Healthy gums are pale pink or pigmented, and wrap tightly around the neck of the teeth. Prevalence of gingival overgrowth induced by antihypertensive drugs. Plaque induced inflammation appears to be a general stimulating effect regardless of the mechanism of gingival enlargement. Nov 15, 2014 in this video, dr kuljeet mehtaperiodontist, demonstrates periodontal gingival overgrowth enlargement treated by periodontal surgery. One such syndrome is jones syndrome, which is associated with gingival enlargement and progressive hearing loss. Gingival enlargement definition of gingival enlargement by. Prescription of calcium channel blockers is relatively common, making it difficult to determine the true incidence of druginduced gingival enlargement.
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. Drug induced gingival enlargement periodontal disease. Pdf drug induced gingival enlargement researchgate. Cyclosporineinduced gingival enlargement is more vascularized than phenytoin enlargement figures 1610 and 1611. Cyclosporin is an immunosuppressant which has been reported to cause gingival enlargement in 2580% of patients. There is a clear demarcation between normal and involved gingival figure. Its clinical appearance is usually detected by pink, diffuse, firm and leathery, nonhemorrhagic and asymptomatic gingival enlargement. Genetic disorders associated with gingival enlargement. The possibility of druginduced enlargement was ruled out based on the medical history. Gingival enlargement or gingival overgrowth, a common trait of gingival disease, is characterized by an increase in the size of gingiva. The usual form of enlargement is inflammatory enlargement which is seeded by the plaque adjacent to the gingiva. This is an atypical case report of a 20yearold male patient who suffered from unusual unilateral, gingival enlargement together with rapidly progressive alveolar bone loss. Idiopathic gingival enlargement and its management. Bds, mfdrcsi, msckhatroum university, paedodontics national ribat university, sudan.
Regardl ess of its cause, gingival enlar gement can cause problems in controlling pl aque, chewing, teething, speech and aesthetics 1. Results a total of 1187 cases of lges affecting 1187 patients represented 6. 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. Usual allergens known to be associated with this lesion could be, e. Health, general anticonvulsants health aspects chronic myeloid leukemia case studies gingivitis care and treatment causes of diagnosis gum diseases nifedipine complications and side. Gingival enlargement and its treatment authorstream. Gingival enlargement is an unwanted adverse effect of some drugs such as. Jan, 2018 epulis is growth or enlargements of gums or alveolar mucosa. Management of druginduced gingival enlargement barbara anne taylor, department of periodontics, united dental hospital of sydney, sydney synopsis healthy gums are pale pink or pigmented, and wrap tightly around the neck of the teeth. Gingival enlargement the currently accepted terminology for an increase in the size of the gingiva, is a common feature of gingival disease. Dhwanit thakore free download as powerpoint presentation. Druginduced gingival enlargement was first observed in patients who were taking phenytoin for epilepsy, with approximately 50% having gingival overgrowth. Gingivitis classification is useful for diagnosis, prognosis and treatment planning.
The differential diagnosis included enlargement due to drugs e. Unusual clinical presentation of generalized gingival. When the gingival condition is fibrotic, it might not subside completely, which results. Diffuse, fibrotic gingival enlargement with partial coverage of the tooth crowns in a patient taking phenytoin for seizures. Gingival enlargement is one of the frequent features of gingival diseases. The enlargement can be inflammatory,fibrotic or a combination of both. Pertinent management depends on precisely diagnosing the origin of enlargement. Gingival fibromatosis is a rare and heterogeneous group of disorders that develop as slowly progressive, local or diffuse enlargements within marginal and attached gingiva or interdental papilla. 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. Calcium channel blockers, gingival overgrowth, nifedipine. Gingiva overgrowth an overview sciencedirect topics. Gingival enlargement classificationdental health tips. Pregnancy induced gingival enlargementa case report.
Feb 21, 2017 the enlargement can be inflammatory,fibrotic or a combination of both. Perio gingivitis and gingival enlargement flashcards quizlet. Unilateral gingival enlargement an unusual case report. In recent years,flap surgery have been used more often to treat gingival enlargement than gingivectomy. There are many anticonvulsants, immunosuppressants and calcium channel blockers that may lead to gingival enlargement in varied presentations table table1 1 and figure figure7. Gingival overgrowth enlargement, hyperplasia is benign painless condition.
