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Shinoda-Ito Y, Hirai A, Omori K, Ideguchi H, Yamamoto H, Kato F, Obata K, Ogawa T, Nakano K, Nakadoi T, Katsuyama E, Ibaragi S, Yamamoto T, Nagatsuka H, Hirasawa A, Takashiba S. Ligneous periodontitis exacerbated by Behçet's disease in a patient with plasminogen deficiency and a stop-gained variant PLG c.1468C > T: a case report. BMC Oral Health 2023; 23:843. [PMID: 37940896 PMCID: PMC10633900 DOI: 10.1186/s12903-023-03586-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Plasminogen serves as the precursor to plasmin, an essential element in the fibrinolytic process, and is synthesized primarily in the liver. Plasminogen activation occurs through the action of plasminogen activator, converting it into plasmin. This conversion greatly enhances the fibrinolytic system within tissues and blood vessels, facilitating the dissolution of fibrin clots. Consequently, congenital deficiency of plasminogen results in impaired fibrin degradation. Patients with plasminogen deficiency typically exhibit fibrin deposits in various mucosal sites throughout the body, including the oral cavity, eyes, vagina, and digestive organs. Behcet's disease is a chronic recurrent systemic inflammatory disease with four main symptoms: aphthous ulcers of the oral mucosa, vulvar ulcers, skin symptoms, and eye symptoms, and has been reported worldwide. This disease is highly prevalent around the Silk Road from the Mediterranean to East Asia. We report a case of periodontitis in a patient with these two rare diseases that worsened quickly, leading to alveolar bone destruction. Genetic testing revealed a novel variant characterized by a stop-gain mutation, which may be a previously unidentified etiologic gene associated with decreased plasminogen activity. CASE PRESENTATION This case report depicts a patient diagnosed with ligneous gingivitis during childhood, originating from plasminogen deficiency and progressing to periodontitis. Genetic testing revealed a suspected association with the PLG c.1468C > T (p.Arg490*) stop-gain mutation. The patient's periodontal condition remained stable with brief intervals of supportive periodontal therapy. However, the emergence of Behçet's disease induced acute systemic inflammation, necessitating hospitalization and treatment with steroids. During hospitalization, the dental approach focused on maintaining oral hygiene and alleviating contact-related pain. The patient's overall health improved with inpatient care and the periodontal tissues deteriorated. CONCLUSIONS Collaborative efforts between medical and dental professionals are paramount in comprehensively evaluating and treating patients with intricate complications from rare diseases. Furthermore, the PLG c.1468C > T (p.Arg490*) stop-gain mutation could contribute to the association between plasminogen deficiency and related conditions.
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Affiliation(s)
- Yuki Shinoda-Ito
- Department of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8525, Japan
| | - Anna Hirai
- Department of Periodontics and Endodontics, Division of Dentistry, Okayama University Hospital, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8525, Japan
| | - Kazuhiro Omori
- Department of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8525, Japan
| | - Hidetaka Ideguchi
- Department of Periodontics and Endodontics, Division of Dentistry, Okayama University Hospital, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8525, Japan
| | - Hideki Yamamoto
- Department of Clinical Genomic Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Fumino Kato
- Department of Clinical Genomic Medicine, Okayama University Hospital, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Kyoichi Obata
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8525, Japan
| | - Tatsuo Ogawa
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8525, Japan
| | - Keisuke Nakano
- Department of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8525, Japan
| | - Takato Nakadoi
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Eri Katsuyama
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8525, Japan
| | - Tadashi Yamamoto
- The Center for Graduate Medical Education (Dental Division), Okayama University Hospital, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8525, Japan
| | - Hitoshi Nagatsuka
- Department of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8525, Japan
| | - Akira Hirasawa
- Department of Clinical Genomic Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Shogo Takashiba
- Department of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8525, Japan.
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Chaubey P, Chandra S, Razi MA, Qamar S. Massive gingival enlargement in a nine-year-old paediatric patient: A rare case report. Indian J Dent Res 2021; 32:127-130. [PMID: 34269251 DOI: 10.4103/ijdr.ijdr_559_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Gingival enlargement (GE) is a well-known clinical phenomena with the primary aetiology being plaque and poor oral hygiene. Many reasons for GE have been known. Most of the time good oral hygiene is sufficient to achieve normal healthy gingiva. GE is a heterogeneous group of disorder characterized by progressive enlargement of the gingiva with an increase in submucosal connective tissue elements. Some of them are inherited and iatrogenic while others are idiopathic. In this case, we report a case with massive idiopathic GE in a 9-year-old female child; treatment received, histopathological description and follow-up are discussed.
