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

AIMS

This study aimed to evaluate and compare the reliability and quality of the information about gingival enlargements on YouTube and TikTok.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

Non-surgical treatment of idiopathic gingival enlargement: A case report

BACKGROUND

Idiopathic gingival enlargement is associated with plaque, but other contributing factors are unclear. The prognosis of idiopathic gingival enlargement is closely related to the patient's oral hygiene habits and regular follow-up.

CASE PRESENTATION

This article reports a case of a 32-year-old male patient with idiopathic gingival enlargement. The patient presented to the department of stomatology with a 2-month history of gingival swelling and pain on the right upper posterior teeth. During the treatment, oral hygiene instruction, supragingival cleaning, subgingival scaling, and root planning were carried out, and part of the hyperplastic gingiva was taken and sent for pathology. Pathological examination showed gingival enlargement with chronic suppurative inflammation. At 4-month follow-up, the patient's periodontal condition remained basically stable, and the gingival enlargement did not recur.

CONCLUSION

The treatment of this case resulted in significant reduction of gingival swelling and patient's pain reduction through non-surgical treatment and good plaque control, indicating that patients with idiopathic gingival enlargement can also achieve ideal results through non-surgical treatment. Through oral hygiene instruction, the patient mastered the method of self-plaque control, which is conducive to the long-term stabilization of the periodontal situation.

Drug induced gingival enlargement - phenytoin: an overview and case report

Gingival enlargement is a side effect of several different medication, including immunosuppressants, anticonvulsants, and calcium channel blockers. It is an inflammatory response that starts when plaque and calculus build up on the tooth surface. The most prevalent long-term neurological condition affecting people is epilepsy. In affluent nations, the prevalence of epilepsy is ~ 1%, whereas in less developed countries, it may >2%. The preferred medication for the condition, phenytoin, has major side effects include gingival enlargement. In addition to being visually disfiguring, this enlargement frequently affects speech, chewing and eating. Furthermore, those with poor dental hygiene, causes disabilities with motor coordination and muscular limitations leading to mental disability and physical impairments are more prone to periodontal disease. This article enlightened the mechanism of drug induced gingival enlargement clinically, microbiologically, and surgically.

Gingival overgrowth approached using recent mechanical and laser technologies: A case report

Gingival enlargement is a side effect of different drug classes, with calcium channel blockers being among the most often cited examples. Most often accompanied by a disruption in the oral biofilm, this form of gingival overgrowth, with histological signs of hyperplasia and hypertrophy, becomes a chronic inflammatory condition with the oral biofilm a primary cause. This periodontal disease is now classified as 'dental biofilm-induced gingivitis', and its preferred name is drug-influenced gingival expansion. The present study presented the case of a patient with gingival enlargement while being treated with nifedipine for cardiac disease. This patient had factors that contributed to the retention of bacteria, ranging from poor oral hygiene practices to poorly adapted prosthodontics. After reducing these factors, a multimodal treatment was conducted, including bacterial mechanical decontamination through guided biofilm therapy protocol, laser bacterial decontamination, and surgical laser gingivectomy. The patient was referred to their cardiologist for substituting the calcium channel blocker medication. Clinical evaluations followed each treatment step. At 12 months, the patient presented positive, stable results, with an improvement in gingival status (no gingival overgrowth in the area where all risk factors were eliminated and minimal overgrowth in the area where old poorly marginally adapted prosthodontics were kept in place and no/minimal signs of gingival inflammation).

Management of Orthodontic-Induced Gingival Enlargement: A Case Report

The aetiology of gingival enlargement (GE) is highly distinct. Plaque-induced gingival inflammation can be the sole reason for gingival enlargement. Poor dental hygiene, irritation from anatomical variations, and ineffective restorative and orthodontic appliances are all factors that encourage the formation and retention of plaque. In the given case report, a case of gingival enlargement associated with an orthodontic appliance of a 23-year-old female patient referred from the Department of Orthodontics was reported to the Department of Periodontics. Under local anaesthesia, the excess gingival tissue is removed using a scalpel by gingivectomy and gingivoplasty procedures. The gingivectomy and gingivoplasty procedures using a scalpel gave the best results in the orthodontic treatment associated with gingival enlargement. After achieving hemostasis, the periopack (Coe-pack) was placed to assist healing by protecting the tissue. The above case report can appreciate the gingival tissue covering almost half of the crown, causing plaque retention and presenting the patient with aesthetic concerns. After the surgical procedure, a proper gingival contour eliminates suprabony pockets and provides pleasant esthetics. This case report demonstrates that eliminating the suprabony pockets by gingivectomy and gingivoplasty leads to a physiologic gingival contour and eliminates plaque retention. The conventional scalpel gingivectomy procedure is an effective form of treatment when indicated.

