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Ge M, Li M, Shen L. Non-surgical treatment of idiopathic gingival enlargement: A case report. Medicine (Baltimore) 2024; 103:e37448. [PMID: 38728494 PMCID: PMC11081537 DOI: 10.1097/md.0000000000037448] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/09/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Idiopathic gingival enlargement is associated with plaque, but other contributing factors are unclear. The prognosis of idiopathic gingival enlargement is closely related to the patient's oral hygiene habits and regular follow-up. CASE PRESENTATION This article reports a case of a 32-year-old male patient with idiopathic gingival enlargement. The patient presented to the department of stomatology with a 2-month history of gingival swelling and pain on the right upper posterior teeth. During the treatment, oral hygiene instruction, supragingival cleaning, subgingival scaling, and root planning were carried out, and part of the hyperplastic gingiva was taken and sent for pathology. Pathological examination showed gingival enlargement with chronic suppurative inflammation. At 4-month follow-up, the patient's periodontal condition remained basically stable, and the gingival enlargement did not recur. CONCLUSION The treatment of this case resulted in significant reduction of gingival swelling and patient's pain reduction through non-surgical treatment and good plaque control, indicating that patients with idiopathic gingival enlargement can also achieve ideal results through non-surgical treatment. Through oral hygiene instruction, the patient mastered the method of self-plaque control, which is conducive to the long-term stabilization of the periodontal situation.
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Affiliation(s)
- Mingjie Ge
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, China
| | - Mengli Li
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, China
| | - Liheng Shen
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, China
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2
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Affiliation(s)
- Hiroyuki Teruya
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Hiroyuki Yano
- Department of Medicine, Okinawa Chubu Hospital, Japan
| | - Mitsuyo Kinjo
- Department of Medicine, Okinawa Chubu Hospital, Japan
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Mihai LL, Parlatescu I, Calin A, Burcea A. Gingival overgrowth approached using recent mechanical and laser technologies: A case report. Exp Ther Med 2024; 27:84. [PMID: 38274335 PMCID: PMC10809356 DOI: 10.3892/etm.2024.12374] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 11/23/2023] [Indexed: 01/27/2024] Open
Abstract
Gingival enlargement is a side effect of different drug classes, with calcium channel blockers being among the most often cited examples. Most often accompanied by a disruption in the oral biofilm, this form of gingival overgrowth, with histological signs of hyperplasia and hypertrophy, becomes a chronic inflammatory condition with the oral biofilm a primary cause. This periodontal disease is now classified as 'dental biofilm-induced gingivitis', and its preferred name is drug-influenced gingival expansion. The present study presented the case of a patient with gingival enlargement while being treated with nifedipine for cardiac disease. This patient had factors that contributed to the retention of bacteria, ranging from poor oral hygiene practices to poorly adapted prosthodontics. After reducing these factors, a multimodal treatment was conducted, including bacterial mechanical decontamination through guided biofilm therapy protocol, laser bacterial decontamination, and surgical laser gingivectomy. The patient was referred to their cardiologist for substituting the calcium channel blocker medication. Clinical evaluations followed each treatment step. At 12 months, the patient presented positive, stable results, with an improvement in gingival status (no gingival overgrowth in the area where all risk factors were eliminated and minimal overgrowth in the area where old poorly marginally adapted prosthodontics were kept in place and no/minimal signs of gingival inflammation).
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Affiliation(s)
- Laurenta Lelia Mihai
- Department of Oral Pathology, Faculty of Dental Medicine, Titu Maiorescu University of Bucharest, Bucharest 031593, Romania
| | - Ioanina Parlatescu
- Department of Oral Pathology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest 050037, Romania
| | - Anca Calin
- Department of Materials Science and Engineering, Polytechnic University of Bucharest, Bucharest 060042, Romania
| | - Alexandru Burcea
- Department of Medical and Surgical Emergencies in Dental Medicine, Anesthesia and Sedation, Faculty of Dental Medicine, Titu Maiorescu University of Bucharest, Bucharest 031593, Romania
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Bengi VU, Saraç Atagün Ö, Ceylan Şen S, Özcan E, Paksoy T, Güler ÖŞ. How much information regarding gingival enlargement can we get from TikTok and YouTube? Spec Care Dentist 2024. [PMID: 38177079 DOI: 10.1111/scd.12957] [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: 11/01/2023] [Revised: 11/29/2023] [Accepted: 12/23/2023] [Indexed: 01/06/2024]
Abstract
AIMS This study aimed to evaluate and compare the reliability and quality of the information about gingival enlargements on YouTube and TikTok. METHODS Two popular video sites, YouTube and TikTok, were searched for gingival enlargement and gingival hyperplasia. The reliability and quality of the first 300 videos for each search term, which is 1200 videos in total, were evaluated by social media video content evaluation tools: Global Quality Score (GQS) for quality and modified DISCERN for reliability. RESULTS Health professionals uploaded 68.6% of the videos on YouTube and 54.5% on TikTok. It was observed that 50% of TikTok videos and 65.9% of YouTube videos were educational. In terms of quality, 2.7% of the videos on YouTube are of excellent quality, while in TikTok there are no videos of perfect quality. TikTok videos had considerably more views, likes, viewing rates, and interaction index scores than YouTube videos (P < 0.01). CONCLUSIONS The videos and pieces of information on YouTube are more reliable and accurate in terms of gingival enlargement when compared to TikTok. Nevertheless, it was discovered that videos on both platforms were of poor reliability and quality in general.
