Concentrated growth factor in the treatment of gingival. Effect of orthodontic treatment on periodontal health. Specifically, this gingival enlargement interfered with the wearing of a removable partial denture and was causing a distortion of the upper lip that affected her facial appearance. Gingival enlargement represents an overexuberant response to a variety of local and systemic conditions 1. However, sever enlargement associated with an aggressive type of periodontitis is an infrequent finding. Idiopathic gingival hyperplasia and orthodontic treatment. Journal of evolution of medical and dental science 2011. Gingival enlargement an overview sciencedirect topics. Aug 09, 2016 flap technique for gingival enlargement. Surgical approach to drug induced gingival enlargement in renal transplant patients case report christina popova, antoaneta mlachkova department of periodontology, faculty of dental medicine, medical university sofia, bulgaria journal of imab annual proceeding scientific papers 2007, vol.
Listing a study does not mean it has been evaluated by the u. The difference number of bacterial colonies between smokers and nonsmokers gingivitis patients in periodontics department at usu dental hospital. Gingival enlargement can be caused by a number of factors, including inflammatory conditions and the side effects of certain medications. Although the gingival index and sulcus bleeding index have been widely used as. Most important local factor appears to be the dental plaque and calculus, which in the presence of trauma, illfitting prosthetic appliances or presence. Gingival enlargement may result from the administration of. Druginduced gingival hyperplasia clinical presentation. In contrast to inflammatory gingival enlargement, the gum tissues in such cases are typically firm, nontender, pale pink in color, and do not bleed easily. The possibility of druginduced enlargement was ruled out based on the medical history. Learn the shocking truth about uterine fibroids, drugs and surgeries. The enlargement can be inflammatory,fibrotic or a combination of both. Gingivitis classification is useful for diagnosis, prognosis and treatment planning. Go is characterized by the accumulation of extracellular matrix in gingival connective tissues, particularly collagenous components, with varying degrees of inflammation. Gingival enlargement produces aesthetic changes and clinical symptoms including.
Unusual clinical presentation of generalized gingival. This case report presented the clinical features of a typical. However, the pseudo pockets formed by gingival enlargement make the maintenance of good oral hygiene difficult, perpetuating a cycle of inflammation and fibrosis the involved. Gingival enlargement is a ordinary finding in clinical practice and the appropriate treatment depends on correctly diagnosing the cause of the enlargement. Gingival enlargement induced by felodipine resolves with a conventional periodontal treatment and drug modification. Pdf the difference number of bacterial colonies between. Gingival overgrowth go is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers. A film of plaque adhering to the free gingival margin and adjacent area of the. Gingival enlargement and its treatment authorstream. Gingival enlargement may cause discomfort, interfere with speech or chewing, result in halitosis and unilateral gingival enlargement a case report kalburge j v, metgud rashmi abstract a 14 year old female patient suffered from unusual unilateral gingival enlargement on left. Stoopler and faizan alawi abstract pigmented lesions of the oral mucosa are encountered on a routine basis in clinical practice. There are many anticonvulsants, immunosuppressants and calcium channel blockers that may lead to gingival enlargement in varied presentations table table1 1 and figure figure7. Unilateral gingival enlargement an unusual case report. Several causes of gingival hyperplasia are known, and the most recognized is druginduced gingival enlargement.
Hence, the identification of these factors and precise diagnosis forms the key to proper treatment planning. Prescription of calcium channel blockers is relatively common, making it difficult to determine the true incidence of druginduced gingival enlargement. Most prevalent are the inflammatory type and druginduced type of gingival hyperplasia. Gingival enlargement associated with multiple factors is leading to gingival dimorphism agrawal, 2015. Unusual clinical presentation of generalized gingival enlargementa report of 3 cases. Larger areas of gingival enlargement more than 6 teeth or areas where attachment loss and osseous defect are present should be treated by the flap technique, as should any situation in which the gingivectomy may create a mucogingival problem. The periodontal flap technique used for the treatment of.
