown of the maxillary anterior teeth, in occasions generates an aesthetic problem for some patients.There are different etiologies of gummy smile, it concludes in three facets: dentoperiodontal (Altered Passive Eruption and Altered Active Eruption), bone defect (excessive vertical bone growth, dentoalveolar extrution) and muscular (short upper lip and upper lip hyperactivity), and the combination of some of these factors.A multifactorial condition requires a multidisciplinary boarding: plastic periodontal surgery, orthodontic, orthognathic surgery, lip reduction, infiltration of Botulinum toxin and complementary aesthetic treatment


Subject(s)
Humans , Cosmetic Techniques , Smiling/physiology , Facial Muscles/anatomy & histology , Facial Muscles/physiology , Vertical Dimension , Gingival Overgrowth/surgery , Orthodontics/methods , Orthodontics, Corrective/methods , Periodontics , Orthognathic Surgery
3.
J Coll Physicians Surg Pak ; 28(3): S16-S18, 2018 Mar.
Article in English | MEDLINE | ID: mdl-29482692

ABSTRACT

Tuberous sclerosis complex (TSC) is an autosomal dominant, multisystem genetic disorder. It is characterised by formation of benign hamartomas, neurofibromas, and angiofibromas located in different organs. We describe a case of a 13-year boy who complained of gingival enlargement. Clinical examination showed distinctive dermatological signs like hypopigmented macules, shagreen plaques, miliary fibromas, fibrous plaques and multiple angiofibromas. Oral manifestation included localised gingival enlargement. Gingivectomy was performed and the excised tissue was submitted for histopathological examination. The microscopic examination of gingival tissue revealed multiple bundles of collagen fibres with proliferating fibroblast and multiple proliferating blood vessels in the connective tissue. The clinical and histopathological findings were consistent with gingival angiofibromas of TSC. Gingivectomy allowed the patient to have better function and aesthetics. Periodontal examination in conjunction with dermatological examination is important for early diagnosis of TSC.


Subject(s)
Gingival Overgrowth/diagnosis , Tuberous Sclerosis/diagnosis , Adolescent , Angiofibroma/pathology , Gingival Overgrowth/pathology , Gingival Overgrowth/surgery , Gingivectomy , Humans , Male , Treatment Outcome , Tuberous Sclerosis/pathology , Tuberous Sclerosis/surgery
4.
J Cosmet Laser Ther ; 20(4): 215-219, 2018 Aug.
Article in English | MEDLINE | ID: mdl-29351498

ABSTRACT

BACKGROUND: Drug-induced gingival overgrowth (DIGO) is attributed mainly to the prolonged use of calcium channel blocking agents, anticonvulsants, and anti-calcineurin inhibitors . The management of DIGO depends on the severity of the disease and includes surgical intervention and plaque control. Compared to conventional surgical treatment, the recent literature data have shown that gingivectomy using a high-power laser (HPL) is a short and easy procedure, which results in minimal postoperative discomfort and greater patient accep- tance. OBJECTIVE AND METHODS: The purpose of this study was to report two cases of recurrent DIGO treated surgically using HPL (λ 808nm, 1.5W). RESULTS: Minimal bleeding and discomfort were observed during surgery, and patients reported no pain or bleeding after the procedure. After 1 year of follow-up, patients presented a minimal increase of gingival volume, indicating that laser technology can improve the efficiency and prognosis of DIGO. CONCLUSIONS: The HPL was able to preventing hemorrhage and improving the patient's collaboration with the treatment and quality of life.


Subject(s)
Gingival Overgrowth/surgery , Gingivectomy/methods , Lasers, Semiconductor/therapeutic use , Adolescent , Amlodipine/adverse effects , Calcium Channel Blockers/adverse effects , Child , Female , Follow-Up Studies , Gingival Overgrowth/chemically induced , Gingivoplasty , Humans , Male , Time Factors
5.
Article in Spanish | LILACS | ID: biblio-900283