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Affiliation(s)
- Vahdi Umut Bengi
- Department of Periodontology, Gülhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | - Özlem Saraç Atagün
- Department of Periodontology, Gülhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | - Seval Ceylan Şen
- Department of Periodontology, Gülhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | - Erkan Özcan
- Department of Periodontology, Gülhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | - Tuğçe Paksoy
- Department of Periodontology, Hamidiye Faculty of Dentistry, University of Health Sciences, İstanbul, Turkey
| | - Özlem Şebnem Güler
- Department of Periodontology, Gülhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
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5
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Shirbhate U, Bajaj P, Solanki D, Dare S, Sarangi S. Management of Orthodontic-Induced Gingival Enlargement: A Case Report. Cureus 2023; 15:e47660. [PMID: 38021599 PMCID: PMC10670554 DOI: 10.7759/cureus.47660] [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: 09/30/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
The aetiology of gingival enlargement (GE) is highly distinct. Plaque-induced gingival inflammation can be the sole reason for gingival enlargement. Poor dental hygiene, irritation from anatomical variations, and ineffective restorative and orthodontic appliances are all factors that encourage the formation and retention of plaque. In the given case report, a case of gingival enlargement associated with an orthodontic appliance of a 23-year-old female patient referred from the Department of Orthodontics was reported to the Department of Periodontics. Under local anaesthesia, the excess gingival tissue is removed using a scalpel by gingivectomy and gingivoplasty procedures. The gingivectomy and gingivoplasty procedures using a scalpel gave the best results in the orthodontic treatment associated with gingival enlargement. After achieving hemostasis, the periopack (Coe-pack) was placed to assist healing by protecting the tissue. The above case report can appreciate the gingival tissue covering almost half of the crown, causing plaque retention and presenting the patient with aesthetic concerns. After the surgical procedure, a proper gingival contour eliminates suprabony pockets and provides pleasant esthetics. This case report demonstrates that eliminating the suprabony pockets by gingivectomy and gingivoplasty leads to a physiologic gingival contour and eliminates plaque retention. The conventional scalpel gingivectomy procedure is an effective form of treatment when indicated.
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Affiliation(s)
- Unnati Shirbhate
- Department of Periodontics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pavan Bajaj
- Department of Periodontics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Dhruvi Solanki
- Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sneha Dare
- Department of Periodontics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swayangprabha Sarangi
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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6
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Jain S, Dhingra S, Tandon S, Lamba AK, Faraz F. Oral Hemangiolymphangioma Presenting As Gingival Enlargement: A Rare Case With Literature Review. Cureus 2023; 15:e46674. [PMID: 37942374 PMCID: PMC10628606 DOI: 10.7759/cureus.46674] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Accepted: 10/07/2023] [Indexed: 11/10/2023] Open
Abstract
Vascular malformations are anomalies that are caused by disturbances in vasculogenesis. Depending upon the dominant structure present histologically, they may be found in different combinations of vascular elements and are named hemangiolymphangioma (HLA) or lymphangiohemangioma (LHA). HLA occurs in multiple anatomical sites, such as the head and neck, axilla, abdominal cavity, extremities, and urinary bladder, but it is infrequent in the oral cavity. An 18-year-old male with a history of abdominal tuberculosis presented with an asymptomatic mandibular gingival swelling that was histologically diagnosed as HLA. A six-month follow-up revealed no recurrence. The observations reported in this case are unusual, and our literature review revealed no previously documented case of gingival HLA.
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Affiliation(s)
- Supriya Jain
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Sachin Dhingra
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Shruti Tandon
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Arundeep K Lamba
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Farrukh Faraz
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
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Ramesh R, Sadasivan A. Intramucosal Melanocytic Nevi - A Rare Cause for Gingival Enlargement. Report of a Case and Review of Literature. Clin Cosmet Investig Dent 2023; 15:71-77. [PMID: 37152717 PMCID: PMC10155718 DOI: 10.2147/ccide.s408425] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/21/2023] [Indexed: 05/09/2023] Open
Abstract
Background Oral melanocytic nevi are infrequent oral lesions derived from nevus cells of oral mucosa which causes focal hyperpigmentation. The most common site of occurrence of oral nevi is the hard palate followed by buccal mucosa and gingiva. The mean age group affected are in their 3rd and 4th decade of life and there seems to be a predilection for females. Clinically, oral nevi are usually small, well-circumscribed macules but can also present as slightly raised papules. Histologically, nevi can be classified as Junctional, Compound or Intramucosal, with intramucosal being the more common type in the oral cavity. Case Presentation In this paper, we report a case of intramucosal nevus in a 25-year-old female patient. The lesion presented as a gingival enlargement in the mandibular anterior region involving the marginal and attached gingiva, which is an extremely rare presentation. The clinical findings, histologic features and surgical management are presented. The patient was followed up for one year and the one year follow up revealed a small area of focal hyperpigmentation at the site of the previous lesion which is being closely monitored. Conclusion Nevi located in the mucous membrane have been documented to pose a threat of malignant transformation. Hence, all pigmented lesions of the oral cavity should be cautiously diagnosed.
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Affiliation(s)
- Roshni Ramesh
- Department of Periodontics, Government Dental College, Thiruvananthapuram, Kerala, India
| | - Arun Sadasivan
- Department of Periodontics, Sree Mookambika Institute of Dental Sciences, Kulasekharam, Tamil Nadu, India
- Correspondence: Arun Sadasivan, Department of Periodontics, Sree Mookambika Institute of Dental Sciences, Kulasekharam, Tamil Nadu, India, Tel +91 9847246961, Email
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Zigante M, Spalj S, Prpic J, Pavlic A, Katic V, Matusan Ilijas K. Immunohistochemical and Histopathological Features of Persistent Gingival Enlargement in Relation to Metal Allergic Sensitisation during Orthodontic Treatment. Materials (Basel) 2022; 16:81. [PMID: 36614420 PMCID: PMC9821443 DOI: 10.3390/ma16010081] [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] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to analyse the immunohistochemical profile of inflammatory infiltrates in the gingival tissue of patients undergoing orthodontic treatment in relation to patients’ titanium and/or nickel allergy status. Patients with gingival enlargement received initial periodontal therapy, followed by external gingivectomy in the case of persistent gingival enlargement. The sample included 44 patients (22 had metal allergic sensitisation). Histopathological changes were assessed, and an immunohistochemical analysis was performed on formalin-fixed and paraffin-embedded gingival samples using antibodies against CD1a, CD3, CD4, CD8, CD20, CD68, and CD138. Computer-assisted image analysis was performed to evaluate the positive cell count in the gingival tissue. The gingiva of the sensitised patients was characterised by the absence of multifocal inflammatory infiltrates (p < 0.05), while pronounced exocytosis and band-like inflammatory infiltrates were more frequently observed in sensitised patients. In addition, there was an increase in Langerhans cells and T-helper lymphocytes and a decrease in naïve T-lymphocytes, cytotoxic T-lymphocytes, macrophages, and plasma cells in the sensitised subjects compared to non-sensitised. However, the differences were only statistically significant for macrophages, with a moderate effect size (82.8 vs. 133.9; p = 0.041; r = 0.308). The absence of multifocal inflammation appears to be the most characteristic histopathological feature of the gingiva of sensitised patients. Although their gingiva presented certain characteristics of late hypersensitivity immune reactions the observed changes imply dominant irritative effect e.
