Gingival Overgrowth Research Articles

Prognostic factors for wellbeing in patients with hyaline fibromatosis syndrome.

Hyaline fibromatosis syndrome (HFS) is a congenital disorder characterized by subcutaneous skin nodules, congenital multiple arthrogryposis, gingival hyperplasia, and chronic pain. The intellectual ability of patients with HFS is generally normal. This syndrome arises from variants of ANTXR2. Thus far, about 100 cases have been reported but few of these were reported from Japan. This study reports five additional Japanese patients with genetically confirmed HFS, from unrelatd families, and discusses the clinical course and quality of life of these patients. At our last visit the ages of the patients were 3-19 years (the median age was 5 years). All the patients had arthrogryposis, skin nodules, and gingival hyperplasia, and four patients had chronic pain, all of which are distinctive, clinical characteristics of HFS. Four of the patients (80%) had pruritic skin nodules, and three experienced sleep disruptions due to pruritis. The visceral complications are an index of HFS severity. One patient in the present cohort had a mucosal abnormality without any gastrointestinal symptoms. Preventive and routine management of pruritis caused by skin nodules should be shared with the patient's family. Even asymptomatic patients might have endoscopic finding, which would be a soft marker that could predict the development of protein losing enteropathy.

Ciclosporin oral solution in cats: a retrospective survey of compliance with treatment and adverse effects.

The aim of the study was to assess long-term ciclosporin oral solution compliance in cats treated for feline atopic skin syndrome (FASS). A survey was sent by email to 114 owners who had administered ciclosporin oral solution to their cats for FASS. In total, 42 owners completed the survey. The population was composed of 30 domestic shorthair cats and 12 pure breeds. There were 20 males and 22 females, and the median age was 5.5 years. Ciclosporin oral solution was administered directly into the mouth in 32/42 (76%) and with food/other in 10/42 (24%) cats. The administration was considered easy in 18/42 (43%) cats, difficult in 23/42 (55%) and impossible in 1/42 (2%). Treatment was stopped in 25/42 (60%) cats. The causes were as follows: administration difficulty (nine cats, 21%); complete resolution (four cats, 10%); treatment failure (four cats, 10%); price (two cats, 4%); and other causes (two deaths, two neoplasia, one adverse effect and one lack of compliance). Adverse effects involving clinical signs were reported in 25 (60%) cats: ptyalism (8/42); dysorexia/anorexia (6/42); vomiting (4/42); diarrhoea (4/42); gingival hyperplasia (1/42); and a combination of vomiting, diarrhoea and ptyalism (2/42). In addition, altered behaviour was reported in 27/42 (64%) cats: hiding in seven cats; scared of owner in 10 cats; modification of sleeping or playing activity in six cats; inappropriate urination/defecation in two cats; aggression in one cat; and all of the above in one cat. In total, 24 (57%) cats had adverse effects involving both clinical signs and altered behaviour, and only six cats had either adverse clinical signs or behavioural changes. This survey showed that behavioural changes appear to be underestimated in the cats treated with ciclosporin oral solution and this could cause treatment failure due to lack of compliance. Larger-scale studies are needed to confirm these preliminary results.

Leukemic gingival enlargement- A case report and review

Oral signs are an early indicator for a variety of systemic diseases. Gingival enlargement can be due to local factors, certain medications, hormonal changes, and malignant diseases. Leukemia is a malignancy characterized by the proliferation of abnormal white blood cells within the bone marrow; oral changes may be the first and only presenting feature in these patients, making it imperative for dental surgeons to make accurate diagnosis and timely referral to prevent a fatal situation. This article aims to discuss a case of acute myeloid leukemia (AML) that came with the chief complaint of swollen gums for 2-month duration. The case was provisionally diagnosed as a leukemic gingival enlargement on the basis of oral manifestation and lymph node examination. Accurate diagnosis and early initiation of chemotherapy for leukemic gingival enlargement can improve the prognosis of the patient and also helps in avoiding complications. Around 50–80% of patients with AML achieve complete remission, more often in children and patients under the age of 60. This paper aims at emphasizing the importance of thorough oral examination and careful investigations to identify the underlying life-threatening condition.

How much information regarding gingival enlargement can we get from TikTok and YouTube?

