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Debnath K, Couthino A, Chatterjee A, Shenoy S. Enamel renal gingival syndrome: A rare case report. J Indian Soc Periodontol 2019; 23:69-72. [PMID: 30692747 PMCID: PMC6334546 DOI: 10.4103/jisp.jisp_532_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Enamel renal syndrome is a unique syndrome associated with kidney agenesis associated with kidney agenesis, amelogenesis imperfecta, and gingival hyperplasia. The prevalence rate of this rare syndrome is <1/1,000,000. A 17-year-old male patient came to the department of periodontics, with a chief complaint of dislodged crown in the anterior teeth region. On clinical examination, the patient had teeth with mottled enamel and gingival enlargement. The orthopantomograph and gingival biopsy revealed pulpal calcification and gingival calcification, respectively. Furthermore, the renal ultrasonography revealed absence/agenesis of the left kidney. Thus, based on radiographical, histological, and ultrasound investigations, the patient was diagnosed with nephrocalcinosis syndrome. The patient was treated with periodontal therapy and prosthodontic full-mouth rehabilitation. This case report highlights the need of a periodontist to be acquainted about the signs and symptoms of the syndrome to benefit an individual in the right diagnosis and treatment plan.
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Zhao L, Wang XY, Xu Y, Meng S. [Relationship of orthodontic treatment and periodontal soft tissue health]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2018; 36:595-601. [PMID: 30593102 DOI: 10.7518/hxkq.2018.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
With the increasing number of the orthodontic patients, the relationship between periodontal and orthodontic becomes increasingly close. Orthodontic treatment can improve periodontal status, but the adverse clinical problems of periodontal tissue during orthodontic treatment are relatively common. In this paper, we discuss the problems of soft tissue, including causes, prevention, and treatment of gingivitis, gingival enlargement, gingival recession, and gingival invagination in orthodontic treatment.
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Fernandes KS, Gallottini M, Castro T, Amato MF, Lago JS, Braz-Silva PH. Gingival leukemic infiltration as the first manifestation of acute myeloid leukemia. SPECIAL CARE IN DENTISTRY 2018; 38:160-162. [PMID: 29645289 DOI: 10.1111/scd.12283] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Leukemic infiltration of the gingival tissue associated or not with gingival enlargement may be the first manifestation of acute leukemia, despite being rarely reported in the literature. A 10-year-old female patient presented with a 1-month history of an asymptomatic, firm, and pinkish-red generalized gingival overgrowth. There was no bone resorption. Incisional biopsy of the gingival tissue was performed, with histopathological examination revealing a diffuse and hypercellular infiltration of monocytoid cells. The patient was referred to a hematologist and underwent a bone marrow biopsy, which led to a conclusive diagnosis of acute myeloid leukemia. The patient was treated with chemotherapy and we observed regression of gingival enlargement after 4 weeks from the initial therapy.
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Ratre MS, Gulati R, Khetarpal S, Parihar A. Regular oral screening and vigilance: can it be a potential lifesaver? J Indian Soc Periodontol 2018; 22:171-173. [PMID: 29769773 PMCID: PMC5939026 DOI: 10.4103/jisp.jisp_136_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Acute myeloid leukemia (AML) is a malignant neoplasm of myeloid series defined by the presence of immature blast cells (>30%) in peripheral circulation. Oral manifestations are the potential indicators of systemic health and disease. Oral cavity is the frequently and early involved sites in AML. Gingival overgrowth due to leukemia is one such condition encountered by periodontists. Hence, understanding, identifying, and correlating oral manifestations with systemic diseases are the ultimate responsibility of every dental clinician because of its lethal and unpredictable course. In the present case, we are discussing an undiagnosed case of AML who presented to us with oral complaints.
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Chowdhri K, Tandon S, Lamba AK, Faraz F. Leukemic gingival enlargement: A case report and review of literature. J Oral Maxillofac Pathol 2018; 22:S77-S81. [PMID: 29491612 PMCID: PMC5824525 DOI: 10.4103/jomfp.jomfp_205_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The oral cavity manifests signs of various systemic diseases. This entails thorough examination of the oral mucosa, gingiva, teeth, tongue and other oral tissues. Occasionally, oral signs can be an expression of systemic conditions such as endocrine imbalance, nutritional deficiencies and blood disorders. Leukemia is a malignancy of white blood cells, which may result in significant morbidity and mortality. Oral changes maybe the first and only presenting features in leukemia patients, making it imperative for the dentist to diagnose the disease accurately.