Oral Hemangiolymphangioma Presenting As Gingival Enlargement: A Rare Case With Literature Review

Vascular malformations are anomalies that are caused by disturbances in vasculogenesis. Depending upon the dominant structure present histologically, they may be found in different combinations of vascular elements and are named hemangiolymphangioma (HLA) or lymphangiohemangioma (LHA). HLA occurs in multiple anatomical sites, such as the head and neck, axilla, abdominal cavity, extremities, and urinary bladder, but it is infrequent in the oral cavity. An 18-year-old male with a history of abdominal tuberculosis presented with an asymptomatic mandibular gingival swelling that was histologically diagnosed as HLA. A six-month follow-up revealed no recurrence. The observations reported in this case are unusual, and our literature review revealed no previously documented case of gingival HLA.

Intramucosal Melanocytic Nevi - A Rare Cause for Gingival Enlargement. Report of a Case and Review of Literature

Background

Oral melanocytic nevi are infrequent oral lesions derived from nevus cells of oral mucosa which causes focal hyperpigmentation. The most common site of occurrence of oral nevi is the hard palate followed by buccal mucosa and gingiva. The mean age group affected are in their 3rd and 4th decade of life and there seems to be a predilection for females. Clinically, oral nevi are usually small, well-circumscribed macules but can also present as slightly raised papules. Histologically, nevi can be classified as Junctional, Compound or Intramucosal, with intramucosal being the more common type in the oral cavity.

Case Presentation

In this paper, we report a case of intramucosal nevus in a 25-year-old female patient. The lesion presented as a gingival enlargement in the mandibular anterior region involving the marginal and attached gingiva, which is an extremely rare presentation. The clinical findings, histologic features and surgical management are presented. The patient was followed up for one year and the one year follow up revealed a small area of focal hyperpigmentation at the site of the previous lesion which is being closely monitored.

Conclusion

Nevi located in the mucous membrane have been documented to pose a threat of malignant transformation. Hence, all pigmented lesions of the oral cavity should be cautiously diagnosed.

Immunohistochemical and Histopathological Features of Persistent Gingival Enlargement in Relation to Metal Allergic Sensitisation during Orthodontic Treatment

This study aimed to analyse the immunohistochemical profile of inflammatory infiltrates in the gingival tissue of patients undergoing orthodontic treatment in relation to patients’ titanium and/or nickel allergy status. Patients with gingival enlargement received initial periodontal therapy, followed by external gingivectomy in the case of persistent gingival enlargement. The sample included 44 patients (22 had metal allergic sensitisation). Histopathological changes were assessed, and an immunohistochemical analysis was performed on formalin-fixed and paraffin-embedded gingival samples using antibodies against CD1a, CD3, CD4, CD8, CD20, CD68, and CD138. Computer-assisted image analysis was performed to evaluate the positive cell count in the gingival tissue. The gingiva of the sensitised patients was characterised by the absence of multifocal inflammatory infiltrates (p < 0.05), while pronounced exocytosis and band-like inflammatory infiltrates were more frequently observed in sensitised patients. In addition, there was an increase in Langerhans cells and T-helper lymphocytes and a decrease in naïve T-lymphocytes, cytotoxic T-lymphocytes, macrophages, and plasma cells in the sensitised subjects compared to non-sensitised. However, the differences were only statistically significant for macrophages, with a moderate effect size (82.8 vs. 133.9; p = 0.041; r = 0.308). The absence of multifocal inflammation appears to be the most characteristic histopathological feature of the gingiva of sensitised patients. Although their gingiva presented certain characteristics of late hypersensitivity immune reactions the observed changes imply dominant irritative effect e.