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Affiliation(s)
- Martina Zigante
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Stjepan Spalj
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Department of Dental Medicine, Faculty of Dental Medicine and Health, J. J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Jelena Prpic
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Andrej Pavlic
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Visnja Katic
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Koviljka Matusan Ilijas
- Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Department of General Pathology and Pathological Anatomy, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
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Rathod AD, Jaiswal P. Gingival overgrowth during orthodontic treatment and its management. Pan Afr Med J 2022; 42:305. [PMID: 36425538 PMCID: PMC9653544 DOI: 10.11604/pamj.2022.42.305.36600] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/17/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
- Aishwarya Deepaksingh Rathod
- Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, India,Corresponding author: Aishwarya Deepaksingh Rathod, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, India.
| | - Priyanka Jaiswal
- Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, India
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Sadasivan A, Ramesh R. Lymphangioma Circumscriptum - A Rare Cause of Gingival Enlargement: A Case Report and Review of Literature. Clin Cosmet Investig Dent 2022; 14:199-206. [PMID: 35845977 PMCID: PMC9285531 DOI: 10.2147/ccide.s367281] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/24/2022] [Indexed: 12/03/2022] Open
Abstract
Background Lymphangiomas or microcystic lymphatic malformations (MLM) are hamartomatous formations that occur due to the proliferation of lymphatic vessels. They commonly manifest in the head and neck region with only a few cases reported within the oral cavity. Lymphangioma circumscriptum in the gingiva is a rare condition which presents as asymptomatic pebbly gingival enlargement. They are characterized by lesions that are microscopic thin-walled cysts. Histopathologically, they show multiple dilated lymphatic channels which are lined by endothelial cells. The lumen is filled with lymphatic fluid, red blood cells, and other inflammatory cells. These are dispersed within connective tissue stroma. Multiple modalities of treatment have been reported, including surgical excision, laser therapy, and sclerotherapy. Case Presentation This paper reports a rare case of multiple lymphangiomas of the gingiva in a 21-year-old female patient. The clinical picture, surgical treatment, histologic features, and immunohistochemistry [IHC] findings are presented. The histologic findings of lymphangioma were confirmed with IHC being positive for lymphatic marker D2-40. The patient was followed up for a period of 2 years, with no recurrence noted. Conclusion Lymphangiomas or microcystic lymphatic malformations presenting as a gingival enlargement are a rare occurrence. Therefore, lymphangiomas may also be considered in the differential diagnosis of gingival enlargements.
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Affiliation(s)
- Arun Sadasivan
- Department of Periodontics, SMIDS, Kulashekaram, Tamil Nadu, India
| | - Roshni Ramesh
- Department of Periodontics, Government Dental College, Trivandrum, Kerala, India
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11
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Joshi M, Prasanth T, Kosala M, Bhandari SK. Plasma cell gingivitis: A perplexing and rare clinical entity. J Indian Soc Periodontol 2022; 26:397-400. [PMID: 35959311 PMCID: PMC9362808 DOI: 10.4103/jisp.jisp_806_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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/08/2021] [Accepted: 07/21/2021] [Indexed: 11/22/2022] Open
Abstract
Plasma cell gingivitis (PCG) is a diagnostic dilemma for clinicians. It is also referred to as atypical gingivostomatitis, idiopathic gingivostomatitis, allergic gingivostomatitis, and plasma cell gingivostomatitis which are characterized by bright fiery red gingiva with spontaneous bleeding on slight provocation. It is often confused with inflammatory gingival enlargement, erythematosus lichen planus, and other lesions. One such rare and benign entity is discussed in this article and managed after thorough clinical, radiological, histopathology, immunohistochemistry analysis.
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Affiliation(s)
- Muneesh Joshi
- Department of Periodontology, Armed Forces Medical College, Pune, Maharashtra, India
| | - T Prasanth
- Department of Periodontology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Manab Kosala
- Department of Periodontology, Armed Forces Medical College, Pune, Maharashtra, India
| | - S K Bhandari
- Department of Dental Surgery and Oral Health Sciences, Armed Forces Medical College, Pune, Maharashtra, India
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Almansob YA, Alhammadi MS, Luo XJ, Alhajj MN, Zhou L, Almansoub HA, Mao J. Comprehensive evaluation of factors that induce gingival enlargement during orthodontic treatment: A cross-sectional comparative study. Niger J Clin Pract 2021; 24:1649-1655. [PMID: 34782504 DOI: 10.4103/njcp.njcp_69_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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]
Abstract
Background Gingival enlargement (GE) is one of the most common soft tissue problems encountered during fixed orthodontic treatment. Aims: This study aimed to evaluate the factors affecting GE in adolescents and young adults, compared with their normal peers. Subjects and Methods This is a cross-sectional comparative study. The sample consisted of 329 subjects (ages 10-30 years) of both genders, which was divided into four main groups: The control group (G0) with no orthodontic treatment; subjects who underwent orthodontic treatment were divided according to treatment duration into G1 (4-12 months), G2 (13-24 months), and G3 (>24 months). The clinical examinations included the level of debris, calculus (simplified oral hygiene), and GE indices. Regression analyses were used to assess the GE association in all the studied groups. Results The mean GE score increased significantly with increased treatment duration (0.42 ± 0.29 for G0 and 1.03 ± 0.52 for G3). GE scores of the lower arch were significantly higher in the anterior segment than in the posterior segment among all treatment groups. Regression analysis revealed that gender, age, oral hygiene, and treatment duration had a significant effect on GE (P < 0.05), while angle classification, overjet, overbite, treatment stage, bracket type, and therapeutic extraction did not show significant associations (P > 0.05). Conclusion Gender, age, oral hygiene, and treatment duration were the most important risk factors for GE during fixed orthodontic treatment.