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Sandoval MJ, Zekeridou A, Spyropoulou V, Courvoisier D, Mombelli A, McLin V, Giannopoulou C. Oral health of pediatric liver transplant recipients. Pediatr Transplant 2017; 21. [PMID: 28670817 DOI: 10.1111/petr.13019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2017] [Indexed: 01/25/2023]
Abstract
To evaluate oral health conditions in pediatric liver transplant recipients, with special focus on caries, green staining of the teeth, gingival bleeding, and gingival overgrowth. 40 patients (mean age 11.6 years) were examined at a routine follow-up visit, 6 months to 16 years after liver transplantation at the Swiss Center for Liver Disease in Children. After the medical examination, participants were further examined for the presence of dental caries, periodontal disease, GE, and GTC. The mean decay, missing, and filled teeth (dmft/DMFT) score was 3.8. 45% of the participants presented at least one carious lesion. Two-third of the participants had more than 20% of sites with the presence of plaque and gingival inflammation. Signs of GE were found in 18% and GTC in 30% of the participants. A positive correlation was identified between GTC and peak serum bilirubin (P<.001) and primary diagnosis of cholestatic disease (P=.04). Gingival inflammation was associated with plaque (P<.001), use of immunosuppressive medication (P=.04), and was more pronounced in children with cholestatic disease (P=.007). Children and young adults with liver transplants presented a rather poor oral health status. Liver transplant physicians should counsel patients for regular dental follow-up in order to avoid serious dental infections.
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Kala N, Babu SPKK, Manjeu J, Aadivalavan A, Khan R. Allele-specific polymerase chain reaction for the detection of single nucleotide polymorphism in amlodipine-induced gingival enlargement. J Clin Pharm Ther 2017; 43:110-113. [PMID: 28656587 DOI: 10.1111/jcpt.12587] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 06/05/2017] [Indexed: 12/25/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Studies indicate that there is an increased serum concentration of amlodipine (a calcium channel blocker used to treat hypertension and angina) in patients having mutant multidrug resistance 1 (MDR1) gene. Hence, genetic factors may play a very significant role in amlodipine-induced complications including gingival enlargement. CASE DESCRIPTION Three patients with amlodipine-induced gingival enlargement showed improvement following drug substitution of amlodipine with enalapril (an angiotensin-converting enzyme inhibitor) and non-invasive periodontal therapy. Using allele-specific polymerase chain reaction, single nucleotide polymorphism of MDR1 gene of heterozygous mutant type (CT genotype) was identified in all three cases. WHAT IS NEW AND CONCLUSION Drug-induced complications can potentially be a result of genetic factors, in combination with various local and systemic factors. Identifying genetic polymorphisms early might help predict adverse reactions and determine prognosis.
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Yadav VS, Chakraborty S, Tewari S, Tewari N, Ghosh T. Cryotherapy as a conservative treatment modality for gingival enlargement in a patient with Sturge-Weber Syndrome. Intractable Rare Dis Res 2017; 6:145-1147. [PMID: 28580218 PMCID: PMC5451749 DOI: 10.5582/irdr.2017.01023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This case report describes a case of Sturge-Weber syndrome reported for unilateral gingival enlargement and bleeding from gingiva in maxillary left region. Initial treatment in the form of scaling and root planing was done but recurrence was observed after one year of follow up. Instead of performing conventional surgery, an alternative conservative treatment was planned in the form of cryotherapy with the help of closed nitrous oxide probe. Seeing the satisfactory results obtained, cryotherapy can be suggested as an atraumatic, bloodless and effective chair side procedure for treating vascular gingival enlargement.