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Affiliation(s)
- Pallavi Chaubey
- Department of Pedodontics and Preventive Dentistry, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Saurav Chandra
- Department of Dentistry, R. G. Kar Medical College and Hospital, Kolkata, West Bengal, India
| | - Mohammed Ahsan Razi
- Department of Periodontology, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
| | - Seema Qamar
- Department of Pedodontics and Preventive Dentistry, Hazaribag College of Dental Sciences and Hospital, Hazaribag, Jharkhand, India
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Sridhar M, Sai Sankar AJ, Sankar KS, Kumar KK. Accidental displacement of primary anterior teeth following extraction of neonatal teeth. J Indian Soc Pedod Prev Dent 2020; 38:311-314. [PMID: 33004731 DOI: 10.4103/jisppd.jisppd_48_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Eruption of the first tooth at 6 months of age is a significant stage in a child's life. However, the presence of a tooth in the oral cavity of a newborn can lead to a lot of delusions. Natal and neonatal teeth are of utmost importance not only to a dentist but also for a pediatrician due to parental anxiety, folklore superstitions, and numerous complications associated with it. The present case report describes a 1.5 cm × 1.5 cm, slow-growing, soft-tissue gingival mass which developed following the extraction of a tooth-like structure in a 4-month-old male patient. Histological examination revealed that it contained a tooth-like hard tissue intermingled with bone and fibrous tissue. Based on clinical and histological findings, the present case was diagnosed as gingival hyperplasia with displaced tooth buds of 71 and 81, which might be due to chronic irritation or traumatic extraction of the neonatal teeth. No abnormal recurrence of the lesion was detected during the follow-up period. However, postoperative clinical and radiographic photographs further reconfirmed the absence of tooth in relation to 71 and 81.
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Affiliation(s)
- M Sridhar
- Department of Pedodontics and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - A J Sai Sankar
- Department of Pedodontics and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - K Siva Sankar
- Department of Pedodontics and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - K Kiran Kumar
- Department of Oral and Maxillofacial Pathology, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
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Raj SC, Mahapatra A, Agrawal P, Patnaik K, Pradhan SS. Chronic idiopathic neutropenia: A periodontist's diagnosis. J Indian Soc Periodontol 2020; 24:173-177. [PMID: 32189847 PMCID: PMC7069110 DOI: 10.4103/jisp.jisp_149_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/29/2019] [Accepted: 09/09/2019] [Indexed: 11/23/2022] Open
Abstract
Our aim is to report the periodontal findings of a 10-year-old boy who visited the outpatient department of periodontology, with the chief complaint of swelling in the right cheek region for the last 2 months, increasing mobility of the teeth, and frequent bleeding from the gums. Since the age of 4 years, he suffered from recurrent febrile episodes, with boils and furuncles on the face. After several hematological and immunological investigations, he was diagnosed with chronic idiopathic neutropenia. He was prescribed a 150 μg subcutaneous injection of recombinant granulocyte colony-stimulating factor, once daily for 8 days. For reducing oral inflammation, he was advised an oral rinse of 15 ml of chlorhexidine gluconate (0.12%) twice daily and advised for a routine periodontal checkup, every 3–4 weeks for evaluation, maintenance, and avoiding any acute inflammatory flare-ups.
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Affiliation(s)
- Subash Chandra Raj
- Department of Periodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Annuroopa Mahapatra
- Department of Periodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Poonam Agrawal
- Department of Periodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Kaushik Patnaik
- Department of Periodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Shib Shankar Pradhan
- Department of Periodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
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Ikeda K. Drug-Induced Oral Complications. Atlas Oral Maxillofac Surg Clin North Am 2017; 25:127-132. [PMID: 28778302 DOI: 10.1016/j.cxom.2017.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kentaro Ikeda
- Department of Diagnostics and Biological Sciences, University of Colorado School of Dental Medicine, 13065 East 17th Avenue, Mail Stop F844, Aurora, CO 80045, USA; Department of Family Medicine, University of Colorado School of Medicine, 12631 East 17th Avenue, Aurora, CO 80045, USA.