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Affiliation(s)
- Y A Almansob
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - M S Alhammadi
- Department of Preventive Dental Sciences, Division of Orthodontics and Dentofacial Orthopedics, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - X J Luo
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - M N Alhajj
- Department of Prosthodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - L Zhou
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - H A Almansoub
- Department of Pathophysiology, Key Lab of Neurological Disorder of Education Ministry, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China; Department of Pathology, Faculty of Medicine, University of Saba Region, Marib, Yemen
| | - J Mao
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
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13
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Yadav VS, Das P, Yadav R, Tewari N. Inflammatory myofibroblastic tumor manifesting as recurrent generalized gingival enlargement: Report of a rare case. INDIAN J PATHOL MICR 2021; 63:441-444. [PMID: 32769335 DOI: 10.4103/ijpm.ijpm_431_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
Oral inflammatory myofibroblastic tumor (IMT) is extremely rare and its manifestation as generalized gingival enlargement (GGE) has never been reported. We are reporting the case of 50-year-old female patient presenting with recurrent GGE for 4 years. Panoramic radiograph revealed severe bone loss in posterior sextants and root resorption in some teeth. Initial incisional biopsy was suggestive of chronic inflammatory infiltrate with fibrocollagenous tissue. Definitive treatment comprised of surgical excision of the enlarged gingiva with a tapering dose of steroid therapy. Histopathological and immunohistochemical examination from a repeat biopsy of deeper tissues was suggestive IMT. No recurrence was found at 2 years follow up. Recurrent GGE with advanced bone loss and external root resorption should raise the suspicion of a locally aggressive lesion. Dentists should be aware of oral IMT and include it in differential diagnosis of gingival enlargements for comprehensive management to avoid recurrence of the lesion.
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Affiliation(s)
- Vikender S Yadav
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Prasenjit Das
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Renu Yadav
- Department of Prosthodontics, Surendera Dental College and Research Institute, Sriganganagar, Rajasthan, India
| | - Nitesh Tewari
- Division of Pedodontics and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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14
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Papadopoulos KS, Pantazidou G, Karagkouni E, Papadopoulos G, Papaioannou I. Local Mucosal Flap for the Treatment of Gingival Defect After Gingival Fibromatosis Excision. Cureus 2020; 12:e12016. [PMID: 33437556 PMCID: PMC7793370 DOI: 10.7759/cureus.12016] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Gingival fibromatosis (GF) is a rare condition of fibrous enlargement of the gingivae causing functional or aesthetic problems. We report a case of localized GF in a 51-year-old healthy male patient who presented in our department with localized gingival enlargement. We performed gingivectomy and restored the defect with a novel local transpositional mucosal flap with excellent functional and aesthetic results. This type of intervention is accompanied by short surgical time, provides predictable results, and should be considered in adult patients with large defects from sizable lesions.
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Affiliation(s)
| | - Georgia Pantazidou
- Otolaryngology - Head and Neck Surgery, General Hospital of Patras, Patras, GRC
| | - Eleni Karagkouni
- Otolaryngology - Head and Neck Surgery, General Hospital of Patras, Patras, GRC
| | - George Papadopoulos
- Otolaryngology - Head and Neck Surgery, General Hospital of Patras, Patras, GRC
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15
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Bansal S, Garg A, Khurana R, Bansal A. Primary orofacial granulomatous involvement of lip and gingiva only: A diagnostic challenge. J Indian Soc Periodontol 2020; 24:575-578. [PMID: 33424177 PMCID: PMC7781253 DOI: 10.4103/jisp.jisp_18_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/10/2020] [Revised: 05/29/2020] [Accepted: 07/16/2020] [Indexed: 11/26/2022] Open
Abstract
Wiesenfeld described orofacial granulomatosis (OFG) as a group of noncaseating granulomatous disorders affecting the different parts of the body including oral and maxillofacial region, which can have variable etiology. The involvement of oral and maxillofacial region can be exclusive or primary before the involvement of other organs. OFG is a multifactorial clinicopathologic disorder, and its clinical manifestation mimics the various systemic conditions making its diagnosis tough for a dentist. Delay in diagnosis and evaluation of OFG may cause indurated, swollen lips that may compromise cosmetic face value, speaking, and eating functions, and other possible systemic granulomatous disorders can be missed. Here, we present a case of OFG with tooth-associated infection without any recognizable systemic cause. This article presents the diagnostic challenges that a dentist may face in diagnosing such cases, and thus treatment planning should be of the multidisciplinary approach. Regular follow-up is very essential for proper care and management.