The differential diagnosis included enlargement due to drugs e. Gingival enlargement can occur by taking certain medications, leading to problems in speech, eating, teething functions and aesthetics. Programs on maintaining good oral hygiene while using fixed orthodontic appliances should be taught as a prevention measure in maintaining healthy gingival and. Gingival enlargement the currently accepted terminology for an increase in the size of the gingiva, is a common feature of gingival disease. The purpose of this study was to determine if keratinized gingiva has an effect on the success of implants. Selfinflicted gingival injuries in children and adolescents can occur as a result of accidental trauma, premeditated infliction, or chronic habits such as fingernail biting, digit sucking, or sucking on objects such as pens, pencils or pacifiers.
Mechanism of azithromycin treatment on gingival overgrowth. Health, general anticonvulsants health aspects chronic myeloid leukemia case studies gingivitis care and treatment causes of diagnosis gum diseases nifedipine complications and side. Gingival hyperplasia is a histopathology diagnosis based on a gingival biopsy. Furthermore, causes of congenital gingival enlargement include hereditary and metabolic disorders, such the fetal valproate syndrome. Gingival enlargement ge, also known as gingival overgrowth or hyperplasia. These results are consistent with a significant role of oestrogen during primate pregnancy in the fig.
To get the facts on exactly how to eliminate your uterine fibroids from the root 100% naturally and permanently and achieve lasting freedom from pcos related symptoms without spending your hardearned money on drugs and over the counters. Chronic inflammatory gingival enlargement also called as chronic hyperplastic gingivitis is an enlargement of the gingiva as a result of chronic inflammation due to local or systemic factors. Case report chronic inflammatory gingival enlargement. Gingival enlargement can be hereditary or acquired. Gingival enlargement is a welldocumented and extensively researched condition in the field of dentistry but the diagnosis of this condition is complicated by a variety of interrelated factors in its etiology and progression. Gingival enlargement associated with use of phenytoin is. Signs and symptoms related to gingival enlargement are seen within 24 mo of initiation of drug intake. A customized decision tree is designed, which will help clinicians to keep a broad view when formulating a differential diagnosis of localized isolated, discrete, regional or generalized gingival enlargement and arrive at a particular diagnosis is an easy and systematic manner. A healthy 56year old african american woman was concerned about a large growth of the maxillary gingiva. Localized gingival enlargementa diagnostic dilemma. Pregnancy induced gingival enlargementa case report.
Enlargement of the gingiva can be due to various causes. Etiology of pigmented lesions may be attributed to a local phenomenon andor. A case series atul anand bajoria 1, m l asha 2, medha babshet 3, preeti patil, piyush sukhija 1 1 postgraduate, department of oral medicine and radiology, sri hasanamba dental college and hospital, hassan, karnataka, india, 2 professor and. Jan 17, 2015 having read this chapter, the reader should be aware of the contemporary surgical techniques used for the surgical management of gingival overgrowth. Licensed under creative commons attribution cc by unilateral gingival enlargement an unusual case report motazatia1, yosra ali2, yasiryousif3. Cyclosporineinduced gingival enlargement is more vascularized than phenytoin enlargement figures 1610 and 1611. Bds, mfdrcsi, msckhatroum university, paedodontics national ribat university, sudan. Concentrated growth factor in the treatment of gingival recessions the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. These are strictly clinical descriptive terms, and they avoid the erroneous pathologic connotations of terms used in the past, such as hypertrophic gingivitis and gingival hyperplasia. Chan3 verifiable cpd paper condition of root surface presence of calculus, caries, contaminated cementum or restorations on root surface prominent fraenal attachments depth of vestibule. Pregnancy induced gingival enlargementa case report t. The management is complex in nature considering the multitude of factors involved such as substitution of drug strict plaque control along with excision of the tissue to be. Gingival enlargement is an increase in the size of the gingiva gums.
Gingival enlargement may result from the administration of 1. Druginduced gingival overgrowth remains the most widespread unwanted effect of systemic medication on the periodontal tissues. Gingival enlargement can occur in one area of the mouth or generalized throughout all four quadrants of the mouth. One of the main drugs associated with go is the antiepileptic. Inflammatory gingival enlargement a case report nitin tomar 1, gazal jain 2, anamika sharma 3, amit wadhawan 4 1,4 reader, 2 pg student, 3 professor and head of department, subharti dental college. Gingival overgrowthhyperplasia can be attributed to several causes, but druginduced gingival overgrowthhyperplasia arises secondarily to prolonged use of antihypertensive drugs, anticonvulsants and immunosuppressants. Gingivitis may improve with the following measures. Background druginduced gingival overgrowth digo is a wellknown adverse effect of cyclosporine a csa and nifedipine nf therapy. Having read this chapter, the reader should be aware of the contemporary surgical techniques used for the surgical management of gingival overgrowth. Study 43 gingivitis and gingival enlargement flashcards from matthew l.