This study aimed to evaluate and compare the reliability and quality of the information about gingival enlargements on YouTube and TikTok. Two popular video sites, YouTube and TikTok, were searched for gingival enlargement and gingival hyperplasia. The reliability and quality of the first 300 videos for each search term, which is 1200 videos in total, were evaluated by social media video content evaluation tools: Global Quality Score (GQS) for quality and modified DISCERN for reliability. Health professionals uploaded 68.6% of the videos on YouTube and 54.5% on TikTok. It was observed that 50% of TikTok videos and 65.9% of YouTube videos were educational. In terms of quality, 2.7% of the videos on YouTube are of excellent quality, while in TikTok there are no videos of perfect quality. TikTok videos had considerably more views, likes, viewing rates, and interaction index scores than YouTube videos (P < 0.01). The videos and pieces of information on YouTube are more reliable and accurate in terms of gingival enlargement when compared to TikTok.Nevertheless, it was discovered that videos on both platforms were of poor reliability and quality in general.

Dermatoglyphics: The elusive nexus decoding the conundrum of amlodipine-induced gingival enlargement – A cross-sectional, pilot, observational study

Abstract: Background: Dermatoglyphics is a scientific study dealing with the dermal ridge configurations of the palmar and plantar surfaces of the upper and lower limbs. Drug-induced gingival enlargement refers to engorgements in gingiva as a consequence of drug usage. This pilot study was done to see the pattern of fingerprints using dermatoglyphics and amlodipine-induced gingival enlargement in hypertensive patients. Materials and Methods: The subjects for the study were prospectively recruited from the outpatients reporting to the Department of Periodontology, Tamil Nadu Government Dental College during the study period of 3 months following the inclusion criteria. Twenty people presenting with amlodipine induced gingival enlargement were thus recruited for the study and their fingerprint patterns were recorded and analyzed with the assistance of magnifying lens. Results: It was thus observed that there was a preponderance of whorls (55%) while observing fingerprint patterns of the recipients of amlodipine presenting with gingival enlargement. Females outnumbered males in the study. The gender difference was seen in the type of fingerprint. A preponderance of whorls (55%, 11 participants) 30% arch (6 participants) and 15% with loop (3 participants). Similar results were recorded in both genders with whorl recording the highest incidence of 80% and 46.67% in males and females, respectively. No zero loop patterns were recorded in males. Conclusion: The relative preponderance of whorls being observed in this study might be a predictive marker for those amlodipine consumers with a heightened predilection to develop gingival enlargement The subdued expression of loops which are otherwise the most commonly expressed fingerprint pattern among the humans, and the ascendancy of whorls characterizing this category of people is indeed a finding, which by further supportive studies, could help find preventive strategies to combat amlodipine-induced gingival enlargement.

Amlodipine-induced gingival overgrowth in a patient with hypertension

Amlodipine-induced gingival overgrowth (AIGO) is characterized by an increase in the volume of connective tissue matrix in the gingiva. Amlodipine is one of the commonly prescribed antihypertensive drugs, and gingival hyperplasia is one overlooked side effect in patients taking amlodipine. Many factors can contribute to the development of gingival overgrowth, including: plaque control; periodontal variables; medications and their relative dose; age; sex; and, genetic factors. Currently, more than 20 prescription medications are associated with gingival enlargement. Drugs associated with gingival overgrowth can be broadly divided into three categories: Anticonvulsants, calcium channel blockers, and immunosuppressant. In the present case, a 66 year old male patient who presented with gingival overgrowth and was found taking Amlodipine for 20 year.

Hereditary Gingival Fibromatosis: A Case Report and Review of Literature

Hereditary gingival fibromatosis (HGF) has been defined as a rare disorder characterized by a benign, nonhemorrhagic, fibrous gingival overgrowth that can appear in isolation or as part of a syndrome. Because it has no specific cause, it is also known as idiopathic gingival fibromatosis. HGF starts in its mildest form and progresses very slowly to reach a severe form that can cover the teeth, causing severe functional and cosmetic problems. Clinically, it appears as diffuse or localized gingival overgrowth, pinkish, and firm in consistency that could be seen in both the buccal and lingual gingiva of both the mandible and maxilla. There could be ulceration and bleeding secondary to traumatic biting on the lesion. We report a case of a 12-year-old boy who presented with 5-year history of multiple gingival lesions clinically diagnosed with HGF. The relevant literature and important aspect in the management of this condition has also been discussed.

Oral sedation using triclofos for short dental procedures in a precooperative child

Abstract A 1-year 6-month-old male child reported the chief complaint of pain and bleeding from the gums for the past 7 days in the upper left front tooth region. On intraoral examination, the patient had a crown-root fracture involving tooth 61 with gingival overgrowth almost covering the distal half of the fractured crown. A diagnosis of Ellis class IX fracture in relation to tooth 61 was made, and the planned treatment was extraction. However, since the child was precooperative, a simple chairside extraction was not possible. Thus, the extraction was carried out with oral sedation using triclofos on an outpatient basis.