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Affiliation(s)
- Shweta Bansal
- Department of Periodontology, Jan Nayak Choudhary Devi lal Dental College and Hospital, Sirsa, Haryana, India
| | - Arun Garg
- Department of Periodontology, Jan Nayak Choudhary Devi lal Dental College and Hospital, Sirsa, Haryana, India
| | - Richa Khurana
- Department of Periodontology, Jan Nayak Choudhary Devi lal Dental College and Hospital, Sirsa, Haryana, India
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16
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Sharma S, Shahi AK, Prajapati VK, Singh B. Idiopathic gingival fibromatosis with massive gingival overgrowth: A rare case report. J Indian Soc Periodontol 2020; 24:379-382. [PMID: 32831513 PMCID: PMC7418552 DOI: 10.4103/jisp.jisp_426_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: 08/09/2019] [Revised: 02/06/2020] [Accepted: 02/16/2020] [Indexed: 11/28/2022] Open
Abstract
Idiopathic gingival overgrowth can present itself as a part of syndrome or as an isolated entity. This is a case report of a massive gingival enlargement in a 12-year-old female child with nonsyndromic gingival fibromatosis, which was treated by multidisciplinary approach involving surgical and prosthetic rehabilitation and at the same time instilling psychological benefit.
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Affiliation(s)
- Swati Sharma
- Department of Pedodontics and Preventive Dentistry, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Ajoy Kumar Shahi
- Department of Oral and Maxillofacial Surgery, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Virendra Kumar Prajapati
- Department of Oral and Maxillofacial Surgery, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Bishnupati Singh
- Department of Prosthodontics, Crown Bridge, Aesthetic Dentistry and Oral Implantology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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17
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Sadasivan A, Ramesh R, Kurien NM. Peripheral Adenomatoid Odontogenic Tumor - A Rare Cause of Gingival Enlargement: A Case Report with CBCT Findings. Clin Cosmet Investig Dent 2020; 12:297-304. [PMID: 32801923 PMCID: PMC7398881 DOI: 10.2147/ccide.s261308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/26/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction Adenomatoid odontogenic tumor (AOT) is an uncommon benign odontogenic lesion with varied clinical and histological presentation. It has slow growth potential and a low recurrence rate. The tumor is mainly seen in females in the second decade of life, predominantly affecting the maxilla and associated most often with unerupted canine teeth, earning the epithet “two-thirds tumor”. There are three variants: intrafollicular, extrafollicular, and peripheral. The peripheral or extra osseous type is a rare form that arises in gingival tissue. Case Presentation This article describes a case of AOT in a 10-year-old girl who presented with gingival enlargement in relation to the maxillary left central incisor. Interestingly, intraoral periapical radiography did not show any significant findings. However, cone-beam computed tomography of the site revealed significant bone loss in the area. A surgical excision was done. Histopathological examination revealed features of AOT. Based on clinical, radiographic, and histological evidence, a diagnosis of peripheral AOT (PAOT) was made. Conclusion PAOT is a rare disease entity in children that mimics gingival swelling, and may often be misdiagnosed by dentists. With literature still ambiguous on the origin of the tumor and biological course, it becomes imperative to examine any gingival swelling in children with a proper clinical examination, periapical radiography, and if necessary cone-beam computed tomography. Excision and histopathological evaluation will help in confirming the exact disease condition.
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Affiliation(s)
- Arun Sadasivan
- Department of Periodontics, Sree Mookambika Institute of Dental Sciences, Kulashekaram, Tamil Nadu, India
| | - Roshni Ramesh
- Department of Periodontics, Government Dental College, Thrissur, Kerala, India
| | - Nikhil M Kurien
- Department of Oral and Maxillofacial Surgery, PMS College of Dental Science and Research, Trivandrum, Kerala, India
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18
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Vishnu V, Ramesh R, P Radhakrishnan R, Sreelakshmi RM. Plasma Cell Gingivitis Mimicking Granulomatous Disease: A Diagnostic Dilemma. Clin Adv Periodontics 2020; 11:220-224. [PMID: 32383330 DOI: 10.1002/cap.10108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/27/2019] [Accepted: 04/20/2020] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Plasma cell gingivitis is an uncommon benign inflammatory condition of the gingiva which is considered to arise as a hypersensitivity reaction to certain allergens. The distinguishing feature of this condition is massive infiltration of plasma cells into the subepithelial connective tissue. This case report discusses a case of plasma cell gingivitis which produced a diagnostic dilemma due to its unusual histopathologic appearance. CASE PRESENTATION A 13-year-old female patient presented with diffuse gingival enlargement in relationship to upper anterior teeth. The case was managed successfully by gingivectomy following phase I therapy. Histopathological examination showed presence of epithelioid granulomas and foreign body giant cells along with plasma cells which is an uncommon finding in plasma cell gingivitis. Further tests conducted excluded granulomatous disease and the diagnosis was confirmed as plasma cell gingivitis. CONCLUSION Plasma cell gingivitis can present a diagnostic dilemma and should be included in the differential diagnosis of patients presenting with non-specific gingival enlargements.
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Affiliation(s)
- Vidya Vishnu
- Department of Periodontics, Malabar Dental College and Research Centre, Malappuram, Kerala, India
| | - Roshni Ramesh
- Department of Periodontics, Government Dental College, Thrissur, Kerala, India
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19
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Ravindran DM, Ravi S, Santhanakrishnan M, Sk B. LASER Assisted Excision of Solitary Neurofibroma in the Gingiva. Cureus 2020; 12:e7118. [PMID: 32257664 PMCID: PMC7105066 DOI: 10.7759/cureus.7118] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Neurofibromatosis (NF) is a genetic disorder that presents as benign tumours of the nervous system originating from the nerve sheath. It is of three types: Type I, Type II and Schwannomatosis. Type I Neurofibromatosis or von Recklinghausen's disease is the most common type of neurofibromatosis seen and it accounts for 90% of all cases seen. It can be seen as light brown pigmentation spots (Café-au-lait) on the skin and multiple small tumours among the nerves. Oral manifestations of NF are very rare and can be seen as sessile lesion in the tongue or the gingiva. The major complaints of the oral manifestations include difficulty in speech and mastication which it results in progression of periodontal disease. Here, we present a case report of Type I NF which presented as a sessile lesion in the right maxillary gingiva, for which we performed an excisional biopsy using LASER.