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Momen-Heravi F, Kang P. Management of cannabis-induced periodontitis via resective surgical therapy: A clinical report. J Am Dent Assoc 2016; 148:179-184. [PMID: 27871617 DOI: 10.1016/j.adaj.2016.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/05/2016] [Accepted: 10/18/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OVERVIEW There is a lack of clinical research on the potential effect of cannabis use on the periodontium as well as its effect on treatment outcomes. The aim of this case report is to illustrate the clinical presentation of periodontal disease in a young woman who was a chronic cannabis user, as well as successful treatment involving motivating the patient to quit cannabis use and undergo nonsurgical and surgical therapy. CASE DESCRIPTION A 23-year-old woman sought care at the dental clinic for periodontal treatment. During a review of her medical history, the patient reported using cannabis frequently during a 3-year period, which coincided with the occurrence of gingival inflammation. She used cannabis in the form of cigarettes that were placed at the mandibular anterior region of her mouth for prolonged periods. Localized prominent papillary and marginal gingival enlargement of the anterior mandible were present. The mandibular anterior teeth showed localized severe chronic periodontitis. The clinicians informed the patient about the potentially detrimental consequences of continued cannabis use; she was encouraged to quit, which she did. The clinicians performed nonsurgical therapy (scaling and root planing) and osseous surgery. The treatment outcome was evaluated over 6 months; improved radiographic and clinical results were observed throughout the follow-up period. CONCLUSIONS AND PRACTICAL IMPLICATIONS Substantial availability and usage of cannabis, specifically among young adults, requires dentists to be vigilant about clinical indications of cannabis use and to provide appropriate treatments. Behavioral modification, nonsurgical therapy, and surgical therapy offer the potential for successful management of cannabis-related periodontitis.
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Bhoyar N, Gupta S, Ghosh S. Odontogenic myxofibroma of gingiva in a pediatric patient with tuberous sclerosis: A rare case report. Contemp Clin Dent 2016; 7:558-561. [PMID: 27994429 PMCID: PMC5141676 DOI: 10.4103/0976-237x.194120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Tuberous sclerosis complex (TSC) is a rare multisystem genetic disease, with an estimated incidence of 1 in 6000-1 in 10,000. TSC is an autosomal dominant syndrome involving heart, kidneys, lungs, and skin. The classic triad of TSC is seizures, mental retardation, and angiofibromas; this triad occurs in only 29% of patients. The clinical diagnostic guidelines on TSC are prepared based on clinical features, radiographic findings. The most common oral manifestations of TSC are fibroma, gingival hyperplasia, and enamel hypoplasia. Odontogenic myxofibroma represents a rare slow-growing benign neoplasm found rarely in children below 10 years or adults over 50 years of age. The prevalence of myxoma is between 0.04% and 3.7%. Here, we are reporting a rare case of myxofibroma of gingiva in an 8-year-old female TSC patient.
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Hassona Y, Kasabreh N, Hammoudeh H, Scully C. Oral healthcare management in Bardet Biedl syndrome. SPECIAL CARE IN DENTISTRY 2016; 37:47-50. [PMID: 27571505 DOI: 10.1111/scd.12198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Bardet Biedl syndrome is a rare autosomal recessive disorder with variable clinical presentation and challenging diagnosis. Recognition of orofacial features might help in the diagnosis. Dental management of affected patients might be complicated by renal, cardiac, metabolic, neurosensory, and cognitive defects.
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George N, Santhosh VC, Kumar H, Gopal S. Gingival enlargement in myelodysplastic syndrome. J Indian Soc Periodontol 2016; 19:687-9. [PMID: 26941522 PMCID: PMC4753716 DOI: 10.4103/0972-124x.164761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The myelodysplastic syndrome (MDS) is characterized by peripheral blood cytopenias and increased risk of transformation to acute myeloid leukemia. This syndrome affects blood cell production and behavior. MDS is difficult to diagnose because of the absence of symptoms in the early stage of the disease. Often it is accidentally discovered during a routine physical exam/blood test. Till date, only a few cases of gingival enlargement associated with MDS are reported in the literature. Here is a remarkable case of gingival enlargement heralding the presence of MDS.