Juvenile Hyaline Fibromatosis- Child with Scalp Swellings

Juvenile hyaline fibromatosis is a recessive autosomal hereditary disorder characterized by abnormal growth of hyalinized fibrous tissue. Its clinical presentation is manifested by benign skin lesions, bone lesions, joint contractures, and gingival hyperplasia. The underlying cause is an abnormal growth of hyalinized fibrous tissue with cutaneous, mucosal, osteoarticular, and systemic involvement. This report presents a case of a 4-year-old male child; with complaints of multiple painful body swellings and pus discharge from scalp swellings for the past two years admitted at Dr. Ruth Pfau Civil Hospital, Karachi, 2021. This patient had right occipital scalp swelling of 10x 10 cm due to which surgery was done and the excision was successful. Other findings included stiff joints, skin overgrowth over the scalp and back + buttocks, multiple firm cystic swellings on the scalp, back, trunk, and whole body involving the face (nose), anal region, gum hypertrophy, and various papules over the nose.

Oral Surgery and Dental Implants in Patients with Chronic Kidney Disease: Scoping Review for Oral Health Status.

The number of chronic kidney disease (CKD) patients requiring renal replacement therapy is increasing, often exhibiting oral manifestations including periodontal disease, gingival hyperplasia, altered saliva composition, and uremic stomatitis. Uremic stomatitis, xerostomia, and candidiasis are very frequent, particularly among patients undergoing dialysis or kidney transplant recipients. CKD patients also experience profound alterations in bone metabolism inherent in the homeostasis of calcium, phosphorus, vitamin D, parathyroid hormone, and fibroblast growth factor (FGF). These alterations lead to demineralization of the jaw bones, reduced bone trabeculae, reduced cortical bone thickness, fibrocystic bone lesions, bone fractures, and delayed wound healing post-tooth extraction. Consequently, oral health management of elderly hemodialysis patients poses serious clinical problems. This review focused on the oral health and rehabilitation of patients with CKD or on dialysis.

Nonsurgical management of puberty-associated gingival enlargement in an adolescent female: a case report with a follow-up of 6 months

Sex hormones have long been thought to have an impact on periodontal tissue, bone turnover, wound healing, and the development of periodontal disease. In adolescence, hormonal changes may affect both male and female gingival tissues, altering the tissues’ response to dental plaque and perhaps causing conditioned gingival growth. Such overgrowths may cause several issues, including speech difficulties, gum bleeding, and even aesthetic problems. The ability to deal with hormonal factors linked to the reproductive process is well understood by oral health-care experts. In the current case study, we have covered how to treat gingival inflammatory overgrowth associated with puberty through a nonsurgical approach. The present case report leads us to conclude that nonsurgical treatment for puberty-induced gingival enlargement is the best alternative treatment option than surgical intervention.

Case series of infantile systemic hyalinosis: Suggested diagnostic criterion

Background: Infantile systemic hyalinosis (ISH) is a rare autosomal recessive disease which happens within the first weeks of life. It is present in Saudi Arabia due to positive parental consanguinity. A suggestive diagnostic criterion was proposed which would be helpful in determining ISH. Case Presentation: Seven children were diagnosed with infantile systemic hyalinosis based on clinical pictures and histopathological examination. A prospective consecutive and observational study was designed to determine the diagnostic criteria of ISH. On clinical examination, all patients had joints contractures which lead to frog like position, hyperpigmentation overlying the distal joints, in addition to failure to thrive. Only five patients of seven (71.42%) had erythematous papules coalesce to form plaque on the posterior neck. Out of seven, four patients (57.14%) had nodules (perianal &amp; subcutaneous), and gingival hypertrophy. Three patients of seven (42.85%) had intractable diarrhea. And just one patient (14.28%) had small pearly skin papules on the face. Hyaline deposits were evident in histopathological examination of the skin biopsies for all the patients. Although, severity index and genetic study was unavailable Conclusion: Infantile systemic hyalinosis is a congenital disease characterized by excessive hyaline deposits. Diagnostic criterion was evaluated for the seven patients as three major criteria and five minor criteria. It was suggested that the presence of all three major criteria or two major and two minor criteria is essential for the diagnosis of infantile systemic hyalinosis. The diagnostic criterion would help in the early evaluation of the disease prognosis and would enhance early intervention.