Lymphangioma Circumscriptum - A Rare Cause of Gingival Enlargement: A Case Report and Review of Literature

Background

Lymphangiomas or microcystic lymphatic malformations (MLM) are hamartomatous formations that occur due to the proliferation of lymphatic vessels. They commonly manifest in the head and neck region with only a few cases reported within the oral cavity. Lymphangioma circumscriptum in the gingiva is a rare condition which presents as asymptomatic pebbly gingival enlargement. They are characterized by lesions that are microscopic thin-walled cysts. Histopathologically, they show multiple dilated lymphatic channels which are lined by endothelial cells. The lumen is filled with lymphatic fluid, red blood cells, and other inflammatory cells. These are dispersed within connective tissue stroma. Multiple modalities of treatment have been reported, including surgical excision, laser therapy, and sclerotherapy.

Case Presentation

This paper reports a rare case of multiple lymphangiomas of the gingiva in a 21-year-old female patient. The clinical picture, surgical treatment, histologic features, and immunohistochemistry [IHC] findings are presented. The histologic findings of lymphangioma were confirmed with IHC being positive for lymphatic marker D2-40. The patient was followed up for a period of 2 years, with no recurrence noted.

Conclusion

Lymphangiomas or microcystic lymphatic malformations presenting as a gingival enlargement are a rare occurrence. Therefore, lymphangiomas may also be considered in the differential diagnosis of gingival enlargements.

Plasma cell gingivitis: A perplexing and rare clinical entity

Plasma cell gingivitis (PCG) is a diagnostic dilemma for clinicians. It is also referred to as atypical gingivostomatitis, idiopathic gingivostomatitis, allergic gingivostomatitis, and plasma cell gingivostomatitis which are characterized by bright fiery red gingiva with spontaneous bleeding on slight provocation. It is often confused with inflammatory gingival enlargement, erythematosus lichen planus, and other lesions. One such rare and benign entity is discussed in this article and managed after thorough clinical, radiological, histopathology, immunohistochemistry analysis.

Comprehensive evaluation of factors that induce gingival enlargement during orthodontic treatment: A cross-sectional comparative study

Background

Gingival enlargement (GE) is one of the most common soft tissue problems encountered during fixed orthodontic treatment. Aims: This study aimed to evaluate the factors affecting GE in adolescents and young adults, compared with their normal peers.

Subjects and Methods

This is a cross-sectional comparative study. The sample consisted of 329 subjects (ages 10-30 years) of both genders, which was divided into four main groups: The control group (G0) with no orthodontic treatment; subjects who underwent orthodontic treatment were divided according to treatment duration into G1 (4-12 months), G2 (13-24 months), and G3 (>24 months). The clinical examinations included the level of debris, calculus (simplified oral hygiene), and GE indices. Regression analyses were used to assess the GE association in all the studied groups.

Results

The mean GE score increased significantly with increased treatment duration (0.42 ± 0.29 for G0 and 1.03 ± 0.52 for G3). GE scores of the lower arch were significantly higher in the anterior segment than in the posterior segment among all treatment groups. Regression analysis revealed that gender, age, oral hygiene, and treatment duration had a significant effect on GE (P < 0.05), while angle classification, overjet, overbite, treatment stage, bracket type, and therapeutic extraction did not show significant associations (P > 0.05).

Conclusion

Gender, age, oral hygiene, and treatment duration were the most important risk factors for GE during fixed orthodontic treatment.

Inflammatory myofibroblastic tumor manifesting as recurrent generalized gingival enlargement: Report of a rare case

Oral inflammatory myofibroblastic tumor (IMT) is extremely rare and its manifestation as generalized gingival enlargement (GGE) has never been reported. We are reporting the case of 50-year-old female patient presenting with recurrent GGE for 4 years. Panoramic radiograph revealed severe bone loss in posterior sextants and root resorption in some teeth. Initial incisional biopsy was suggestive of chronic inflammatory infiltrate with fibrocollagenous tissue. Definitive treatment comprised of surgical excision of the enlarged gingiva with a tapering dose of steroid therapy. Histopathological and immunohistochemical examination from a repeat biopsy of deeper tissues was suggestive IMT. No recurrence was found at 2 years follow up. Recurrent GGE with advanced bone loss and external root resorption should raise the suspicion of a locally aggressive lesion. Dentists should be aware of oral IMT and include it in differential diagnosis of gingival enlargements for comprehensive management to avoid recurrence of the lesion.