ABSTRACT

RESUMEN: La búsqueda de la excelencia estética es un objetivo importante de la odontología. La sonrisa gingival es una de las principales quejas estéticas, ya que perjudica la autoestima y las relaciones sociales del paciente. Nuevas técnicas como la aplicación de la toxina botulínica (TB) pueden tornarse una opción terapéutica más conservadora, y ayudar a disminuir las proporciones de las intervenciones quirúrgicas resectivas. El propósito de este trabajo es describir la aplicación de la TB como adyuvante de la cirugía gingival resectiva, a través del reporte de un caso clínico de discrepancia dentogingival y sonrisa gingival. Con la cirugía resectiva el equilibrio dentogingival fue mejorado, y la aplicación de TB tipo A causó la dehiscencia uniforme del labio superior, devolviendo la armonía facial. La TB es un complemento útil y conservador en la mejora estética de la sonrisa, y puede aumentar los resultados de la cirugía gingival resectiva.


ABSTRACT: The search for aesthetic excellence is an important goal in dentistry. The gummy smile is one of the main aesthetic complaints as it can affect self-esteem, and prejudice the patients' social relationships. New techniques, such as the application of botulinum toxin (BT) may become a more conservative treatment option and help to reduce the proportions of resective surgery. The purpose of this paper is to describe the application of BT, used as an adjuvant to gingival resection surgery, using a case report of a dento-gingival discrepancy and gummy smile. The resection surgery improved the dento-gingival equilibrium and the application of BT led to a uniform dehiscence of the upper lip, and facial harmony. BT is a useful and conservative adjuvant in the aesthetic enhancement of the smile, and can improve the outcomes of gingival resection surgery.


Subject(s)
Humans , Female , Young Adult , Smiling , Botulinum Toxins/therapeutic use , Gingival Overgrowth/therapy , Neurotoxins/therapeutic use , Combined Modality Therapy , Gingival Overgrowth/surgery , Gingival Overgrowth/drug therapy , Esthetics, Dental
6.
Oncotarget ; 8(12): 20496-20509, 2017 Mar 21.
Article in English | MEDLINE | ID: mdl-28147333

ABSTRACT

Gingival hyperpigmentation and the condition known as gummy smile are very common dental cosmetic problems. Gingival hyperpigmentation arises due to the excess presence of melanin in certain regions of the gums. In the case of gummy smile, more than the required amount of gingival tissue is exposed upon smiling. An aesthetically pleasing smile should expose only a negligible amount of gingival tissue. Gummy smile and gingival hyperpigmentation can have detrimental effects on the aesthetic quality of a smile, and thereby a wide variety of treatment options must be taken into consideration depending patient outcome objectives. The use of a laser as a treatment modality is considered to be a promising option for such cases. We aim to explain the effects of using a laser on the gingiva and discuss the advantages and disadvantages of this type of treatment and the resulting alteration of the genetic composition of the gingival tissue. This article reviews the histological aspects and biological effects of a laser treatment for oral hyperpigmentation and gummy smile and analyzes the use of the laser as a modality to improve the smiles of people with hyperpigmentation and excessive gingival display. We also attempt to provide insight into the use of plasma as a novel technology for medical and dental research and its future implications with regard to, dental soft tissue procedures.


Subject(s)
Dentistry/methods , Gingival Overgrowth/surgery , Hyperpigmentation/surgery , Laser Therapy/methods , Plasma Gases/therapeutic use , Gingival Diseases/surgery , Humans
7.
Int J Esthet Dent ; 11(3): 338-54, 2016.
Article in English | MEDLINE | ID: mdl-27433549

ABSTRACT

Prior to initiating any treatment, it is necessary to visualize the desired outcomes. It then becomes possible to formulate the steps required to achieve this result. Digital Smile Design (DSD) utilizes patient input and information gathered through diagnostic procedures to create an esthetic treatment scheme. In the case presented here, the NYUCD Esthetic Evaluation Form, intraoral and extraoral photographs, mounted diagnostic casts, physical examination, and radiographs were the diagnostic modalities. The gathered information served as a starting point for a wax-up and intraoral mock-up. This case report demonstrates how the DSD served as a template for crown lengthening procedures and design of the final porcelain veneer restorations.


