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Abstract
Non-plaque induced diffuse gingival overgrowth represents a broad class of conditions caused by several etiological factors. The aim of this review is to highlight the most recent updates and classifications of all the existent gingival overgrowths. In addition, we highlighted the diagnostic pathway that should be employed in patients affected by gingival overgrowth. Gingival overgrowth can be related to syndromic diseases including a wide spectrum of genetic and chromosomal alterations. However, thanks to scientific sharing and the availability of genetic panels it is possible to obtain an accurate phenotypic identification of well-known syndromes and also to identify new ones. This narrative review shows that through rigid, strict diagnostic protocols, the work of the clinician is greatly facilitated, despite the wide variety of pathologies considered. In conclusion, the exchange of specialists’ competencies and the multidisciplinary management of these patients, are crucial to reach diagnosis and the correct clinical-therapeutic management.
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Vincent-Bugnas S, Borsa L, Gruss A, Lupi L. Prioritization of predisposing factors of gingival hyperplasia during orthodontic treatment: the role of amount of biofilm. BMC Oral Health 2021; 21:84. [PMID: 33627113 PMCID: PMC7903590 DOI: 10.1186/s12903-021-01433-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 02/09/2021] [Indexed: 12/26/2022] Open
Abstract
Background The mechanism of gingival growth that may occur during fixed orthodontic treatment is not yet fully understood and the amount of dental plaque is often incriminated. The objective of this study was to evaluate the prevalence of gingival growth during multi-attachment orthodontic treatment and to prioritize its predicting factors, especially the quantity of biofilm. Methods This comprehensive cross-sectional descriptive study was conducted on orthodontic patients aged 9 to 30 years, in good health, treated by a fixed appliance. Periodontal clinical parameters such as plaque index, gingival index, probing pocket depth, periodontal phenotype and gingival enhancement index were recorded. Likewise, the brushing habits and the date of the last scaling were noted. The orthodontic parameters studied were the duration of the treatment, the type of bracket, the alloys used for the arches and the type of ligatures. Descriptive statistics were carried out, and variables presenting p value < 0.25 were included in a multivariate analysis to calculate the Odds Ratio (OR) of gingival enlargement”. Results A total of 193 patients were included (16.38 ± 4.89 years). Gingival growth occurred for 49.7% of patients included. The predisposing factors for this pathology during fixed orthodontic treatment were conventional metal brackets (p = 0.021), mouth breathing (p = 0.040), male gender (p = 0.035), thick periodontal phenotype (p = 0.043), elastomeric ligations (p = 0.007), duration of treatment (p = 0.022) and presence of plaque (p = 0.004). After achievement of the logistic regression, only two factors remained related to gingival enlargement: metallic brackets (OR: 3.5, 95% CI: 1.1–10.55) and duration of treatment (OR: 2.03, 95% CI: 1.01–4.08). The amount of plaque would not be directly related to the development of gingival increase during orthodontic treatment. Conclusions Among the predisposing factors that underlie gingival growth during multi-attachment therapy, the amount of plaque is not found. The qualitative assessment of the plaque and its evolution during treatment could clarify the role of the biofilm in the occurrence of gingival overgrowth.
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Affiliation(s)
- Séverine Vincent-Bugnas
- Département de parodontologie, Université Côte d'Azur, UFR Odontologie, 24 Avenue des diables bleus, 06300, Nice, France. .,Pôle d'Odontologie, Centre Hospitalier Universitaire de Nice, 5 Rue Pierre Dévoluy, 06000, Nice, France. .,Laboratoire MICORALIS EA7534, Université Côte d'Azur, 24 Avenue des diables bleus, 06300, Nice, France.