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Hosadurga R, Nabeel Althaf MS, Hegde S, Rajesh KS, Arun Kumar MS. Influence of sex hormone levels on gingival enlargement in adolescent patients undergoing fixed orthodontic therapy: A pilot study. Contemp Clin Dent 2016; 7:506-511. [PMID: 27994419 PMCID: PMC5141666 DOI: 10.4103/0976-237x.194099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Sex hormones may be a modifying factor in the periodontal disease pathogenesis. Aim: The association between gingival enlargement and sex hormone levels in adolescent patients undergoing fixed orthodontic therapy needs to be determined. Settings and Design: This study was conducted in the Department of Periodontology in association with the Department of Orthodontics, Yenepoya Dental College, Yenepoya University, Mangaluru. Materials and Methods: A pilot study was conducted on 21 adolescent patients between the age group of 13–19 years, who had undergone fixed orthodontic therapy for at least 3 months. Apicocoronally, the gingival enlargement was assessed by the index described by Miller and Damm. Miranda and Brunet index was used to assess gingival overgrowth in the buccal–lingual direction in the interdental papilla. Furthermore, the patients were assigned to two groups - Group 1-GE and Group 2-non-GE. Sex hormones assessed were estradiol and progesterone in females and testosterone in males in both groups. Results: 57.1% of the study population had enlargement of the gingiva. The mean plaque score was 0.59 and 0.56, respectively, in both groups. A statistically significant relationship was found between estradiol and testosterone levels with gingival enlargement. However, a significant relationship was not obtained for progesterone levels with the gingival enlargement. Conclusion: Direct correlation between estradiol, testosterone, and gingival enlargement was seen.
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Pant VA, Pandey S. A rare case report of grade III gingival enlargement associated with chronic periodontitis: Comparison of two treatment techniques. Natl J Maxillofac Surg 2015; 6:119-22. [PMID: 26668468 PMCID: PMC4668722 DOI: 10.4103/0975-5950.168231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Idiopathic gingival enlargement (GE) is a rare entity characterized by massive enlargement of the gingiva. It may be associated with other diseases/conditions characterizing a syndrome, but rarely documented in literature occurring along with chronic periodontitis. This case report describes a rare case of long standing massive GE in a systemically healthy, nonsyndromic young female involving both the arches, thereby posing a diagnostic dilemma. Furthermore, in this case, we compared two surgical approaches, that is, scalpel and electrosurgery for the convenience as well as the postoperative comfort of the patient. Quadrants 1 and 3 were treated by ledge and wedge technique using scalpel and blade while quadrants 2 and 4 were treated by electrosurgery. The patient was followed postoperatively up to 1-year. The massive GE subsided without recurrence and patient was completely satisfied with the treatment, though better compliance was observed at the site treated by conventional scalpel and blade technique.
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Sethi N, Patankar S, Jain R, Mehta A. An unusual case of Burkitt's lymphoma presenting as a gingival enlargement. J Indian Soc Periodontol 2015; 19:573-7. [PMID: 26644726 PMCID: PMC4645546 DOI: 10.4103/0972-124x.156880] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Burkitt's lymphoma is an undifferentiated non-Hodgkin's B-cell lymphoma. Three clinical subtypes are recognized: African (endemic), American and other areas (sporadic) and human immunodeficiency virus (HIV) associated. Sporadic Burkitt's lymphoma is a rare malignancy among Asian population. This report describes a case of sporadic Burkitt's lymphoma presenting as generalized gingival enlargement with an alarmingly rapid spread. This type of rapid progression bespeaks the need for prompt recognition and life-saving referral by the dental practitioner. The purpose of this case report and review of the literature was to illustrate the fact that an inconspicuous and benign looking gingival enlargement may turn out to be an aggressive malignancy like Burkitt's lymphoma.
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Bansal M, Singh N, Patne S, Singh SK. Orofacial granulomatosis affecting lip and gingiva in a 15-year-old patient: A rare case report. Contemp Clin Dent 2015; 6:S94-6. [PMID: 25821385 PMCID: PMC4374329 DOI: 10.4103/0976-237x.152958] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Orofacial granulomatosis (OFG) is a rare disorder affecting the orofacial region, and clinically characterized by diffuse, nontender, soft to firm, painless swelling restricted to one or both lips and intraoral sites such as tongue, gingiva and buccal mucosa. Histologically, OFG is characterized by noncaseating granulomatous inflammation. The early diagnosis of OFG is essential for the better prognosis of the lesion. Delay in diagnosis of OFG results into formation of indurated and permanent swelling of the lip that not only compromises esthetic appearance but also causes impairment in function such as speaking and eating. Early diagnosis of OFG is challenging to the health care professionals due to clinical and histological resemblance to other chronic granulomatous disorders. Thus, dentists may act as a first person to diagnose the lesion and play an important role in the multidisciplinary treatment of granulomatous disorders. Here, we present a case of OFG affecting lips and gingiva in a 15-year-old patient without any identifiable systemic or local causes.