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Kalgaonkar PS, Wade M, Warke C, Makhecha M, Khare M. Juvenile Hyaline Fibromatosis- A Rare Autosomal Recessive Disease. J Clin Diagn Res 2017; 11:SD04-SD06. [PMID: 28892992 DOI: 10.7860/jcdr/2017/25280.10293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 05/11/2017] [Indexed: 11/24/2022]
Abstract
Systemic hyalinosis is inherited as an autosomal recessive disease. It may also be referred to as Fibromatosis hyalinica multiplex juvenilis and Murray-Puretic-Drescher syndrome. A four and a half-year-old female child presented with multiple soft tissue swellings involving the nose, orbital ridges, ears, bony prominences of the ulna and tibia and the parietal and occipital prominence and had gum hypertrophy. The diagnosis of this rare condition was based upon clinicopathological correlation, wherein the histopathological examination of cutaneous lesions reveals accumulation of hyaline material with fibroblast in the dermis. A multidisciplinary approach helped in correct diagnosis, management and in providing counseling for the parents. The child's parents were counseled about the surgical excision of the lesion; however, the parents opted for non-surgical conservative management.
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Affiliation(s)
- Prarthana Sameer Kalgaonkar
- Consultant, Department of Paediatrics, Dr R N Cooper Hospital and Hindu Hriday Samrat Balasaheb Thackrey Medical College, Vile Parle West, Mumbai, India
| | - Minal Wade
- Associate Professor, Department of Paediatrics, Dr R N Cooper Hospital and Hindu Hriday Samrat Balasaheb Thackrey Medical College, Vile Parle West, Mumbai, India
| | - Charusheela Warke
- Associate Professor, Department of Paediatrics, Dr R N Cooper Hospital and Hindu Hriday Samrat Balasaheb Thackrey Medical College, Vile Parle West, Mumbai, India
| | - Meena Makhecha
- Associate Professor, Department of Dermatology, Dr R N Cooper Hospital and Hindu Hriday Samrat Balasaheb Thackrey Medical College, Vile Parle West, Mumbai, India
| | - Manisha Khare
- Professor, Department of Pathology, Dr R N Cooper Hospital and Hindu Hriday Samrat Balasaheb Thackrey Medical College, Vile Parle West, Mumbai, India
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Lee HJ, Lee H, Kim MH, Choi YY, Ahn KS, Um JY, Lee SG, Yang WM. Angelica dahurica ameliorates the inflammation of gingival tissue via regulation of pro-inflammatory mediators in experimental model for periodontitis. J Ethnopharmacol 2017; 205:16-21. [PMID: 28455165 DOI: 10.1016/j.jep.2017.04.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 04/17/2017] [Accepted: 04/20/2017] [Indexed: 06/07/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Anti-inflammatory effects of Angelica dahurica (AD) have been reported in previous studies. In this study, we investigated the anti-inflammatory effects of AD on periodontitis. MATERIALS AND METHODS Male Sprague-Dawley rats aged 7 weeks (n=7) were subjected to ligature around bilateral mandibular first molars. 1 and 100mg/mL of AD were topically applied to first molars for 14 days. Histological changes were observed in gingival epithelial layer, and the thickness of the gingival epithelial layer as well as the number of epithelial cells were quantified. To investigate the mRNA expression of pro-inflammatory cytokines in gingival tissues, reverse transcriptase polymerase chain reaction was performed. To confirm the anti-inflammatory effects of AD, pro-inflammatory mediators including cytokines and NF-kB, COX-2, and iNOS were analyzed in LPS-stimulated Raw 264.7 cells. RESULTS Topical application of AD attenuated not only the thickness of epithelial layer, also the number of epithelial cells in gingival tissue. The expressions of IL-1β, IL-6, IL-8, and IFN-γ in gingiva were significantly reduced by AD treatment. Additionally, the expressions of IL-1β, IL-6, IL-8 and IFN-γ mRNA were inhibited by AD in LPS-treated RAW264.7 macrophage cells. Furthermore, AD treatment decreased LPS-induced elevation of NF-κB, COX-2 and iNOS protein levels in RAW264.7 cells. CONCLUSION Taken together, AD application ameliorated the hyperplasia of gingival epithelial layer by down-regulating pro-inflammatory mediators. AD might have therapeutic potentials for periodontal diseases.