| | - Leslie Borsa
- Pôle d'Odontologie, Centre Hospitalier Universitaire de Nice, 5 Rue Pierre Dévoluy, 06000, Nice, France.,Laboratoire MICORALIS EA7534, Université Côte d'Azur, 24 Avenue des diables bleus, 06300, Nice, France.,Département de santé publique, Université Côte d'Azur, UFR Odontologie, 24 Avenue des diables bleus, 06300, Nice, France
| | - Apolline Gruss
- Pôle d'Odontologie, Centre Hospitalier Universitaire de Nice, 5 Rue Pierre Dévoluy, 06000, Nice, France.,Université Côte d'Azur, UFR Odontologie, 24 Avenue des diables bleus, 06300, Nice, France
| | - Laurence Lupi
- Pôle d'Odontologie, Centre Hospitalier Universitaire de Nice, 5 Rue Pierre Dévoluy, 06000, Nice, France.,Laboratoire MICORALIS EA7534, Université Côte d'Azur, 24 Avenue des diables bleus, 06300, Nice, France.,Département de santé publique, Université Côte d'Azur, UFR Odontologie, 24 Avenue des diables bleus, 06300, Nice, France
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Clery J, Clémençon S, Sebbane G, Pamoukdjian F. [Not Available]. SOINS. GERONTOLOGIE 2020; 25:47-48. [PMID: 32988488 DOI: 10.1016/j.sger.2020.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Josué Clery
- Hôpital Avicenne, service de médecine gériatrique, 125 rue de Stalingrad, 93000 Bobigny, France
| | - Stéphanie Clémençon
- Hôpital Avicenne, service de médecine gériatrique, 125 rue de Stalingrad, 93000 Bobigny, France
| | - Georges Sebbane
- Hôpital Avicenne, service de médecine gériatrique, 125 rue de Stalingrad, 93000 Bobigny, France
| | - Frédéric Pamoukdjian
- Hôpital Avicenne, service de médecine gériatrique, 125 rue de Stalingrad, 93000 Bobigny, France; Université Paris 13, Sorbonne Paris Cité, 99 avenue Jean-Baptiste-Clément, 93430 Villetaneuse, France.
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Amlodipine-induced gingival enlargement: A case report. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 121:308-311. [PMID: 31055091 DOI: 10.1016/j.jormas.2019.04.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 11/20/2022]
Abstract
Gingival enlargements (GEs) can be caused by local, systemic diseases or drugs. Three molecules can be responsible of GEs: ciclosporin, phenytoin and calcium channel blockers (CCBs). We report the case of a 56-year-old male treated by Amlodipine, a CCB, for hypertension for many years and who recently developed a severe GE affecting both mandibular and maxillary arches inducing dental malposition. The histological examination showed non-specific inflammation with a predominance of lymphocytes. Amlodipine was suspected and suspended in agreement with his physician. One month later, the enlargement significantly reduced but GE was so severe and dental malposition so marked that all the teeth but the canines were extracted. No recurrence was noted one year later. This exceptional case should encourage every practitioner to be vigilant with patient treated with CCBs and their potential side effects and consequences.
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Godillot C, Laprie A, Eid C, Fricain JC, Boulinguez S, Casassa E, Vigarios E, Sibaud V. Le phénomène de la langue verte, ou le diagnostic par Google. Ann Dermatol Venereol 2018; 145:429-432. [DOI: 10.1016/j.annder.2018.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 09/13/2017] [Accepted: 02/13/2018] [Indexed: 10/14/2022]
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Fricain JC, Sibaud V. [Pigmentations of the oral cavity]. Presse Med 2017; 46:303-319. [PMID: 28410949 DOI: 10.1016/j.lpm.2017.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 02/14/2017] [Accepted: 02/21/2017] [Indexed: 12/29/2022] Open
Abstract
Buccal mucosa color is explained by hemoglobin in the vessels and melanin in the epithelium. Abnormal presence of melanin pigments (hypermelaninosis, hypermelanocytosis), hematic pigments (hemoglobin, hemosiderin, iron) but also some exogenous circonstancies explain pigmented lesions (figure 1). These lesions could be localized (single lesions), multifocal (multiple lesions) or diffused. In case of a localized pigmentation with melanic appearance, melanoma must be systematically eliminated with a biopsy. In the case of a more diffused lesion, systemic disease must be evoked. A drug etiology is also possible. A blood pigment excess could be a vascular malformation (flat lesions) or a tumoral process (nodular or swollen lesions). In both cases, Kaposi's disease should be systematically eliminated. Pigmentations near dental restorations (amalgams, prosthetic crowns) could be explained by an exogenous factor but a biopsy should be performed in case of a doubt with melanoma.
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Affiliation(s)
- Jean-Christophe Fricain
- CHU de Bordeaux, Inserm U1026, UFR odontologie, consultation de pathologies buccales, 146, rue Léo-Saignat, 33076 Bordeaux cedex, France.
| | - Vincent Sibaud
- Institut universitaire du cancer, Toulouse Oncopole 1, oncodermatologie et consultation pluridisciplinaire de pathologies buccales, avenue Irène-Joliot-Curie, 31100 Toulouse, France
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