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Affiliation(s)
- Deepak M Ravindran
- Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Shravanthy Ravi
- Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | | | - Balaji Sk
- Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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20
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Kumar SS, Mohammad H, Kar K. Management of Cyclosporine-Influenced Gingival Enlargement With Azithromycin. Clin Adv Periodontics 2020; 10:140-144. [PMID: 32074404 DOI: 10.1002/cap.10097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/26/2019] [Accepted: 08/29/2019] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Management of drug-influenced gingival enlargement is challenging, and surgery is most often indicated. However, because of a unique mechanism of action, azithromycin helps in the management of gingival enlargement caused by cyclosporine. An incidental observation of the effect of azithromycin in the cyclosporine-influenced gingival enlargement by physicians in 1995 led to series of basic investigations and clinical trials confirming this observation and providing a non-surgical treatment modality. CASE PRESENTATION In this report, successful management of cyclosporine-influenced gingival enlargement in a 39-year-old renal transplant patient with the use of azithromycin without any surgical intervention is presented. CONCLUSION Use of azithromycin for managing cyclosporine-influenced gingival enlargement is a useful alternative or adjunct to surgical management. It is hoped that this report will raise further awareness of this non-surgical modality in patients taking cyclosporine.
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Affiliation(s)
- Satish S Kumar
- Department of Periodontics, Arizona School of Dentistry and Oral Health, A. T. Still University, Mesa, AZ
| | - Husain Mohammad
- Faculty of Dentistry, University of Kuwait, Kuwait.,Department of Periodontics, Ministry of Health, Kuwait
| | - Kian Kar
- Division of Periodontology, Diagnostic Sciences and Dental Hygiene, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA
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21
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Kala N, Prasad H, Babu P, Babu SPKK. Son of Sevenless-1 genetic status in an Indian family with nonsyndromic hereditary gingival fibromatosis. J Indian Soc Periodontol 2020; 24:280-283. [PMID: 32773981 PMCID: PMC7307476 DOI: 10.4103/jisp.jisp_329_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/14/2019] [Revised: 09/29/2019] [Accepted: 11/28/2019] [Indexed: 11/20/2022] Open
Abstract
Hereditary gingival fibromatosis (HGF) is a rare condition affecting the gingiva and may or may not be a clinical feature of other syndromes. It has been classified as a nondental biofilm-induced gingival disease. The pathogenesis of this condition has been poorly understood till date. Although different genetic mutations have been implicated to play a role, there is considerable interest on an addition mutation of Son of Sevenless-1 (SOS-1) gene. We report a case of a 27-year-old male patient who came to us with the complaint of enlarged gums of several years' duration. There were other members in his family who were similarly affected. After the clinical diagnosis of HGF was confirmed, the patient and his available family members were subjected to a genetic analysis for identification of mutation in SOS-1 gene, which turned out to be negative. The patient was treated with nonsurgical periodontal therapy and is under regular follow-up. To the best of our knowledge, this is the first study to assess SOS-1 mutation in an Indian family.
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Affiliation(s)
- Nitya Kala
- Department of Periodontology, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - Harikrishnan Prasad
- Department of Oral Pathology and Microbiology, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - Premalatha Babu
- Department of Oral Pathology and Microbiology, Mahatma Gandhi Post Graduate Institute of Dental Sciences, Pondicherry, India
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22
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Uppal J, Trivedi H, Gupta ND, Bey A. Periodontal management of severe periodontitis and generalized gingival enlargement in a patient with chronic renal failure. J Indian Soc Periodontol 2020; 24:284-288. [PMID: 32773982 PMCID: PMC7307469 DOI: 10.4103/jisp.jisp_194_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 03/26/2019] [Revised: 06/04/2019] [Accepted: 06/13/2019] [Indexed: 11/04/2022] Open
Abstract
Gingival enlargement is a common periodontal pathology seen in medically compromised patients. Although it is not the disease itself, certain medications used to treat these chronic diseases are known to precipitate the gingival enlargement. Periodontitis (PD) and gingival enlargement have been reported increasingly in patients with chronic renal failure. Severe enlargement is detrimental to esthetics and function while having a negative impact on the overall oral health-related quality of life. Treatment of such cases requires comprehensive periodontal management by a specialist, keeping in mind the medically compromised state of the patient. This report presents a case of severe PD with generalized gingival enlargement in a 45-year-old male who was a known case of Stage 4 chronic kidney disease, obstructive uropathy, and hypertension. Gingival enlargement was managed by gingivectomy and gingivoplasty. Six months' follow-up showed no sign of recurrence.
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Affiliation(s)
- Jaiti Uppal
- Department of Periodontics, Dr. Ziauddin Ahmad Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Himanshu Trivedi
- Department of Periodontics, Dr. Ziauddin Ahmad Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Narinder Dev Gupta
- Department of Periodontics, Dr. Ziauddin Ahmad Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Afshan Bey
- Department of Periodontics, Dr. Ziauddin Ahmad Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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23
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Barbe AG, Röhrig G, Hieggelke L, Noack MJ, Derman SHM. Interdisciplinary assessment and management of a patient with a fibrous gingival enlargement of unknown origin: A case report. Clin Case Rep 2020; 8:159-165. [PMID: 31998508 PMCID: PMC6982473 DOI: 10.1002/ccr3.2605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 12/21/2022] Open
Abstract
A gingival enlargement of unclear cause could only be diagnosed after interdisciplinary cooperation as plasma cell gingivitis of unknown origin. Interdisciplinary approaches remain crucial when diagnosing rare gum diseases.