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Affiliation(s)
- Hye Ji Lee
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Haesu Lee
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Mi Hye Kim
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - You Yeon Choi
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Kwang Seok Ahn
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Jae-Young Um
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Seok-Geun Lee
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Woong Mo Yang
- College of Korean Medicine, Basic Research Laboratory for Comorbidity Regulation, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
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Guru SR, Suresh A, Padmanabhan S, Reddy A. A Rare Case of Digoxin Associated Gingival Overgrowth. J Clin Diagn Res 2017; 11:ZD30-ZD32. [PMID: 28571294 DOI: 10.7860/jcdr/2017/25858.9729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/06/2017] [Indexed: 11/24/2022]
Abstract
This case report presents a case of drug induced gingival overgrowth in a 28-year-old female patient with history of Coronary Artery Disease (CAD) and was prescribed digoxin in combination with furosemide and acitrom for the same. On clinical examination, the patient presented with severe gingival overgrowth. The volume of enlargement seen did not correlate solely with the diagnosis of inflammatory Gingival Enlargement (GE), hence an added drug induced component to the Gingival Overgrowth (GO) was suspected. It was decided to treat the condition using initial therapy {meticulous Scaling and Root Planning (SRP)} followed by a period of observation and maintenance. On recall, since there was no marked improvement, surgical intervention was planned. Periodic treatment combining surgery and maintenance ultimately produced the desired results clinically. Thus, this article within limits highlights that because of time-relationship between the starting of the medication that is digoxin and manifestation of GO, a causal relationship is likely.
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Affiliation(s)
- Sanjeela Rakshith Guru
- Reader, Department of Periodontics, Vydehi Institute of Dental Sciences and Research Centre, Bengaluru, Karnataka, India
| | - Aparnna Suresh
- Senior Lecturer, Department of Periodontics, Vydehi Institute of Dental Sciences and Research Centre, Bengaluru, Karnataka, India
| | - Shyam Padmanabhan
- Professor and Head, Department of Periodontics, Vydehi Institute of Dental Sciences and Research Centre, Bengaluru, Karnataka, India
| | - Adithya Reddy
- Postgraduate Student, Department of Periodontics, Vydehi Institute of Dental Sciences and Research Centre, Bengaluru, Karnataka, India
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Abstract
The aim of this case review was to touch upon the various clinical presentations and diagnostic features of Sturge-Weber syndrome (SWS) as seen in the dental/medical practice. Sturge-Weber syndrome is a rare congenital disorder that belongs to a group of disorders collectively known as the phakomatoses. The characteristic pathological elements of the disease include leptomeninges angioma extending out to cerebral cortex with angiomatous lesions on the same side and unilateral facial nevus that affects trigeminal nerve division. The classic oral lesions involve haemangiomatous gingival lesion limited on the same side of upper or lower jaw. An 18-year-old female patient reported to the Department of Oral Medicine and Radiology with oral manifestations of SWS. The evaluation of the patient, radiological findings as well as the management is discussed in this case report. It is important for the dental physician to be aware of the non-oral manifestations of SWS in order to identify and manage it appropriately. The challenge here is to see the oral manifestation as part of the syndrome and not as an isolated oral condition. Early diagnosis and appropriate treatment plan is imperative to prevent development of complications.
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Affiliation(s)
- Mahesh Neerupakam
- Reader, Department of Oral Medicine and Radiology, Lenora Institute of Dental Sciences, Rajanagaram, Rajahmundry, Andhra Pradesh, India
| | - Podduturi Sanjay Reddy
- Professor, Department of Oral Medicine and Radiology, Lenora Institute of Dental Sciences, Rajanagaram, Rajahmundry, Andhra Pradesh, India
| | - Beeraboina Anand Babu
- Senior Lecturer, Department of Oral Medicine and Radiology, Lenora Institute of Dental Sciences, Rajanagaram, Rajahmundry, Andhra Pradesh, India
| | - Guttikonda Vamsi Krishna
- Postgraduate Student, Department of Oral Medicine and Radiology, Lenora Institute of Dental Sciences, Rajanagaram, Rajahmundry, Andhra Pradesh, India
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Abstract
Juvenile hyaline fibromatosis (JHF) is a rare hereditary disease with an autosomal recessive transmission. JHF is characterized by papulonodular skin lesions, osteolytic bone lesions, flexural joint contractures, and gingival hyperplasia and usually diagnosed in infancy or early childhood. JHF is thought to be a disorder of collagen metabolism and characterized by homogenous amorphous eosinophilic material and fibrous tissue. We report the case of a 14-year-old male child with multiple papulonodular skin lesions, progressive flexion contractures of joints, and severe gingival hyperplasia, with a 10-year follow-up. Although the lesions were totally removed thrice during the last 10 years, they recurred rigorously.
