Management Of Gingival Enlargement Research Articles

Gingivectomy using scalpel as a management of gingival enlargement in patient under orthodontic treatment

Gingivectomy using scalpel as a management of gingival enlargement in patient under orthodontic treatment

Drug-Induced Changes in the Gingival Tissue

Abstract Introduction Drug-induced gingivitis is caused by the administration of certain drugs such as hydantoin, calcium blockers, beta-blockers, cyclosporine, and oral contraceptives. The aim of this study was to evaluate the modifications linked to drug-induced gingivitis such as changes in color, volume, and consistency, and the clinical signs of periodontal disease. Materials and methods The study was based on a questionnaire made up of 14 questions, formulated using colloquial language to increase addressability. Results The most frequently used drugs were beta-blockers (37%), calcium channel blockers (33%), followed by anticonvulsants (18%), oral contraceptives (8%) and cyclosporine (4%). Color changes occurred in 81% of anticonvulsant treatments and 57% of oral contraceptives. Increases in the gingival volume were higher with anticonvulsants (73%) followed by cyclosporine (67%). Gingival consistency was higher with anticonvulsant treatments (90%), followed by calcium channel blockers (60%). Gingival changes and gingival bleeding during brushing were higher with anticonvulsant treatments, followed by beta-blocker medication. Spontaneous gingival bleeding had a higher prevalence in anticonvulsant treatments, followed by cyclosporine. Conclusions The patients most affected by gingival enlargement were those under hydantoin treatment, followed by cyclosporine. Calcium channel blockers and beta-blockers had similar effects on gingival pathology. The intensity of the pathological changes that occurred secondary to the administration of these drugs was influenced by the dose, the duration of the treatment, and the association of several drugs. Early detection and management of gingival enlargement is important in order to allow patients to continue with their therapy, and also to increase their quality of life.

Management of gingival enlargement with orthodontic treatment- A case report

Gingival inflammation, fibrous outgrowth, or a combination of the two can result in gingival enlargement (GE), which has negative effects such as difficulties controlling plaque, difficulty chewing and speaking, as well as esthetic and psychological issues. Orthodontic treatment is one of the causes of gingival hypertrophy. A 20-year-old woman reported to the department of periodontics and oral implantology with a complaint of GE in relation to the front teeth. She was undergoing orthodontic treatment for treating tooth spacing in the anterior teeth. This article describes the treatment of this patient by gingivectomy to remove all extra gingival tissue. The fixed orthodontic treatment was continued with monthly periodontal checkups that were scheduled to control the gingival inflammation. The most crucial factor in successfully treating hyperplasia in patients receiving orthodontic treatment is teamwork between the periodontist and orthodontist.

Management of gingival enlargement by medical & non surgical dental therapy in a cerebral palsy patient - A case report

Gingival enlargement develops as an exaggerated response of periodontal tissues to local factors like dental plaque and dental calculus. Systemic conditions like cerebral palsy, where mental deficiency and loss of manual dexterity is a contributing factor for poor oral hygiene, sometime manifest as gingival enlargement. Nutritional deficiency in combination to systemic disease and conditions, further contributes to an altered response of periodontal tissues to dental plaque and calculus, which may sometimes clinically manifest as gingival enlargement (generalized or localized). Vitamin C deficiency presents with various oral manifestations, specially causing conditioned gingival enlargement. Anemia is also one of the systemic disease/conditions affecting periodontal tissues. Management of these various conditions manifesting as gingival enlargement, warrants diagnosis and treatment of the underlying cause. It becomes more challenging when all these conditions co-exist, demanding a holistic comprehensive approach, not only for addressing the patient’s chief complaint, but also, improving the overall oral and general health as well. This case report is an attempt to discuss the management of an unusual case of massive gingival enlargement mainly due to vitamin C deficiency in an anemic cerebral palsy pediatric patient. Keywords: Anemia, Ascorbic acid deficiency, Cerebral palsy, Gingival overgrowth. Key Messages: Maintenance of proper oral hygiene and nutritional supplementation is essential for overall health of cerebral palsy patient

Surgical and laser gingivectomy are effective adjuncts to nonsurgical periodontal treatment used to reduce probing depth in patients with gingival enlargement secondary to orthodontic treatment with fixed appliances

Lione R, Pavoni C, Noviello A, Clementini M, Danesi C, Cozza P. Conventional versus laser gingivectomy in the management of gingival enlargement during orthodontic treatment: a randomized controlled trial [published online ahead of print May 21, 2019]. Eur J Orthod. https://doi.org/10.1093/ejo/cjz032.