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Tripathi AK, Mukherjee S, Saimbi CS, Kumar V. Low dose amlodipine-induced gingival enlargement: A clinical case series. Contemp Clin Dent 2015; 6:107-9. [PMID: 25684923 PMCID: PMC4319326 DOI: 10.4103/0976-237x.149303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Gingival enlargement sometimes has an adverse effect of certain systemic drugs such as the use of anticonvulsants, phenytoin, antihypertensive, calcium channel blockers and immunosuppressant, cyclosporine. Amlodipine, a relatively newer calcium channel blocker drugs, exhibit adverse effect of gingival enlargement in middle to older aged adults. There are very few reports of amlodipine-induced gingival enlargement at a lower dose (5 mg). In this article, three cases of amlodipine-induced gingival enlargement in the age range of 50-65 years old hypertensive patient with a lower dose of amlodipine (5 mg).
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Dahiya R, Kathuria A. Extragingival pyogenic granuloma histologically mimicking capillary hemangioma. J Indian Soc Periodontol 2014; 18:641-3. [PMID: 25425828 PMCID: PMC4239756 DOI: 10.4103/0972-124x.142463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 02/17/2014] [Indexed: 11/04/2022] Open
Abstract
Pyogenic granuloma is a tumor-like proliferation to a non-specific infection. The tumor-like growth is considered to be non-neoplastic in nature and presents in various clinical and histological forms in the oral cavity. Hemangiomas are benign vascular anomalies characterized by benign proliferation of blood vessels. The aim of this article is to drive attention toward the uncommon location of capillary hemangioma on the palate. In spite of their benign nature, intraoral capillary hemangiomas are always clinically important to be diagnosed well in time and suitably managed. The lesion in the present case although clinically diagnosed as pyogenic granuloma gave a histological picture of capillary hemangioma when surgically excised.
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Balasundaram A, Vinayagavel M, Bandi DP. Speech intelligibility after gingivectomy of excess palatal tissue. Contemp Clin Dent 2014; 5:406-9. [PMID: 25191084 PMCID: PMC4147824 DOI: 10.4103/0976-237x.137974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
To appreciate any enhancement in speech following gingivectomy of enlarged anterior palatal gingiva. Periodontal literature has documented various conditions, pathophysiology, and treatment modalities of gingival enlargement. Relationship between gingival maladies and speech alteration has received scant attention. This case report describes on altered speech pattern enhancement secondary to the gingivectomy procedure. A systemically healthy 24-year- female patient reported with bilateral anterior gingival enlargement who was provisionally diagnosed as “gingival abscess with inflammatory enlargement” in relation to palatal aspect of the right maxillary canine to left maxillary canine. Bilateral gingivectomy procedure was performed by external bevel incision in relation to anterior palatal gingiva and a large wedge of epithelium and connective tissue was removed. Patient and her close acquaintances noticed a great improvement in her pronunciation and enunciation of sounds like “t”, “d”, “n”, “l”, “th”, following removal of excess gingival palatal tissue and was also appreciated with visual analog scale score. Exploration of linguistic research documented the significance of tongue-palate contact during speech. Any excess gingival tissue in palatal region brings about disruption in speech by altering tongue-palate contact. Periodontal surgery like gingivectomy may improve disrupted phonetics. Excess gingival palatal tissue impedes on tongue-palate contact and interferes speech. Pronunciation of consonants like “t”, “d”, “n”, “l”, “th”, are altered with anterior enlarged palatal gingiva. Excision of the enlarged palatal tissue results in improvement of speech.
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Gupta SR, Gupta R, Saran RK, Krishnan S. Plasma cell mucositis with gingival enlargement and severe periodontitis. J Indian Soc Periodontol 2014; 18:379-84. [PMID: 25024555 PMCID: PMC4095634 DOI: 10.4103/0972-124x.134583] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 11/25/2013] [Indexed: 11/16/2022] Open
Abstract
Plasma cell mucositis (PCM) is a very rare, chronic, multifocal, idiopathic, non-neoplastic plasma cell proliferative disorder of the upper aerodigestive tract. The classic clinical presentation is an intensely erythematous mucosa with surface changes described variously as papillomatous, cobblestone, nodular or velvety. It is a very rare condition <50 cases reported in literature. A 72-year-old male patient complained of sore throat, stomatodynia, dysphagia, multiple oral ulcers, enlarged swollen bleeding gums and mobile teeth. There was chronic inflammatory enlargement of the gingiva and palate with severe periodontitis. Histopathological examination revealed a hyperplastic epithelium with a dense infiltrate of mature polyclonal plasma cells in the superficial layer of the lamina propria. PCM is a diagnosis of exclusion, to be differentiated from other infective, reactive, autoimmune, allergic and neoplastic disorders with plasma cell infiltrates. Management with surgical and immunosuppressive therapy is mostly ineffective with short remissions and frequent relapses.