Subject(s)
Crown Lengthening/methods , Dental Porcelain/chemistry , Dental Veneers , Patient Care Planning , Smiling , Adult , Dental Restoration Failure , Esthetics, Dental , Female , Gingiva/pathology , Gingival Overgrowth/surgery , Gingivectomy/methods , Humans , Lip/pathology , Models, Dental , Odontometry/methods , Photography, Dental/methods , Physical Examination , Radiography, Dental
8.
Dent Update ; 42(7): 656-8, 660-2, 665-6, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26630863

ABSTRACT

Juvenile hyaline fibromatosis (JHF) is a rare autosomal recessive inherited condition presenting early in life and characterized by the accumulation of hyaline-like tissue in the skin as well as various organs. Gingival overgrowth is a significant oral manifestation. This paper highlights how early and essential periodontal intervention may be necessary to improve mastication and subsequent weight gain, and to eliminate pain and improve the patient's quality of life. Here we highlight the key features of this condition and demonstrate how appropriate surgical management can have a significant impact on a patient's wellbeing. CPD/CLINICAL RELEVANCE: Juvenile hyaline fibromatosis has a significant impact on patient wellbeing and it is therefore important that clinicians are able to recognize the condition and ensure that patients receive appropriate care and management.


Subject(s)
Gingival Overgrowth/surgery , Gingivectomy/methods , Hyaline Fibromatosis Syndrome/surgery , Patient Satisfaction , Quality of Life , Follow-Up Studies , Gingival Overgrowth/psychology , Gingivectomy/psychology , Humans , Hyaline Fibromatosis Syndrome/psychology , Male , Mastication/physiology , Patient Care Planning , Speech/physiology , Temporomandibular Joint Disorders/therapy , Trismus/therapy , Young Adult
9.
J Int Acad Periodontol ; 17(3): 77-81, 2015 Jul.
Article in English | MEDLINE | ID: mdl-26373224

ABSTRACT

Drug-induced gingival overgrowth (DIGO) is an oral clinical manifestation associated with certain medications such as immunosuppressants that are administered to organ transplant patients to prevent graft rejection. In patients with cardiac transplants, management of DIGO is critical. In such patients, plaque biofilm accumulation at the gingival interface might be detrimental as it may lead to transient bacteremia as well as systemic inflammation resulting in thromboembolic events. This case report describes the management of DIGO in a cardiac transplant recipient by change of immunosuppressant medication, non-surgical periodontal therapy and laser-assisted gingivectomy.


Subject(s)
Gingival Overgrowth/surgery , Gingivectomy/methods , Gingivoplasty/methods , Heart Transplantation , Laser Therapy/methods , Adult , Cyclosporine/adverse effects , Dental Scaling/methods , Follow-Up Studies , Gingival Overgrowth/chemically induced , Humans , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Lasers, Semiconductor/therapeutic use , Male , Oral Hygiene/education , Root Planing/methods , Sirolimus/therapeutic use
10.
Dent Update ; 42(2): 144-6, 149-50, 153, 2015 Mar.
Article in English | MEDLINE | ID: mdl-26058228

ABSTRACT

This is the first article in a two-part series which aims to provide an overview of the different techniques used to increase clinical crown height. In the first paper, the focus will be on the management of patients who present with gingival tissue excess. The different aetiologies are discussed and illustrated with clinical cases, following which a range of procedures that may be employed in the management of these patients are presented. With an increasingly ageing population, more patients are taking regular medications prescribed from their general medical practitioner, and so having a working knowledge of the specific drugs that may cause gingival enlargement is essential. Clinical Relevance: When patients with gingival tissue excess present in primary or secondary care, a clinician must have a good knowledge of the possible causes of the condition, as well as an idea of how the patient may be managed.


Subject(s)
Crown Lengthening/methods , Gingival Overgrowth/surgery , Adult , Aged , Alveolectomy/methods , Anticonvulsants/adverse effects , Calcium Channel Blockers/adverse effects , Dental Plaque/prevention & control , Female , Fibromatosis, Gingival/genetics , Fibromatosis, Gingival/surgery , Gingiva/transplantation , Gingival Overgrowth/chemically induced , Gingival Overgrowth/etiology , Gingivectomy/methods , Gingivoplasty/methods , Humans , Immunosuppressive Agents/adverse effects , Laser Therapy/methods , Male , Patient Care Planning , Surgical Flaps/transplantation , Tooth Eruption/physiology
11.
J Clin Periodontol ; 42(7): 640-6, 2015 Jul.
Article in English | MEDLINE | ID: mdl-26076712