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Affiliation(s)
- Anna Greta Barbe
- Department of Operative Dentistry and PeriodontologyCenter of Dental MedicineUniversity of CologneKölnGermany
| | - Gabriele Röhrig
- Geriatric Diagnostic CenterMVZ Medicum Köln OstCologneGermany
| | - Lena Hieggelke
- Institute of PathologyUniversity Hospital CologneCologneGermany
| | - Michael Johannes Noack
- Department of Operative Dentistry and PeriodontologyCenter of Dental MedicineUniversity of CologneKölnGermany
| | - Sonja Henny Maria Derman
- Department of Operative Dentistry and PeriodontologyCenter of Dental MedicineUniversity of CologneKölnGermany
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24
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Ravindran DM, Sabarish R, Arul D, Ajit S, Harini DM. Laser-assisted Excision of Gingival Overgrowth in an Endodontic Perforation: A Case Report. Cureus 2019; 11:e4378. [PMID: 31192076 PMCID: PMC6551201 DOI: 10.7759/cureus.4378] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
With the increase in preventive and restorative dentistry, there is also an increase in the iatrogenic conditions that occur in modern dental practice. The goal of modern dentistry is to provide patients with a holistic solution by providing functional restoration. This case report will highlight one such case where a tooth was diagnosed as having a gingival overgrowth through a perforation during prior endodontic treatment. Proper diagnosis and treatment planning helped restore a tooth that would have been lost.
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Affiliation(s)
- Deepak M Ravindran
- Periodontology, Sri Ramachandra Medical College and Research Institute, Chennai, IND
| | - Ram Sabarish
- Periodontology, Sri Ramachandra Medical College and Research Institute, Chennai, IND
| | - Devi Arul
- Periodontology, Sri Ramachandra Medical College and Research Institute, Chennai, IND
| | - Supraja Ajit
- Periodontology, Sri Ramachandra Medical College and Research Institute, Chennai, IND
| | - Dhivya M Harini
- Periodontology, Sri Ramachandra Medical College and Research Institute, Chennai, IND
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25
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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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Affiliation(s)
- Koel Debnath
- Department of Periodontology, Oxford Dental College and Hospital, Bengaluru, Karnataka, India
| | - Amita Couthino
- Department of Periodontology, Oxford Dental College and Hospital, Bengaluru, Karnataka, India
| | - Anirban Chatterjee
- Department of Periodontology, Oxford Dental College and Hospital, Bengaluru, Karnataka, India
| | - Sadhana Shenoy
- Department of Oral Pathology, Oxford Dental College and Hospital, Bengaluru, Karnataka, India
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26
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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 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Lei Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xiao-Yu Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yi Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shu Meng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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27
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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. Spec Care Dentist 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Karin Sá Fernandes
- Department of Stomatology, University of São Paulo School of Dentistry, São Paulo, Brazil.,Department of Orthodontics and Radiology, University of São Paulo City, UNICID, São Paulo, Brazil
| | - Marina Gallottini
- Department of Stomatology, University of São Paulo School of Dentistry, São Paulo, Brazil
| | - Talita Castro
- Department of Stomatology, University of São Paulo School of Dentistry, São Paulo, Brazil
| | | | - Juvani Saturno Lago
- Department of Stomatology, University of São Paulo School of Dentistry, São Paulo, Brazil
| | - Paulo Henrique Braz-Silva
- Department of Stomatology, University of São Paulo School of Dentistry, São Paulo, Brazil.,Laboratory of Virology, University of Sao Paulo Institute of Tropical Medicine of Sao Paulo, Sao Paulo, Brazil
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28
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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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Affiliation(s)
- Madhu Singh Ratre
- Department of Periodontology, Government College of Dentistry, Indore, Madhya Pradesh, India
| | - Ruchi Gulati
- Department of Periodontology, Government College of Dentistry, Indore, Madhya Pradesh, India
| | - Shaleen Khetarpal
- Department of Periodontology, Government College of Dentistry, Indore, Madhya Pradesh, India
| | - Ajay Parihar
- Department of Oral Medicine and Radiology, Government College of Dentistry, Indore, Madhya Pradesh, India
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29
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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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Affiliation(s)
- Kanika Chowdhri
- Department of Periodontology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Shruti Tandon
- Department of Periodontology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Arundeep Kaur Lamba
- Department of Periodontology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Farrukh Faraz
- Department of Periodontology, Maulana Azad Institute of Dental Sciences, New Delhi, India
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30
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Marίa José Sandoval
- Division of Periodontology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Alkisti Zekeridou
- Division of Periodontology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Vasiliki Spyropoulou
- Swiss Center for Liver Disease in Children, University Hospitals Geneva, Geneva, Switzerland
| | | | - Andrea Mombelli
- Division of Periodontology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Valérie McLin
- Swiss Center for Liver Disease in Children, University Hospitals Geneva, Geneva, Switzerland
| | - Catherine Giannopoulou
- Division of Periodontology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
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31
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- N Kala
- Department of Periodontology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Pondicherry, India
| | - S P K K Babu
- Department of Periodontology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Pondicherry, India
| | - J Manjeu
- Department of Periodontology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Pondicherry, India
| | - A Aadivalavan
- Department of Periodontology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Pondicherry, India
| | - R Khan
- Department of Periodontology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Pondicherry, India
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Vikender Singh Yadav
- Department of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
- Address correspondence to: Dr. Vikender Singh Yadav, Department of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi 110029, India. E-mail:
| | - Souvik Chakraborty
- Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak, Harayana, India
| | - Shikha Tewari
- Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak, Harayana, India
| | - Nitesh Tewari
- Department of Pedodontics and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Tuhina Ghosh
- Department of Pedodontics and Preventive Dentistry, Dr. R. Ahmad Dental College and Hospital, Sealdah, Kolkata, West Bengal, India
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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] [What about the content of this article? (0)] [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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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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Affiliation(s)