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Affiliation(s)
- Esra Baltacioglu
- Department of Periodontology, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Esra Guzeldemir
- Department of Periodontology, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Erkan Sukuroglu
- Department of Periodontology, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Kadriye Yildiz
- Department of Pathology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Pinar Yuva
- Beytepe Hospital Dental Clinic, Hacettepe University, Ankara, Turkey
| | - Güven Aydin
- Department of Periodontology, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Naci Karacal
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Abstract
Permanent immunosuppression is necessary to prevent rejection after kidney
transplantation. However, it may predispose patients to different conditions and diseases including
oral lesions. The most common benign oral lesions in kidney transplant recipients are gingival hyperplasia,
oral candidiasis, hairy leukoplakia and saburral tongue. Oral form of Kaposi sarcoma, although
rarely, can also be seen in kidney transplant patients. In this review, we present the incidence, etiology,
clinical findings, diagnosis and treatment options for these lesions. For kidney transplant recipients,it
is important to maintain good oral hygiene and care, as well as regular professional control by the
dentist. This approach can reduce the number and severity of oral lesions.
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Affiliation(s)
| | - Tvrtko Hudolin
- Clinical Department of Urology, Zagreb University Hospital Center, Zagreb, Croatia
| | - Nikolina Bašić-Jukić
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb University Hospital Center, Zagreb, Croatia
| | - Željko Kaštelan
- Clinical Department of Urology, Zagreb University Hospital Center, Zagreb, Croatia
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Agrawal AA. Gingival enlargements: Differential diagnosis and review of literature. World J Clin Cases 2015; 3:779-788. [PMID: 26380825 PMCID: PMC4568527 DOI: 10.12998/wjcc.v3.i9.779] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 06/08/2015] [Accepted: 08/03/2015] [Indexed: 02/05/2023] Open
Abstract
Gingival enlargement is one of the frequent features of gingival diseases. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician. They can be categorized based on their etiopathogenesis, location, size, extent, etc. Based on the existing knowledge and clinical experience, a differential diagnosis can be formulated. Subsequently, after detailed investigation, clinician makes a final diagnosis or diagnosis of exclusion. A perfect diagnosis is critically important, since the management of these lesions and prevention of their recurrence is completely dependent on it. Furthermore, in some cases where gingival enlargement could be the primary sign of potentially lethal systemic diseases, a correct diagnosis of these enlargements could prove life saving for the patient or at least initiate early treatment and improve the quality of life. The purpose of this review article is to highlight significant findings of different types of gingival enlargement which would help clinician to differentiate between them. A detailed decision tree is also designed for the practitioners, which will help them arrive at a diagnosis in a systematic manner. There still could be some lesions which may present in an unusual manner and make the diagnosis challenging. By knowing the existence of common and rare presentations of gingival enlargement, one can keep a broad view when formulating a differential diagnosis of localized (isolated, discrete, regional) or generalized gingival enlargement.
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Kumar P, Rattan V, Rai S. Comparative evaluation of healing after gingivectomy with electrocautery and laser. J Oral Biol Craniofac Res 2015; 5:69-74. [PMID: 26258017 DOI: 10.1016/j.jobcr.2015.04.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 04/28/2015] [Indexed: 11/19/2022] Open
Abstract
PURPOSE OF THE STUDY To evaluate whether laser has got any advantage over electrocautery in performing gingivectomy procedure. METHOD This was randomized split mouth prospective study where 17 patients having symmetrical gingival hyperplasia were treated with electrocautery and laser on each side. Intra- and postoperative parameters assessed were duration of surgery, bleeding, tissue sticking, postoperative pain and healing. The results were statistically analyzed and compared. RESULT There were 7 Females and 10 Males with a mean age of 28.2 ± 11.6 years. The mean time taken on the laser and electrocautery was 16 (±8.05) and 16.7 min (±9.86) respectively and the difference was not significant. On laser side, there was no bleeding in 3 (17.6%) and self limiting in 14 patients (82.4%) whereas electrocautery side, there was no bleeding in 2 (11.8%) and self limiting in 15 patients (88.2%). Both electrocautery and laser were comparable regarding ease of use during gingivectomy procedure. Charring was observed on both sides although there was more charring on the laser side. Fibrinous slough was present on both sides at 24 h. Difference in healing was not significant at various time intervals. There were no significant difference in postoperative pain experienced by the patients among the laser and cautery group at different time intervals. CONCLUSION Both techniques with proper adhesion to safeguards, can be used to remove gingival overgrowth with equal efficiency and wound healing capacity. There is no advantage of diode laser over electrocautery in performing gingivectomy.