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. The following grades were scored in 6 points around each tooth. However, the skills of a clinician is put to test when arriving at a particular diagnosis among the myriad of. Surgical management of gingival overgrowth pocket dentistry. Gingival enlargement can be caused by a number of factors, including inflammatory conditions and the side effects of certain medications. 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. Gingival enlargement is the most common adverse drug drug effect in the young adults and children receiving phenytoin as antiepileptic drug therapy. Thousands of patients have been described in the literature, but the actual prevalence is unknown. Nov 30, 2018 cyclosporineinduced gingival enlargement is more vascularized than the phenytoin enlargement, occurs in approximately 30% of patients receiving the ding, is more frequent in children, and its magnitude appears to be related more to the plasma concentration than to the patients periodontal status. Her familial and past medical history were non contributory. Idiopathic gingival enlargement and its management kumar p. Pdf treatment of gingival enlargement researchgate. International journal of oral health dentistry, july september, 2015.
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. The management of druginfluenced gingival enlargement. 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. Rosenberg, james torosian, in esthetic dentistry third edition, 2015. 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. There are several causes of gingival enlargement and they can be grouped into four categories. Pdf gingival enlargement is one of the frequent features of gingival diseases.
Licensed under creative commons attribution cc by unilateral gingival enlargement an unusual case report motazatia1, yosra ali2, yasiryousif3. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Gingival enlargement can be caused by a variety of etiological factors like inflammation, drugs, and systemic diseases or can be presented as a part of a syndrome. 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. Academy report 1424 a n increasing number of medications are associated with gingival enlargement.
Pregnancy induced gingival enlargement a case report t. J indian soc periodontol serial online 2015 cited 2020 apr 23. D icd usual allergens known to be associated with this lesion could be, e. Gingival fibromatosis, gingival enlargement, gingivectomy. Gingival enlargement is frequently seen in day to day practice and its proper therapy includes the analysis of the cause of the enlargement. Gingival gum enlargement, also known as gingival hyperplasia or hypertrophy, is an abnormal overgrowth of gingival tissues. Signs and symptoms related to gingival enlargement are seen within 24 mo of initiation of drug intake.
Aug 12, 2014 treatment of gingival enlargement in puberty gingival enlargement in puberty is treated by performing scaling and curettage, removing all sources the use of escharotic drugs has been recommended in the past for the removal of gingival enlargements of irritation, and controlling plaque. Diffuse gingival enlargement is defined as an excessive growth of periodontal tissue. Individualized treatment plan for gingival enlargement. Nifedipineinduced gingival enlargement sage journals.
In addition to gingival enlargement, cyclosporine induces other major side effects such as 1 nephrotoxicity 2 hypertension, and 3 hyperthricosis. Generalized inflamed nonfibrotic gingival tissues, bleeds readily on probing, patient reports pain, fever, marked fatigue occurs in 30% of acute and 10% of chronic leukemia cases, inflammation pronounced even with little dental plaque, starts in papillae and then involves marginal and attached gingiva, gingival tissues frequently show initial clinical signs of leukemia with a sudden onset. Gingival enlargement is an increase in the size of the gingiva gums. Jul 21, 2019 gingival enlargement or gingival overgrowth, a common trait of gingival disease, is characterized by an increase in the size of gingiva. 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.
In severe cases, the excess tissue may cover the crowns of the teeth, thus causing functional, esthetic, and periodontal problems, such as bone loss and bleeding, due to the presence of pseudopockets. Gingival enlargement an overview sciencedirect topics. Unusual clinical presentation of generalized gingival enlargement a report of 3 cases. Dec 23, 2014 gingival enlargement also known as gingival hyperplasia, gingival hypertrophy, gingival overgrowth, hypertrophic gingivitis which is caused with the increase in the size of gingiva is called as gingival enlargement. Gingival overgrowthenlargement by drugsperiodontal surgery. Phenytoin is an anticonvulsant which is seen to cause gingival enlargement in human patients with a reported incidence of 50%. Untypical amlodipineinduced gingival hyperplasia hindawi. Idiopathic gingival enlargement and its management pawan kumar 1, saindhyatora sonowal 2 1 unit of periodontics, oral health science centre, post graduate institute of medical education and research, chandigarh, india 2 department of periodontics, regional dental college, bhangagarh, guwahati, assam, india. The new tissue is similar to the normal healthy tissue.
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