Lobular Capillary Haemangioma in the Anterior Maxillary Gingiva of a Six-year-old Patient: A Case Report

Haemangiomas are benign proliferative tumours with vascular tissue origin. These neoplasms are recognised as benign tumours commonly found in infancy, characterised by a period of rapid growth accompanied by proliferation of endothelial cells, followed by gradual involution. The male to female ratio is observed to be 3:1, with a predominant impact on the female population, particularly during the early stages of their second decade of life. The diameter of the lesion spans from a few millimeters to several centimeters, with rare instances exceeding 2.5 cm. The present case report details the occurrence of Lobular Capillary Haemangioma (LCH) in a young male patient of six years, who exhibited gingival overgrowth in the anterior maxillary region. The patient presented with symptoms of discomfort during mastication, occlusal interference, and excessive hemorrhage during oral hygiene practices. Due to the lesion’s extensive blood supply and the confirmation of the diagnosis in the histology report, it was surgically removed in a single session while the patient was under conscious anaesthesia. The patient underwent a thorough six-month follow-up examination, which demonstrated a favourable outcome with no evidence of lesion recurrence. Although haemangiomas are prevalent soft tissue tumours in the head and neck region, they are infrequently found in the oral cavity and rarely encountered by doctors. Intraoral haemangiomas most commonly occur in the lips, tongue, buccal mucosa, and palate. However, this case report describes a rare occurrence in the maxillary anterior site, which has limited documentation. The treatment involved the use of monopolar cautery, which effectively reduced bleeding at the surgical site after the use of a scalpel. The purpose of present case report is to report an unusual case of a benign tumour occurring in the anterior maxillary region, which was diagnosed as LCH.

Avaliação de parâmetros periodontais em pacientes transplantados renais que usam medicações imunossupressoras: estudo transversal

ABSTRACT Objective: The aim of this study was to evaluate periodontal parameters in renal transplant patients compared to a control group, due to the possible interference caused by the use of immunosuppressive medication. Methods: This was a cross-sectional observational epidemiological study of 80 patients. The transplant patients consisted of 40 patients, in whom the plaque index, clinical probing depth, clinical attachment level, bleeding on probing and the presence of gingival hyperplasia were analyzed. The control group, made up of 40 patients, was assessed according to the same indices. Results: No statistically significant difference was found between the groups with regard to the presence of plaque (p = 0.279), bleeding (p = 0.262), severity (p = 0.707) and location (p = 0.949) of periodontitis, only in relation to the grade (p = 0.041), where grade C was more present in transplant patients, with transplant time being a contributing factor. The presence of hyperplasia (p = 0.021), the gingival bleeding index (p = 0.011) and the plaque index (p = 0.031) were significantly higher in patients taking Ciclosporin. transplant patients had rapidly progressing periodontitis. Conclusion: Increased gingival volume, bleeding and plaque index were more associated with Ciclosporin use.

Non-surgical management of inflammatory gingival enlargement associated with malocclusion, mouth breathing and incompetent lips: A case report

Non-surgical management of inflammatory gingival enlargement associated with malocclusion, mouth breathing and incompetent lips: A case report

Management of initial and surgical management of amlodipine-induced gingival enlargement with multifactorial etiology: a case report with 6 months follow-up

Drug-induced gingival enlargement can be seen as a side effect of systemically used drugs such as calcium channel blockers, anticonvulsants, and immunosuppressants. One of these drugs is amlodipine, a dihydropyridine derivative calcium channel blocker used in the treatment of high blood pressure and coronary artery disease. Amlodipine-induced gingival overgrowth is rarely seen compared to other calcium channel blockers. The aim of this case is to present the diagnosis of gingival overgrowth due to amlodipine use and the identification of other etiologic factors such as labial frenulum, phase 1 initial, and phase 2 surgical treatment approaches. A 56-year-old female patient presented to our clinic with severe gingival overgrowth, intense bleeding, difficulty feeding, and pain. The anamnesis revealed that she had hypertension and had been taking amlodipine derivative Norvasc 10 mg once a day for 8 years. A look inside the mouth showed that there was a lot of gum tissue growing over the crowns from the labial and palatal sides, mainly in the front of the maxilla. Phase 1 treatment was initiated. As a result of the consultation with the patient's cardiologist, the hypertension medication Norvasc 10 mg was replaced with Candexil 16 mg by the medical physician. The preoperative tension and blanch test was positive, and the labial frenulum was seen to mobilize the free gingival margin of the central teeth. After the same session of gingivoplasty, the labial frenulum was removed by a frenectomy operation. After the operation, antibiotics, analgesics, and mouthwash were prescribed. The patient stated that he did not have any problems after the operation. 6-month follow-up showed uneventful healing. No recurrence of gingival growth was found in the 1st, 3rd, and 6th month follow-ups. In conclusion, this case report shows that non-surgical periodontal treatment alone isn't always enough to treat drug-induced gingival overgrowths. The gingival shape should be changed so that the patient can properly clean their teeth, and drug-induced gingival overgrowths, like the one in this case, may have more than one cause and may need additional surgery like a labial frenectomy.