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Affiliation(s)
- Praveen Kumar
- Ex Junior Resident, Unit of Oral & Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India
| | - Vidya Rattan
- Professor, Unit of Oral & Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India
| | - Sachin Rai
- Assistant Professor, Unit of Oral & Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India
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Golai S, Nimbeni B, Patil SD, Kakanur M, Paul S. Langerhans histiocytosis in a child - diagnosed by oral manifestations. J Clin Diagn Res 2015; 9:ZD09-11. [PMID: 26023652 DOI: 10.7860/jcdr/2015/12353.5786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Accepted: 02/24/2015] [Indexed: 12/14/2022]
Abstract
Langerhans Histiocytosis (LCH) is a rare reactive and proliferative disease of histiocytes with unknown etiology, characterized by excessive proliferation of histiocytes called Langerhans cells. It occurs mainly in children but occurrence in adults has also been reported. It manifests as punched out lesions in the skull, maxilla, mandible, sternum and other flat bones and causes rapid resorption of the alveolar bone leading to floating teeth appearance in the radiographs. This disease manifests initially in the oral cavity in most of the cases and can be diagnosed by careful clinical and radiological examination. Here, we present a case of LCH in a child which was diagnosed by a swelling in the mandibular region.
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Affiliation(s)
- Shruti Golai
- Assistant Professor, Department of Pedodontics & Preventive Dentistry, College of Dental Sciences, Chitwan Medical College and Teaching Hospital , Bharatpur, Chitwan, Nepal
| | - Basavaraj Nimbeni
- Assistant Professor, Department of Pedodontics & Preventive Dentistry, College of Dental Sciences, Chitwan Medical College and Teaching Hospital , Bharatpur, Chitwan, Nepal
| | - Sandya Devi Patil
- Professor and Head, Department of Pedodontics & Preventive Dentistry, KLE's Institute of Dental Sciences , Bengaluru, Karnataka, India
| | - Madhu Kakanur
- Professor, Department of Pedodontics & Preventive Dentistry, KLE's Institute of Dental Sciences , Bengaluru, Karnataka, India
| | - Santosh Paul
- Professor and Head, Department of Pedodontics & Preventive Dentistry, Sri Rajiv Gandhi College of Dental Science and Hospital , Bengaluru, Karnataka, India
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Abstract
INTRODUCTION The aim of this report is to present a severe case of phenytoin (PHT)-induced gingival hyperplasia in a Saudi patient. MATERIALS AND METHODS A 12-year-old male epileptic patient, undergoing PHT therapy, was diagnosed clinically with severe gingival hyperplasia. His treatment consisted meticulous oral care and weekly professional prophylaxis. The patient was advised oral folic acid supplementation (0.5 mg/day) and was also recommended 0.2% chlorhexidine gluconate mouthwash twice daily. RESULTS There was significant reduction in the hyperplastic tissue within 4 weeks of treatment. CONCLUSION It is possible to treat PHT-induced gingival hyperplasia non-surgically with intensive dental care, correct oral hygiene and oral folic acid supplements.
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Affiliation(s)
- Yousef A AlJehani
- Assistant Professor, Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia, Phone: +966500655550, e-mail:
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Prasetyono TO, Ekaputri K. Hereditary gingivo-alveolar hyperplasia: a report of two siblings. Int Surg 2015; 100:309-13. [PMID: 25692435 DOI: 10.9738/INTSURG-D-13-00174.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Gingival hyperplasia is characterized by fibrotic gingival overgrowth. The lesion may bury all the crown of the teeth and lead to impairment in masticatory functions and aesthetic disfigurement. This inherited disease is considered rare. We presented two cases of gingival hyperplasia in two siblings: an 11-year-old girl and an 8-year-old boy, whose mother had also suffered from the disease. The two siblings presented with generalized gingival overgrowth involving the maxillary and mandibular arches and covering almost all of the teeth. We performed surgery to reduce the excessive gingivo-alveolar tissue and disclosed most of the teeth. The patients showed functional and aesthetic improvement. The last follow-up through a phone call, which was conducted 12 months after the surgery, revealed no recurrent hyperplasia.
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Abstract
PURPOSE Systemic disease can manifest oral signs at an early phase, which may be crucial for the diagnosis and timing of treatment. This report describes two patients who presented with gingival enlargement as an early sign of acute leukemia. METHODS Two patients presented with oral symptoms including severe gingival enlargement. The progress of their symptoms was associated with underlying systemic disease. RESULTS The patients were transferred to the Department of Hematology and diagnosed with acute myelomonocytic leukemia. They received appropriate treatment and survived. CONCLUSIONS Gingival enlargement can be caused by underlying systemic diseases. Accurate diagnosis and timely referral are important for preventing a fatal situation. It must be emphasized that some oral signs and symptoms may be closely correlated with systemic diseases.