Conventional versus laser gingivectomy in the management of gingival enlargement during orthodontic treatment: a randomized controlled trial.

To compare the use of diode laser with conventional surgery evaluating the effectiveness of gingivectomy as an adjunct to non-surgical periodontal treatment in the management of gingival enlargement (GE) during orthodontic treatment. Prospective three-arm parallel group randomized clinical trial with 1:1:1 allocation ratio. Sixty subjects (33 males and 27 females), with a mean age of 14.4 ± 1.9 years, were selected according to inclusion criteria: overgrown gingivae on the labial side of the anterior teeth secondary to fixed appliance therapy, six maxillary anterior teeth present, and healthy non-smokers patients. Patients were enrolled in the study and randomly assigned to three groups by a computer-generated randomization list and by a block size of 4. The allocation information was concealed in opaque and sealed envelopes by the statistician. In the first group, all subjects underwent a conventional scalpel gingivectomy of the maxillary anterior sextant. In the second group, all subjects were treated using laser-assisted gingivectomy; while subjects assigned to the third group underwent only non-surgical periodontal treatment and served as control group (CG). The observer who performed all the measurements was blinded to the group assignment. Blinding was obtained by eliminating from the elaboration file every reference to patient group assignment. Intergroup comparisons of changes in the periodontal parameters were conducted at 1, 3, and 6 months using ANOVA with repeated measures and Tukey's post hoc tests. The significance level was set at P <0.05. After 1 month, the TGs showed a significant improvement of all periodontal parameters when compared with the CG. No statistically significant differences were observed between the two TGs. At the 3-month observation, a relapse occurred in the TGs, while the CG showed the greater improvement of soft tissue health. In the 6-month versus 3-month evaluation, no significant differences between the three groups were found for any periodontal measurements. In the long-term evaluation (6 months versus baseline), a significant greater reduction of pockets were found in the TGs when compared with the CG. The adjunct use of both scalpel gingivectomy and laser gingivectomy was more effective in controlling gingival inflammation than non-surgical periodontal treatment alone at 1, 3 and 6 months. In the control group, greater improvement in the periodontal parameters were observed within 3 months, depending on a self-care approach for the management of GE. This study was a short-term study (6-month follow-up). ClinicalTrials.gov (registration number: NCT03514316).

Gingival enlargement in 10 years old: a case report

Generalized gingival enlargement in children interferes with the eruption of teeth. It may lead to difficulty in mastication and phonetics. Very few cases of generalized gingival enlargement associated with eruption of teeth in as young as 10 year old child had been reported in literature. The pathphysiology for occurrence of gingival enlargement with eruption of teeth is not clearly established. Generalized gingival enlargement was present in a 10 year old girl since the eruption of permanent teeth. The gingival biopsy was done followed by full mouth gingivectomy of maxillary and mandibular arch. The histopathological picture showed hyperplastic tissue. The treatment of gingival enlargement at early stage leads to exposure of teeth. The treatment resulted in improvement in mastication and establishing the aesthetic smile of the 10 year old child. This case represents systematic evaluation of gingival enlargement followed by gingival biopsy and gingivectomy. The management of gingival enlargement in children is challenging and requires systematic follow-up.

Multispeciality Approach in the Management of Patient with Hereditary Gingival Fibromatosis: 1-Year Followup: A Case Report

Background. Hereditary gingival fibromatosis is a fibrotic enlargement of the gingiva. It may exist as an isolated abnormality or as part of multisystem syndrome. This paper reports a case of 16-year-old male with generalized severe gingival overgrowth, involving the maxillary and mandibular arches and covering almost all teeth. Methods. Periodontal management of gingival enlargement included gingivectomy in both arches except in the lower right molar region where flap surgery was done under general anesthesia. After a 2-month followup period, orthodontic treatment was started with fixed appliances. Monthly periodontal checkups and maintainance (scaling and polishing) were scheduled to control the gingival inflammation. Results. Reevaluation of the patient of surgical treatment after two months did not show any recurrence of condition; however, minimal overgrowth was noted 1 month after the beginning of orthodontic treatment which was treated nonsurgically. Conclusions. Although the risk of recurrence is high with this condition, surgical treatment with correction of malocclusion and regular followup can provide excellent outcome as seen in this case.