Amlodipine Induced Gingival Enlargement- A Case Report

Exuberant proliferation of gingival soft tissues in response to local and systemic conditions leads to gingival overgrowth which may create speech problems, difficulty in mastication, altered tooth eruption, and esthetic problems. Gingival enlargement can also occur as a side effect of certain drugs like calcium channel blockers, anti-convulsants and immunosuppressants given for systemic diseases. Hypertension is the major risk factor for cardiovascular diseases. Amlodipine has been widely used from past 2 decades in the management of hypertension and stable angina because of its good efficacy and safety compared with other antihypertensive medications. Here we report a rare case of Amlodipine induced severe gingival enlargement in a 61year old hypertensive male patient taking a dose of 10 mg per day in two divided doses.

Diagnosing an Acute Leukemia From a Necrotizing Ulcerative Gingivitis in The Oral Cavity: a Case Report

Background: Necrotizing ulcerative gingivitis (NUG) is an acute onset of gingival disease, that presents as an acute, painful, and destructive ulceration and inflammation of gingival tissue. This condition is one of the oral manifestations of leukemia in addition to gingival enlargement and spontaneous bleeding, oral ulceration, petechiae, hematoma, and pale mucosa. Case Report: We reported A 50-year-old woman presented with gum swelling, pain, and easy bleeding in the lower jaw gums. The patient often experiences fatigue, spontaneous bruising, dry skin, and hair loss. Extraoral examination revealed bruises on the hand. Intraoral examination revealed swelling, erythematous and ulcerative lesion, tartar, bleeding on probing in the lingual gingiva of lower central incisor teeth, mucosa pallor, and minor petechiae were observed at the buccal mucosa region 47-48. The provisional diagnosis was NUG with suspicion of systemic disorder. Result: A complete blood count was performed which showed anemia, leukopenia, neutropenia, lymphocytosis, and thrombocytopenia. We diagnosed NUG in acute leukemia patients. Conclusion: This case demonstrates the detection of leukemia and its oral manifestations in acute leukemia patient. The patient was referred to the hematologist oncology.

Dental Treatment Approach in an Adolescent Patient With Coffin-Siris Syndrome

Coffin-Siris Syndrome (CSS) is a rare genetic disease with delayed growth, congenital anomalies, abnormal facial features, and mental retardation. Hypoplasia of the 5th fingers or nail agenesis, hirsutism, coarse facial appearance, thick eyebrows, wide lips and nose, dentofacial anomalies, and delayed eruption of teeth are clinically distinctive features. Specific findings and multidisciplinary approac-hes are important for dental treatments. This case report includes the clinical, oral findings, and dental treatments of the patient with CSS. A 15.5-year-old female patient consulted our clinic with the complaint of tooth sensitivity and missing teeth. The patient's family was informed that the patient has CSS. In clinical examination, coarse face, mental retardation, hypoplastic 5th fingers, wide mouth, and lips, sparse hair, and hirsutism, in the oral examination, poor oral hygiene, dental caries, delayed dentition, lack of upper perma-nent first incisor, gingival hyperplasia, gingivitis, and hypoplasia were seen. Panoramic radiography and tomography revealed that the upper permanent incisor and supernumerary canine teeth were impacted. Under general anesthesia, dental scaling, fillings were made, impacted permanent incisors, canine, and lower left third molars were extracted. After general anesthesia, fluoride application and a fiber-supported Maryland bridge designed from the patient's teeth were applied to the anterior region. Regular controls of the patient continue. After the growth and development, the oral surgery department will be consulted for implant application. In den-tistry, preventive applications, oral hygiene motivation, pharmacological and non-pharmacological treatments are important for CSS patients. After consultation with relevant departments, multidisciplinary approaches and appropriate treatments increase the quality of life.

Comprehensive management of gingival epulis

This case report explores gingival epulis, a rare gingival overgrowth, in a 19-year-old male patient (Record No: 26936-23). Gingival diseases often manifest as enlargements with varied appearances, complicating diagnosis. The report highlights the importance of differential diagnosis based on factors like location, size, and etiopathogenesis, emphasizing the role of extensive investigation in confirming diagnoses. Gingival epulis, typically a painless, pedunculated swelling often caused by irritants like dental plaque or trauma, is detailed. This case is unique due to the patient's history of dust allergies, adding complexity to the diagnosis and treatment approach.