ABSTRACT

OBJECTIVES: Gingival overgrowth (GO) is an adverse drug reaction in patients using calcium channel blockers (CCBs). Little is known about the effects of CCBs on the management of periodontal diseases. The aim of this study was to assess how the use of CCBs affects the long-term supportive treatment and outcomes in patients undergoing periodontal therapy. METHODS: All patients using CCBs during the initial treatment and/or the supportive periodontal therapy (SPT) were selected from a periodontal practice. Patients were scored using a Gingival Overgrowth Index (GOI). The effects of CCB types and dosages were assessed in terms of the frequency and the severity of GO, treatment responses, substitutions and extra treatment costs. Mean values, Standard Deviation (SD) and range were calculated. The Mann-Whitney test was used to assess statistically significant differences (p < 0.05) for GO between patients with good and poor oral hygiene, differences between before and after terminating or replacing the CCBs, possible differences between drug dosages (Dihydropyridine 5 mg and 10 mg) and differences between three drug combinations (CCB and inhibitors of the renin-angiotensin system (IRAS), CCB and non-IRAS, CCB and statins). RESULTS: One hundred and twenty-four patients (58 females, 66 males, 4.6% of the patient population) were using CCBs. 103 patients were assessed. Average age was 66.53 years (SD. 9.89, range 42-88) and the observation time was 11.30 years (SD 8.06, range 1-27). Eighty-nine patients had GO, 75 of these required treatment for GO. Terminating or replacing with alternatives to CCBs resulted in significant decreases in GO (p = 0.00016, p = 0.00068) respectively. No differences were found between good and poor oral hygiene (p = 0.074), drug dosages or the various drug combinations. Surgical treatment was more effective than non-surgical treatment in controlling the GO. Long-term tooth loss was 0.11 teeth per patient per year. Forty-two patients needed re-treatments for GO, resulting in an extra life cost per patient of €13471 (discounted €4177). CONCLUSION: The majority of patients (86.4%) using CCBs experienced GO. 47.2% of these experienced recurrence(s) of GO during the SPT and needed re-treatments with resulting added costs. The long-term tooth loss was considerably higher for patients using CCBs than for other patients groups from the same practice setting.


Subject(s)
Calcium Channel Blockers/therapeutic use , Chronic Periodontitis/therapy , Gingival Overgrowth/chemically induced , Adult , Aged , Aged, 80 and over , Calcium Channel Blockers/administration & dosage , Calcium Channel Blockers/adverse effects , Chronic Periodontitis/economics , Dihydropyridines/administration & dosage , Dihydropyridines/adverse effects , Dihydropyridines/therapeutic use , Drug Combinations , Drug Substitution , Female , Follow-Up Studies , Gingival Overgrowth/economics , Gingival Overgrowth/surgery , Health Care Costs , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Male , Middle Aged , Oral Hygiene , Recurrence , Renin-Angiotensin System/drug effects , Retreatment , Tooth Loss/etiology , Treatment Outcome
12.
Braz Dent J ; 26(1): 39-43, 2015.
Article in English | MEDLINE | ID: mdl-25672382

ABSTRACT

Phenytoin-induced gingival overgrowth (PIGO) is a common complication of the continuous use of medications. This paper presents a case of PIGO hindering oral function and compromising oral hygiene and aesthetics, which was treated with a combination of nonsurgical and surgical periodontal therapies. A 39-year-old male patient was referred for dental treatment with several complaints, especially upper and lower gingival overgrowth that hindered speech and swallowing. Generalized deep probing pockets and bone loss were detected. Diagnosis of gingival overgrowth associated with phenytoin and chronic periodontitis was established. The treatment plan consisted of conservative therapy with education on oral health, motivation and meticulous oral hygiene instruction in combination with scaling and root planing. During the revaluation period, a marked reduction in the clinical parameters was noted, particularly probing pocket depth reduction. Surgical therapy for removal of gingival overgrowth was also performed to achieve pocket reduction. Supportive periodontal therapy was proposed and the patient is currently under follow-up for 4 years. Management of PIGO may be obtained by the use of periodontal procedures combined with good oral hygiene and periodontal supportive care.