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Affiliation(s)
- Hyun-Chang Lim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Chang-Sung Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea. ; Department of Applied Life Science, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
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Tejnani A, Mani A, Sodhi NK, Mehta A, Gourkhede S, Thorat V, Marawar P. Incidence of amlodipine-induced gingival overgrowth in the rural population of Loni. J Indian Soc Periodontol 2014; 18:226-8. [PMID: 24872633 PMCID: PMC4033891 DOI: 10.4103/0972-124x.131332] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 10/17/2013] [Indexed: 12/13/2022] Open
Abstract
Aims: Since the incidence of gingival overgrowth induced by amlodipine remains poorly defined, this study was carried out with an aim to determine the incidence. Materials and Methods: Dental patients who received amlodipine (N = 115), for more than 3 months were studied to determine the drug-induced gingival overgrowth. Clinical diagnosis of drug-induced overgrowth was verified by disappearance or decreased severity of gingival overgrowth after withdrawal of the causative drug. Results: The prevalence rate of amlodipine-induced gingival hyperplasia among experimental patients was 3.4%, while it was not observed among the control subjects. Oral examination revealed gingival overgrowth as a lobular or nodular enlargement on interdental papilla located in the anterior interproximal regions. Conclusions: In this study, there was a significant relationship between gingival inflammation resulting from dental plaque and drug dosage, and hyperplasia.
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Affiliation(s)
| | - Ameet Mani
- Department of Periodontology, Rural Dental College, Loni, India
| | | | - Alok Mehta
- Department of Periodontology, Hiranandani Hospital, Thane, Maharashtra, India
| | - Sonal Gourkhede
- Department of Periodontology, Late Shri Yashwantrao Chavan Memorial Medical and Rural Development Foundation's Dental College, Maharashtra, India
| | - Vinayak Thorat
- Department of Periodontology, BVP Dental College, Navi Mumbai, Maharashtra, India
| | - Pramod Marawar
- Department of Periodontology, Rural Dental College, Loni, India
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19
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Patel PV, Gujjari SK. The Morphometrical and Histopathological Changes which were Observed after Topical Ozone Therapy on an Exophytic Fibrous Gingival Lesion: A Case Report. J Clin Diagn Res 2013; 7:1239-43. [PMID: 23905150 DOI: 10.7860/jcdr/2013/4963.3039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 03/19/2013] [Indexed: 11/24/2022]
Abstract
We are presenting 2 cases where ozone therapy was used in the form of ozonated oil on an exophytic fibrous gingival lesion. A 42-years female patient was selected, who presented with a mild to moderately painful, exophytic, fibrous lesion on the upper anterior gingiva. This gingival lesion was treated with 2ml of ozonated oil, thrice daily for one week. After the ozone therapy, the postoperative outcomes were measured and analyzed. Finally, the lesion was subjected to an excisional biopsy and a histopathological evaluation. After the ozone therapy, the patient revealed that there was less pain. On examination of the lesion, an improvement was observed in the clinical sign of the inflammation and also a reduction in the surface ulceration. During the final biopsy, less bleeding was observed. The morphometrical analysis showed a reduction in the size of the lesion. The histopathological analysis showed a reduction in the collagen fibres and in the inflammatory cells in the connective tissue stroma. Topical ozone therapy provides potential benefits for the treatment of exophytic gingival lesions. The observed benefits in present case report needs to be verified in future with well-controlled clinical trials.
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Affiliation(s)
- Punit Vaibhav Patel
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University (B.H.U.) , Varanasi,-05, U.P., India
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20
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Abstract
The management of cardiovascular disorders poses a dilemma for the medical fraternity. Calcium channel blockers are one of the most commonly used drugs for the management of this disorder, and it is also a well known fact that they are one of the most common group of drugs responsible for causing gingival over growth as one of their adverse effects. Amlodipine is a new generation hypertensive, which has found wide acceptance and usage due to its duration of action. Even with all its benefits as a potent hypertensive, its effect on gingival tissues is what causes concern to the patient and dental surgeon equally. The objective of this article is to create awareness regarding the adverse oral effects of amlodipine, its underlying mechanism of action in bringing about this adverse reaction, along with providing a brief review of the pharmacologic profile of this drug.