Local Mucosal Flap for the Treatment of Gingival Defect After Gingival Fibromatosis Excision

Gingival fibromatosis (GF) is a rare condition of fibrous enlargement of the gingivae causing functional or aesthetic problems. We report a case of localized GF in a 51-year-old healthy male patient who presented in our department with localized gingival enlargement. We performed gingivectomy and restored the defect with a novel local transpositional mucosal flap with excellent functional and aesthetic results. This type of intervention is accompanied by short surgical time, provides predictable results, and should be considered in adult patients with large defects from sizable lesions.

Primary orofacial granulomatous involvement of lip and gingiva only: A diagnostic challenge

Wiesenfeld described orofacial granulomatosis (OFG) as a group of noncaseating granulomatous disorders affecting the different parts of the body including oral and maxillofacial region, which can have variable etiology. The involvement of oral and maxillofacial region can be exclusive or primary before the involvement of other organs. OFG is a multifactorial clinicopathologic disorder, and its clinical manifestation mimics the various systemic conditions making its diagnosis tough for a dentist. Delay in diagnosis and evaluation of OFG may cause indurated, swollen lips that may compromise cosmetic face value, speaking, and eating functions, and other possible systemic granulomatous disorders can be missed. Here, we present a case of OFG with tooth-associated infection without any recognizable systemic cause. This article presents the diagnostic challenges that a dentist may face in diagnosing such cases, and thus treatment planning should be of the multidisciplinary approach. Regular follow-up is very essential for proper care and management.

Idiopathic gingival fibromatosis with massive gingival overgrowth: A rare case report

Idiopathic gingival overgrowth can present itself as a part of syndrome or as an isolated entity. This is a case report of a massive gingival enlargement in a 12-year-old female child with nonsyndromic gingival fibromatosis, which was treated by multidisciplinary approach involving surgical and prosthetic rehabilitation and at the same time instilling psychological benefit.

Peripheral Adenomatoid Odontogenic Tumor - A Rare Cause of Gingival Enlargement: A Case Report with CBCT Findings

Introduction

Adenomatoid odontogenic tumor (AOT) is an uncommon benign odontogenic lesion with varied clinical and histological presentation. It has slow growth potential and a low recurrence rate. The tumor is mainly seen in females in the second decade of life, predominantly affecting the maxilla and associated most often with unerupted canine teeth, earning the epithet “two-thirds tumor”. There are three variants: intrafollicular, extrafollicular, and peripheral. The peripheral or extra osseous type is a rare form that arises in gingival tissue.

Case Presentation

This article describes a case of AOT in a 10-year-old girl who presented with gingival enlargement in relation to the maxillary left central incisor. Interestingly, intraoral periapical radiography did not show any significant findings. However, cone-beam computed tomography of the site revealed significant bone loss in the area. A surgical excision was done. Histopathological examination revealed features of AOT. Based on clinical, radiographic, and histological evidence, a diagnosis of peripheral AOT (PAOT) was made.

Conclusion

PAOT is a rare disease entity in children that mimics gingival swelling, and may often be misdiagnosed by dentists. With literature still ambiguous on the origin of the tumor and biological course, it becomes imperative to examine any gingival swelling in children with a proper clinical examination, periapical radiography, and if necessary cone-beam computed tomography. Excision and histopathological evaluation will help in confirming the exact disease condition.

Plasma Cell Gingivitis Mimicking Granulomatous Disease: A Diagnostic Dilemma

INTRODUCTION

Plasma cell gingivitis is an uncommon benign inflammatory condition of the gingiva which is considered to arise as a hypersensitivity reaction to certain allergens. The distinguishing feature of this condition is massive infiltration of plasma cells into the subepithelial connective tissue. This case report discusses a case of plasma cell gingivitis which produced a diagnostic dilemma due to its unusual histopathologic appearance.

CASE PRESENTATION

A 13-year-old female patient presented with diffuse gingival enlargement in relationship to upper anterior teeth. The case was managed successfully by gingivectomy following phase I therapy. Histopathological examination showed presence of epithelioid granulomas and foreign body giant cells along with plasma cells which is an uncommon finding in plasma cell gingivitis. Further tests conducted excluded granulomatous disease and the diagnosis was confirmed as plasma cell gingivitis.

CONCLUSION

Plasma cell gingivitis can present a diagnostic dilemma and should be included in the differential diagnosis of patients presenting with non-specific gingival enlargements.