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Nayyar AS, Khan M, Vijayalakshmi KR, Suman B, Subhas GT, Nataraju B, Anitha M. Phenytoin, folic acid and gingival enlargement: Breaking myths. Contemp Clin Dent 2014; 5:59-66. [PMID: 24808697 PMCID: PMC4012119 DOI: 10.4103/0976-237x.128666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Epilepsy is described as a chronic neurological disorder characterized by recurrent seizures of cerebral origin, presenting with episodes of sensory, motor or autonomic phenomenon with or, without loss of consciousness. A recent meta-analysis of published and unpublished studies puts an overall prevalence rate of epilepsy in India at 5.59 per 1,000 populations. There have been studies that report clinical benefits of the use of folic acid as an adjuvant to the anti-epileptic therapy in the prevention of anti-epileptic drug induced gingival enlargement. However, studies conducted in the past have also reported precipitation of epileptic attacks in patients on folic acid adjuvant therapy due to fall in sera levels of phenytoin due to drug interactions. The study was planned to investigate the association of phenytoin induced gingival enlargement and sera levels of folic acid in epileptic patients on phenytoin therapy so as to justify the use of folic acid as a routine adjuvant to the usual anti-epileptic therapy to prevent this inevitable adverse effect without destabilizing the ongoing regimen leading to the precipitation of seizures in an otherwise stable patient (breakthrough seizures). Materials and Methods: A total of 100 patients between the ages 18 and 50 years were clinically diagnosed with epilepsy prior to the start of phenytoin therapy were included based on selection criteria and written informed consents were obtained. Assessment of serum folic acid levels and gingival enlargement was performed prior to the start of and after 1 year of phenytoin therapy. Statistical Analysis Used: The statistical analysis was carried out using t-test and the baseline serum folate levels and the serum folate levels obtained after 1 year of phenytoin therapy were correlated with the respective grades of gingival enlargement using Pearson's coefficient formula. Results: The results of the study confirmed a significant association between low serum folate levels with increasing severity as well as an early onset of phenytoin induced gingival enlargement. Conclusions: The results of the study suggest a higher incidence of gingival enlargement with an early onset and increased severity in phenytoin treated epileptic patients with a positive correlation with falling serum folic acid levels as the duration of the therapy increases.
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Babu SPKK, Kashyap V, Sivaranjani P, Agila S. An undiagnosed case of acute myeloid leukemia. J Indian Soc Periodontol 2014; 18:95-7. [PMID: 24744555 PMCID: PMC3988656 DOI: 10.4103/0972-124x.128257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 09/11/2013] [Indexed: 01/17/2023] Open
Abstract
Leukemia is a neoplastic disease characterized by an excessive proliferation of immature white blood cells and their precursors. Oral lesions may be the presenting feature of acute leukemia, which can be rapidly fatal if left untreated. Although many cases of gingival enlargement in patients with acute myeloid leukemia's have been reported in the literature, cases diagnosed by the oral manifestations in India are very few. This report describes the case of a 43-year-old female who presented with gingival bleeding and gingival enlargement. Within a month she developed signs and symptoms of systemic disease such as, and splenomegaly, and upon further investigation, she was diagnosed with acute myeloid leukemia to which she succumbed within 10 days after diagnosis. The need for early diagnosis and referral of this fatal disease are also underline.