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Affiliation(s)
- Nsc Charles
- Department of Oral Pathology and Microbiology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Indira Nagar, Gorimedu, Puducherry, India
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Basavanthappa NN, Kagathur U, Basavanthappa RN, Suryaprakash ST. Natal and neonatal teeth: a retrospective study of 15 cases. Eur J Dent 2011; 5:168-72. [PMID: 21494384 PMCID: PMC3075983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To present 17 natal/neonatal teeth in 15 patients and describe their clinical characteristics, associated disorders, complications and treatment. METHODS A retrospective study of neonates who visited the Department of Pedodontics and Preventive Dentistry, College of Dental Sciences, Davangere, India, between 2003 and 2006 was carried out. It was a study of clinical data, such as the age and gender of the patients, the history and chief complaints of mothers, the clinical appearance and location of natal/neonatal teeth, and associated complications and treatments. RESULTS A total of 17 teeth (6 natal, 11 neonatal) were found in 15 patients. No significant gender predilection (8 male, 7 female) was found. Sixteen natal/neonatal teeth were placed in mandibular incisor area (10 on the right side and 6 on the left side) and one tooth in the maxillary incisor area. In 13 patients, the occurrence of natal/neonatal teeth was unilateral, and in 2 patients, it was bilateral. Three cases were associated with enamel hypoplasia, 3 cases with Riga-Fede disease, and 1 case with gingival hyperplasia. One case involved a patient with cleft lip and palate. Radiographic examination confirmed these teeth to be supernumerary, and all teeth exhibited hypermobility. Extraction had been done in all the cases. Eleven of the extracted teeth exhibited only rudimentary roots, and six teeth showed no roots. CONCLUSIONS The occurrence of a natal/neonatal tooth is a rare phenomenon. When it occurs, the teeth have a variety of clinical characteristics and lead to different complications. Knowledge of the management of these structures is essential for the overall well being of a child.
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Affiliation(s)
- Nagaveni N Basavanthappa
- Assistant Professor, Department of Pedodontics & Preventive Dentistry, College of Dental Sciences, Davangere, India,Corresponding author: Dr. Nagaveni N Basavanthappa, Department of Pedodontics & Preventive Dentistry, College of Dental Sciences, Davangere, Karnataka, India. Phone: +91 9675129388, E-mail:
| | - Umashankara Kagathur
- Associate Professor, Department of Oral & Maxillofacial Surgery, College of Dental Sciences, Davangere, India
| | - Radhika N Basavanthappa
- Senior Lecturer, Department of Orthodontics, School of Dentistry, Krishna Institute of Health Sciences, Karad, Maharashtra, India
| | - Satisha T Suryaprakash
- Resident (Periodontics), Department of Dental Surgery, Armed Forces Medical College, Pune, Maharashtra, India
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Demirer S, Özdemir H, Şencan M, Marakoḡlu I. Gingival hyperplasia as an early diagnostic oral manifestation in acute monocytic leukemia: a case report. Eur J Dent 2007; 1:111-4. [PMID: 19212486 PMCID: PMC2609944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Acute Myeloblastic Leukemia (AML) is a malignant disease of bone marrow. Due to its high morbidity rate, early diagnosis and appropriate medical therapy is essential. Rapidly forming gingival hyperplasia is usually the first sign of this disease. This case report describes a 17-year-old female who presented rapid gingival overgrowth together with gingival bleeding in only two weeks time. A medical consultation was asked from hematology clinics and after a detailed medical examination Acute Monocytic Leukemia (FAB M5) was rendered. Chemotherapy was the choice of treatment. The patient responded well to chemotherapeutic induction regimen and after two months of medical therapy disease remised and gingival hyperplasia regressed. This case report shows that the gingival hyperplasia may represent an initial manifestation of an underlying systemic disease. Also, early medical therapy in acute monocytic leukemia may resolve the gingival hyperplasia that companies the disease progression.
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Affiliation(s)
- Serhat Demirer
- Assistant Professor, Kırıkkale University, Faculty of Dentistry, Department of Periodontology, Kırıkkale, Turkey,Corresponding author: Dr. Serhat Demirer, DDS, PhD Kırıkkale Üniversitesi Dişhekimliḡi Fakültesi Periodontoloji AD. 71100 Kırıkkale, Türkiye Tel: +90 318 224 49 27 Fax: +90 346 219 12 37 E-mail:
| | - Hakan Özdemir
- Research Assistant, Cumhuriyet University, Faculty of Dentistry, Department of Periodontology, Sivas, Turkey
| | - Mehmet Şencan
- Associate Professor, Cumhuriyet University, Faculty of Medicine, Department of Hematology, Sivas, Turkey
| | - Ismail Marakoḡlu
- Associate Professor, Selcuk University, Faculty of Dentistry, Department of Periodontology, Konya, Turkey
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