Subject(s)
Anticonvulsants/adverse effects , Chronic Periodontitis/chemically induced , Gingival Overgrowth/chemically induced , Phenytoin/adverse effects , Adult , Chronic Periodontitis/therapy , Esthetics, Dental , Gingival Overgrowth/surgery , Humans , Male , Oral Hygiene
13.
Braz. dent. j ; 26(1): 39-43, Jan-Feb/2015. graf
Article in English | LILACS | ID: lil-735840

ABSTRACT

Phenytoin-induced gingival overgrowth (PIGO) is a common complication of the continuous use of medications. This paper presents a case of PIGO hindering oral function and compromising oral hygiene and aesthetics, which was treated with a combination of nonsurgical and surgical periodontal therapies. A 39-year-old male patient was referred for dental treatment with several complaints, especially upper and lower gingival overgrowth that hindered speech and swallowing. Generalized deep probing pockets and bone loss were detected. Diagnosis of gingival overgrowth associated with phenytoin and chronic periodontitis was established. The treatment plan consisted of conservative therapy with education on oral health, motivation and meticulous oral hygiene instruction in combination with scaling and root planing. During the revaluation period, a marked reduction in the clinical parameters was noted, particularly probing pocket depth reduction. Surgical therapy for removal of gingival overgrowth was also performed to achieve pocket reduction. Supportive periodontal therapy was proposed and the patient is currently under follow-up for 4 years. Management of PIGO may be obtained by the use of periodontal procedures combined with good oral hygiene and periodontal supportive care.


O crescimento gengival induzido pela fenitoína é uma complicação comum do uso contínuo da medicacão. Este artigo apresenta um caso de crescimento gengival excessivo que dificultava a função oral e comprometia a higiene oral e a estética, o qual foi tratado com uma combinação de terapias periodontais não-cirúrgicas e cirúrgicas. Paciente masculino de 39 anos de idade foi encaminhado para tratamento odontológico com várias queixas, especialmente do crescimento gengival superior e inferior que prejudicava a fala e deglutição. Profundidades de sondagens severas generalizadas e perda óssea foram detectadas. Diagnóstico de crescimento gengival induzido pela fenitoína e periodontite crônica foi estabelecido. O plano de tratamento consistiu de terapia conservadora com educação, motivação e meticulosa instrução de higiene oral em associação com raspagem e alisamento corono-radicular. Durante o período de reavaliação, uma acentuada redução nos parâmentros clínicos foi observada, principalmente uma redução das profundidades de sondagem. Terapia cirúrgica para remoção do excesso de tecido gengival também foi realizada para conseguir redução das bolsas. Terapia periodontal de suporte foi proposta e o paciente está atualmente sob acompanhamento por um período de 4 anos. O manejo do crescimento gengival induzido pela fenitoína pode ser obtido pelo uso de procedimentos periodontais combinados com uma boa higiene oral e cuidados periodontais de suporte.


Subject(s)
Humans , Male , Adult , Anticonvulsants/adverse effects , Chronic Periodontitis/chemically induced , Gingival Overgrowth/chemically induced , Phenytoin/adverse effects , Chronic Periodontitis/therapy , Esthetics, Dental , Gingival Overgrowth/surgery , Oral Hygiene
14.
J Med Life ; 7(2): 241-5, 2014 Jun 15.
Article in English | MEDLINE | ID: mdl-25408733

ABSTRACT

Gingival overgrowth is, among other things, a side effect of the administration of dihydropyridine antihypertensives, generally associated with irritant factors of marginal periodontium. This case refers to a patient, female, who developed a large gingival enlargement that has a combined etiology: the systemic medication with lercanidipina and the presence of dental bridges, which are incorrectly adjusted to the dental cervix. The treatment for this case, involved a complex local treatment (antimicrobial, surgical, endodontic and prosthetic) and the collaboration with a specialist cardiologist. Maintaining the normal gingival parameters in time depends on the possibility of changing the antihypertensive medication, the accuracy of the new dental bridges and the periodic monitoring of the patient.