LASER Assisted Excision of Solitary Neurofibroma in the Gingiva

Neurofibromatosis (NF) is a genetic disorder that presents as benign tumours of the nervous system originating from the nerve sheath. It is of three types: Type I, Type II and Schwannomatosis. Type I Neurofibromatosis or von Recklinghausen's disease is the most common type of neurofibromatosis seen and it accounts for 90% of all cases seen. It can be seen as light brown pigmentation spots (Café-au-lait) on the skin and multiple small tumours among the nerves. Oral manifestations of NF are very rare and can be seen as sessile lesion in the tongue or the gingiva. The major complaints of the oral manifestations include difficulty in speech and mastication which it results in progression of periodontal disease. Here, we present a case report of Type I NF which presented as a sessile lesion in the right maxillary gingiva, for which we performed an excisional biopsy using LASER.

Management of Cyclosporine-Influenced Gingival Enlargement With Azithromycin

INTRODUCTION

Management of drug-influenced gingival enlargement is challenging, and surgery is most often indicated. However, because of a unique mechanism of action, azithromycin helps in the management of gingival enlargement caused by cyclosporine. An incidental observation of the effect of azithromycin in the cyclosporine-influenced gingival enlargement by physicians in 1995 led to series of basic investigations and clinical trials confirming this observation and providing a non-surgical treatment modality.

CASE PRESENTATION

In this report, successful management of cyclosporine-influenced gingival enlargement in a 39-year-old renal transplant patient with the use of azithromycin without any surgical intervention is presented.

CONCLUSION

Use of azithromycin for managing cyclosporine-influenced gingival enlargement is a useful alternative or adjunct to surgical management. It is hoped that this report will raise further awareness of this non-surgical modality in patients taking cyclosporine.

Son of Sevenless-1 genetic status in an Indian family with nonsyndromic hereditary gingival fibromatosis

Hereditary gingival fibromatosis (HGF) is a rare condition affecting the gingiva and may or may not be a clinical feature of other syndromes. It has been classified as a nondental biofilm-induced gingival disease. The pathogenesis of this condition has been poorly understood till date. Although different genetic mutations have been implicated to play a role, there is considerable interest on an addition mutation of Son of Sevenless-1 (SOS-1) gene. We report a case of a 27-year-old male patient who came to us with the complaint of enlarged gums of several years' duration. There were other members in his family who were similarly affected. After the clinical diagnosis of HGF was confirmed, the patient and his available family members were subjected to a genetic analysis for identification of mutation in SOS-1 gene, which turned out to be negative. The patient was treated with nonsurgical periodontal therapy and is under regular follow-up. To the best of our knowledge, this is the first study to assess SOS-1 mutation in an Indian family.

Periodontal management of severe periodontitis and generalized gingival enlargement in a patient with chronic renal failure

Gingival enlargement is a common periodontal pathology seen in medically compromised patients. Although it is not the disease itself, certain medications used to treat these chronic diseases are known to precipitate the gingival enlargement. Periodontitis (PD) and gingival enlargement have been reported increasingly in patients with chronic renal failure. Severe enlargement is detrimental to esthetics and function while having a negative impact on the overall oral health-related quality of life. Treatment of such cases requires comprehensive periodontal management by a specialist, keeping in mind the medically compromised state of the patient. This report presents a case of severe PD with generalized gingival enlargement in a 45-year-old male who was a known case of Stage 4 chronic kidney disease, obstructive uropathy, and hypertension. Gingival enlargement was managed by gingivectomy and gingivoplasty. Six months' follow-up showed no sign of recurrence.

Interdisciplinary assessment and management of a patient with a fibrous gingival enlargement of unknown origin: A case report

A gingival enlargement of unclear cause could only be diagnosed after interdisciplinary cooperation as plasma cell gingivitis of unknown origin. Interdisciplinary approaches remain crucial when diagnosing rare gum diseases.

Laser-assisted Excision of Gingival Overgrowth in an Endodontic Perforation: A Case Report

With the increase in preventive and restorative dentistry, there is also an increase in the iatrogenic conditions that occur in modern dental practice. The goal of modern dentistry is to provide patients with a holistic solution by providing functional restoration. This case report will highlight one such case where a tooth was diagnosed as having a gingival overgrowth through a perforation during prior endodontic treatment. Proper diagnosis and treatment planning helped restore a tooth that would have been lost.