Idiopathic gingival enlargement is a type of gingival fibromatosis characterized by progressive overgrowth of the gingival tissues. The accepted current terms for this condition are gingival enlargement and gingival overgrowth. It is hoped that the reader will understand which types of gingival enlargement are amenable to surgical treatment and be aware of alternative key management strategies. Gingival enlargement associated with use of cyclosporine. It is distributed in accordance with the creative commons attribution non commercial cc bync 4.
Every case of gingival enlargement should be treated in a stepwise manner inclusive of consultation with patients physician, substitution of the drug, nonsurgical and surgical therapy. Neoplastic enlargement gingival enlargement is a common finding in clinical practice and the appropriate treatment depends on correctly diagnosing. Surgical management of gingival overgrowth pocket dentistry. Appropriate management for the relief of symptoms of primary herpetic gingivostomatitis in an immunocompromised patient may include 1. The importance of keratinized gingiva surrounding dental. Sometimes the lesions are termed gingivitis artefacta. Gingival enlargement is the correct term to use when seen on oral exam. Pdf idiopathic gingival enlargement and its management. Gingival enlargement is the most common adverse drug drug effect in the young adults and children receiving phenytoin as antiepileptic drug therapy.
Pdf drug induced gingival enlargement researchgate. Surgical management using free grafts and guided tissue regeneration m. Plaque induced inflammation appears to be a general stimulating effect regardless of the mechanism of gingival enlargement. These are strictly clinical descriptive terms and they avoid the erroneous pathologic connotations of terms of terms used in the past, such as hypertrophic and gingival hyperplasia.
Currently, more than 20 prescription medications are associated with gingival enlargement,1 and an estimated 5% of the elderly outpatient population in the united states is taking these medications. Laserassisted periodontal management of druginduced. This is strictly a clinical description of the condition and avoids the erroneous pathologic connotations of terms used in the past such as hypertrophic gingivitis or gingival hyperplasia. Severe gingival enlargement associated with aggressive. Gingival enlargement induced by felodipine resolves with a. More than 20 prescription medications are associated with gingival overgrowth. An increase in size of the gingiva is a common feature of gingival disease. Management of druginduced gingival enlargement australian. Regardl ess of its cause, gingival enlar gement can cause problems in controlling pl aque, chewing, teething, speech and aesthetics 1. Atul anand bajoria, department of oral medicine and radiology, sri hasanamba dental college and hospital, hassan. Gingival enlargement definition of gingival enlargement by.
Gingival enlargement may cause discomfort, interfere with speech or chewing, result in halitosis bad odour to the breath and it may look unsightly. Academy report 1424 a n increasing number of medications are associated with gingival enlargement. Phenytoin is an anticonvulsant which is seen to cause gingival enlargement in human patients with a reported incidence of 50%. To the right is an example caused by the cardiovascular drug nifedipine.
Feb 29, 2016 gingival enlargement induced by felodipine resolves with a conventional periodontal treatment and drug modification nabil khzam, 1 david bailey, 1 helen s. Gingival gum enlargement, also known as gingival hyperplasia or hypertrophy, is an abnormal overgrowth of gingival tissues. Feb 21, 2017 the enlargement can be inflammatory,fibrotic or a combination of both. In recent years,flap surgery have been used more often to treat gingival enlargement than gingivectomy.
Treatment of gingival enlargement by dr harshavardhan patwal. Oral healthcare providers must assess several parameters associated with pigmented lesions,suchaslocation,shape,color,andsize. There are several causes of gingival enlargement and they can be grouped into four categories. As gingival enlargement develops, it affects the normal oral hygiene practice and may interfere with masticatory functions. In july, 2015 the aap announced a focused update that addresses three specific areas of. The classification presented below is from development of a classification system for periodontal diseases and conditions by gc armitage, dds 1999 and is used by the american academy of periodontology aap. Introduction gingival enlargement is a common feature of gingival disease and may be caused by fibrous overgrowth or gingival inflammation or a combination of two.
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