Subject(s)
Calcium Channel Blockers/adverse effects , Denture, Partial/adverse effects , Gingival Overgrowth/etiology , Gingival Overgrowth/pathology , Hypertension/drug therapy , Calcium Channel Blockers/therapeutic use , Dental Prophylaxis , Dihydropyridines/adverse effects , Female , Gingival Overgrowth/chemically induced , Gingival Overgrowth/surgery , Gingivectomy , Humans , Middle Aged
15.
BMJ Case Rep ; 20142014 Oct 19.
Article in English | MEDLINE | ID: mdl-25331149

ABSTRACT

The authors describe a seminal case report of a 10-year-old boy with enlarged gingivae in relation to his maxillary anterior teeth. The lesion, provisionally diagnosed as idiopathic gingival enlargement, was completely excised and divided into two sections. The histological and immunohistochemical findings in one of the sections showed it to be characteristic of schwannoma while the other section showed indications of idiopathic gingival enlargement. The patient has been followed up carefully and no recurrence has been noted.


Subject(s)
Gingival Neoplasms/surgery , Gingival Overgrowth/surgery , Neurilemmoma/surgery , Child , Diagnosis, Differential , Gingiva/surgery , Gingiva/ultrastructure , Gingival Neoplasms/ultrastructure , Humans , Male , Neurilemmoma/ultrastructure
16.
J Mich Dent Assoc ; 96(7): 36-47, 2014 Jul.
Article in English | MEDLINE | ID: mdl-25163184

ABSTRACT

Localized overgrowths of gingiva such as peripheral fibroma, peripheral ossifying/cementifying fibroma, pyogenic granuloma and peripheral giant cell granuloma belong to a common group of lesions designated as focal reactive overgrowths (FROG). These growths are reactive in nature. They occur in response to chronic, low grade irritation caused by plaque or any other irritant. Etiology, clinical features and treatment modes of these lesions are the same with slight variations. The present case series describes five different cases of FROG where the lesions were treated by surgical excision under local anesthesia followed by a three month re-evaluation where no recurrences were observed.


Subject(s)
Gingival Overgrowth/diagnosis , Adolescent , Adult , Diagnosis, Differential , Female , Fibroma/diagnosis , Fibroma/surgery , Fibroma, Ossifying/diagnosis , Fibroma, Ossifying/surgery , Follow-Up Studies , Gingival Diseases/diagnosis , Gingival Diseases/surgery , Gingival Hyperplasia/diagnosis , Gingival Hyperplasia/surgery , Gingival Neoplasms/diagnosis , Gingival Neoplasms/surgery , Gingival Overgrowth/surgery , Gingivectomy/methods , Granuloma, Giant Cell/diagnosis , Granuloma, Giant Cell/surgery , Granuloma, Pyogenic/diagnosis , Granuloma, Pyogenic/surgery , Humans , Middle Aged , Young Adult
17.
BMJ Case Rep ; 20142014 Jul 21.
Article in English | MEDLINE | ID: mdl-25053668

ABSTRACT

Gingival enlargement or overgrowth (GO) is a common complication of the anticonvulsant drug phenytoin (PHT). GO is evident in almost half of the patients receiving PHT therapy. PHT-induced gingival overgrowth (PGO) is more common in children than in adults and affects both males and females equally. PGO may vary from mild to severe and does not seem to be dose dependant. It is supposed that PHT and its metabolites cause a direct effect on the periodontal tissues; however, poor oral hygiene may contribute to the severity of gingival inflammation in patients with PGO. Management of PGO includes meticulous oral hygiene practice to reduce inflammation and surgical excision of the overgrown tissue, known as gingivectomy. We present a case of PHT-induced severe GO in a 10-year-old boy and discuss the clinical features, aetiology, pathogenesis and management of PGO.