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Krishna KB, Raju PK, Chitturi RR, Smitha G, Vijai S, Srinivas BVV. Prevalence of gingival enlargement in Karnataka school going children. J Int Oral Health 2014; 6:106-10. [PMID: 24653613 PMCID: PMC3959147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 12/29/2013] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Periodontal diseases affect more people all over the world than dental caries. Increase in size of gingiva is known as gingival hyperplasia or gingival enlargement. Gingival swelling is almost universally the result of Fluid accumulation within the tissues. Enlargement and even aesthetically disfiguring over growth of the gingival tissue, is also a common finding of leukemia, scurvy and subjects undergoing the hormonal changes of puberty, pregnancy, menopause and drugs. MATERIALS & METHODS A sample size of 1500 was taken. All children who were between the chronological age of 5-12 years from selected schools were included in the study.Three age groups were selected for the study, Group I: 5-7yrs, Group II: 7-9 yrs, Group III 9-12yrs. Each group comprised of 500 students. The examination of gingival enlargement was made according to Gingival Enlargement Index. The oral hygiene status of the child was examined using Oral Hygiene Index-Simplified. RESULTS The prevalence of Gingival Enlargement increased with the increase of age. Though the Prevalence of GE in female children (15.1%) was more than male children (13.4%), it was not statistically significant. Female children (1.6%) had a higher prevalence of epilepsy than male children (0.29%) in this present study. CONCLUSION The prevalence of gingival enlargement was predominantly inflammatory, showing that the oral hygiene status of the oral Children in Karnataka was far from satisfactory. Further studies need to be undertaken regarding the prevalence if GE in School going children. How to cite the article: Krishna KB, Raju PK, Chitturi RR, Smitha G, Vijai S, Srinivas BV. Prevalence of gingival enlargement in Karnataka school going children. J Int Oral Health 2014;6(1):106-10.
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Singh Nayyar A, Khan M, Vijayalakshmi KR, Subhas GT, Nataraju B, Anitha M. A study on gingival enlargement and folic acid levels in phenytoin-treated epileptic patients: Testing hypotheses. Surg Neurol Int 2013; 4:133. [PMID: 24231926 PMCID: PMC3814993 DOI: 10.4103/2152-7806.119232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 06/08/2013] [Indexed: 11/10/2022] Open
Abstract
Background: There have been studies that report clinical benefits of the use of folic acid as an adjuvant to the antiepileptic therapy in the prevention of antiepileptic drug-induced gingival enlargement. However, studies in the past have also reported precipitation of epileptic attacks in patients on folic acid adjuvant therapy due to fall in sera levels of phenytoin due to drug interactions. The study was planned to investigate the association of phenytoin-induced gingival enlargement and sera levels of folic acid in epileptic patients on phenytoin therapy. The statistical analysis was done using t-test and the baseline serum folate levels and the serum folate levels obtained after 6 months of phenytoin therapy were correlated with the respective grades of gingival enlargement using Pearson's coefficient formula. Methods: A total of 25 patients aged between 18 and 50 years, clinically diagnosed with epilepsy prior to the start of phenytoin therapy were included based on selection criteria and written informed consents were obtained. Assessment of serum folic acid levels and gingival enlargement was done prior to the start of and after 6 months of phenytoin therapy. Results: The results of the study confirmed a significant association between low serum folate levels with increasing severity as well as an early onset of phenytoin-induced gingival enlargement. Conclusions: The results of the study suggest a higher incidence of gingival enlargement in phenytoin treated epileptic patients with a positive correlation with falling serum folic acid levels as the duration of the therapy increases.
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Makkar A, Tewari S, Kishor K, Kataria S. An unusual clinical presentation of plasma cell gingivitis related to "Acacia" containing herbal toothpaste. J Indian Soc Periodontol 2013; 17:527-30. [PMID: 24174738 PMCID: PMC3800421 DOI: 10.4103/0972-124x.118330] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 07/11/2013] [Indexed: 11/23/2022] Open
Abstract
A 17-year-old female patient presented with unusual enlargement of the gingiva with generalized alveolar bone loss. In spite of periodontal therapy, including plaque control, scaling, root planning and surgical treatment, recurrence with the same degree of the gingival enlargement and further loss of attachment level occurred. Biopsy revealed dense infiltration of normal plasma cells separated by collagenous stroma. Discontinuation of herbal toothpaste resulted in remarkable remission of the gingival enlargement within 2 weeks. Enzyme-linked immunosorbent assay of toothpaste components disclosed “Acacia” as an etiologic antigenic agent and confirmed the diagnosis of plasma cell gingivitis (PCG). Usually, PCG is not associated with the loss of attachment. This case report appears to be the first publication to document an atypical presentation of PCG with generalized aggressive periodontitis related to the use of herbal toothpaste containing “Acacia” extract from the tree “Acacia Arabica.”
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