Subject(s)
Epilepsy/drug therapy , Gingival Overgrowth/chemically induced , Phenytoin/adverse effects , Anticonvulsants/adverse effects , Anticonvulsants/therapeutic use , Child , Diagnosis, Differential , Gingival Overgrowth/diagnosis , Gingival Overgrowth/surgery , Humans , Male , Oral Hygiene , Oral Surgical Procedures , Phenytoin/therapeutic use , Radiography, Panoramic
18.
Ghana Med J ; 47(3): 107-11, 2013 Sep.
Article in English | MEDLINE | ID: mdl-24391225

ABSTRACT

AIM: To compare the use of the 810nm diode laser with conventional surgery in the management of soft tissue mucogingival problems associated with orthodontic treatment. METHODS: Orthodontic patients requiring different soft tissue surgical procedures were randomly assigned to receive conventional surgery or soft tissue diode laser, (wavelength 810 nm). MAIN OUTCOME MEASURES: Parameters documented include the type of anaesthesia used, intra and post operative pain, bleeding, the use of scalpel and sutures. The chi-squared test was used to test for significance at 95% confidence level. Probability values (p-values) less than 0.05 were regarded as significant. RESULTS: Only 2(16.7%) of the procedures carried out with the soft tissue laser required infiltration anaesthesia compared to 10 (90.9%) with conventional surgery and this was significant (P<0.001). Post operative pain was significantly reduced in all cases treated with the diode laser (P<0.001). There was also a significant difference (P<0.05) in post operative bleeding in all cases treated with the diode laser. No sutures were used in all soft tissue cases managed with the diode laser and this was significant (P<0.001). There was no statistically significant difference in treatment time in the use of the laser compared with conventional surgery. CONCLUSION: Orthodontic patients treated with the diode laser required less infiltration anaesthesia, had reduced bleeding during and after surgery, rapid postoperative haemostasis, elimination of the need for sutures and an improved postoperative comfort and healing.


Subject(s)
Gingivectomy/methods , Gingivoplasty/methods , Lasers, Semiconductor/therapeutic use , Mouth Mucosa/surgery , Pain, Postoperative/etiology , Adolescent , Adult , Anesthesia, Local , Child , Female , Gingival Overgrowth/surgery , Humans , Lasers, Semiconductor/adverse effects , Male , Orthodontics , Tooth, Impacted/surgery , Tooth, Unerupted/surgery , Young Adult
19.
Compend Contin Educ Dent ; 33(5): e78-82, 2012 May.
Article in English | MEDLINE | ID: mdl-23268589

ABSTRACT

Gingival enlargement is a known side effect of calcium channel blockers--especially the dihydropyridine group. It is a serious concern for both the patient and the clinician due to its unesthetic appearance and formation of new niches for periodontopathogenic bacteria. Among the calcium channel blockers, gingival enlargement has most frequently been described as a side effect following administration of nifedipine. The incidence with amlodipine is much lower; however, there have been few reports showing the association of this drug with gingival enlargement. This case report aims to make dentists aware of the adverse effects of amlodipine, as well offers a brief review of its effects on the gingiva and the management of enlargement.


Subject(s)
Amlodipine/adverse effects , Antihypertensive Agents/adverse effects , Calcium Channel Blockers/adverse effects , Gingival Overgrowth/chemically induced , Female , Gingival Overgrowth/surgery , Humans , Hypertension/drug therapy , Middle Aged
20.
J Dent Hyg ; 86(4): 272-7, 2012.
Article in English | MEDLINE | ID: mdl-23168101

ABSTRACT

PURPOSE: This paper identifies 3 specific classifications of commonly prescribed medications that are known to cause gingival enlargement and describes surgical and non-surgical treatment therapies. Primary risks associated with drug-induced gingival enlargement, including increased dental decay and periodontal disease are also discussed. The precise bacterial etiology in gingival enlargement remains unclear, although sufficient evidence exists to support the role of good oral hygiene in decreasing the incidence and severity of gingival enlargement and improving overall gingival health. Etiology, treatment planning and coordination of care between physician, dentist or dental hygienist when indicated are important factors determining whether a surgical or non-surgical course of treatment should be considered.


Subject(s)
Gingival Overgrowth/chemically induced , Anti-Infective Agents, Local/therapeutic use , Anticonvulsants/adverse effects , Calcium Channel Blockers/adverse effects , Chlorhexidine/therapeutic use , Dental Plaque/prevention & control , Gingival Overgrowth/surgery , Gingival Overgrowth/therapy , Gingivectomy/methods , Humans , Immunosuppressive Agents/adverse effects , Laser Therapy , Mouthwashes/therapeutic use , Oral Hygiene , Patient Care Planning , Patient Care Team , Risk Factors , Surgical Flaps
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