- Yazan Hassona
- Assistant Professor, Department of Oral Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman
| | - Najla Kasabreh
- Teaching Assistant, School of Dentistry, The University of Jordan, Amman
| | - Hanin Hammoudeh
- Teaching Assistant, School of Dentistry, The University of Jordan, Amman
| | - Crispian Scully
- Codirector WHO Collaborating Centre for Oral Health-General Health and Professor Emeritus, University College London, UK
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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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Affiliation(s)
- Navia George
- Department of Periodontology, KMCT Dental College, Calicut, Kerala, India
| | | | - Harish Kumar
- Department of Periodontology, KMCT Dental College, Calicut, Kerala, India
| | - Saumiya Gopal
- Department of Periodontology, KMCT Dental College, Calicut, Kerala, India
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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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Affiliation(s)
- Nidhi Bhoyar
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Sunita Gupta
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Sujoy Ghosh
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Rajesh Hosadurga
- Department of Periodontics, Yenepoya Dental College, Mangalore, Karnataka, India; Department of Periodontics, Melaka Manipal Medical College, Melaka, Malaysia
| | - M S Nabeel Althaf
- Department of Periodontics, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Shashikanth Hegde
- Department of Periodontics, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Kashyap S Rajesh
- Department of Periodontics, Yenepoya Dental College, Mangalore, Karnataka, India
| | - M S Arun Kumar
- Department of Periodontics, Yenepoya Dental College, Mangalore, Karnataka, India
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Vandana A Pant
- Department of Periodontics, Babu Banarasi Das College of Dental Sciences, BBD University, Lucknow, Uttar Pradesh, India
| | - Suraj Pandey
- Department of Periodontics, Babu Banarasi Das College of Dental Sciences, BBD University, Lucknow, Uttar Pradesh, India
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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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Affiliation(s)
- Neerja Sethi
- Department of Oral Pathology and Microbiology, Desh Bhagat Dental College and Hospital, Muktsar, Punjab, India
| | - Sangeeta Patankar
- Deparment of Oral Pathology and Microbiology, YMTs Dental College and PG Institute, Navi Mumbai, Maharashtra, India
| | - Rohit Jain
- Department of Periodontics, Desh Bhagat Dental College and Hospital, Muktsar, Punjab, India
| | - Ankit Mehta
- Deparment of Oral Pathology and Microbiology, Maitri College of Dentistry and Research Centre, Durg, Chhattisgarh, India
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40
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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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Affiliation(s)
- Monika Bansal
- Department of Periodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Nootan Singh
- Department of Periodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Shashikant Patne
- Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Satyendra Kumar Singh
- Department of Dermatology and Venerology Faculty of Modern Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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41
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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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Affiliation(s)
- Amitandra Kumar Tripathi
- Department of Periodontology, Career Postgraduate Institute of Dental Sciences and Hospital, Lucknow, Uttar Pradesh, India
| | - Sudarshana Mukherjee
- Department of Periodontology, Dr. R. Ahmed Dental College, Kolkata, West Bengal, India
| | - Charanjit Singh Saimbi
- Department of Periodontology, Career Postgraduate Institute of Dental Sciences and Hospital, Lucknow, Uttar Pradesh, India
| | - Vivek Kumar
- Department of Periodontology, Career Postgraduate Institute of Dental Sciences and Hospital, Lucknow, Uttar Pradesh, India
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42
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Ritu Dahiya
- Department of Periodontics, P. D. M. Dental College, Bahadurgarh, Haryana, India
| | - Abhinav Kathuria
- Department of Periodontics, P. D. M. Dental College, Bahadurgarh, Haryana, India
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43
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Aruna Balasundaram
- Department of Periodontology, SRM Dental College, Chennai, Tamil Nadu, India
| | | | - Dhathri Priya Bandi
- Department of Periodontology, SRM Dental College, Chennai, Tamil Nadu, India
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Shalini R Gupta
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Rajiva Gupta
- Department of Rheumatology and Clinical Immunology, Medanta Medicity, Gurgaon, Haryana, India
| | - Ravindra K Saran
- Department of General Pathology, Govind Vallabh Pant Hospital, New Delhi, India
| | - Sriram Krishnan
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India
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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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Affiliation(s)
- Abhishek Singh Nayyar
- Departments of Oral Medicine and Radiology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Mubeen Khan
- Departments of Oral Medicine and Radiology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - K R Vijayalakshmi
- Departments of Oral Medicine and Radiology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - B Suman
- Departments of Oral Medicine and Radiology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - G T Subhas
- Departments of Neurology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
| | - B Nataraju
- Departments of Neurology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
| | - M Anitha
- Department of Clinical Biochemistry, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
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46
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- S P K Kennedy Babu
- Department of Periodontics, Mahatma Post Graduate Institute of Dental Sciences, Indira Nagar, Gorimedu, Pondicherry, India
| | - Vineet Kashyap
- Department of Periodontics, Mahatma Post Graduate Institute of Dental Sciences, Indira Nagar, Gorimedu, Pondicherry, India
| | - P Sivaranjani
- Department of Periodontics, Mahatma Post Graduate Institute of Dental Sciences, Indira Nagar, Gorimedu, Pondicherry, India
| | - S Agila
- Department of Periodontics, Mahatma Post Graduate Institute of Dental Sciences, Indira Nagar, Gorimedu, Pondicherry, India
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- K Bala Krishna
- Department of Pedodontics & Preventive Dentistry, Lenora Dental College, Rajamundry, Andhra Pradesh, India
| | - P Krishnam Raju
- Department of Pedodontics & Preventive Dentistry, Sri Sai Dental College, Srikakulam, Andhra Pradesh, India
| | - Radha Raani Chitturi
- Department of Pedodontics & Preventive Dentistry, Githam Dental College, Vishakapatna, Andhra Pradesh, India
| | - G Smitha
- Department of Oral Pathology & Microbiology, Rajarajeswari Dental College, Bangalore, Karnataka, India
| | - S Vijai
- Department of Pedodontics & Preventive Dentistry, Sri Arabind Dental College, Indore. Madhya Pradesh, India
| | - B V V Srinivas
- Department of Periodontics, Sri Sai Dental College, Srikakulam, Andhra Pradesh, India
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48
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Abhishek Singh Nayyar
- Department of Oral Medicine and Radiology, Government Dental College and Research Institute, Bangalore, Karnataka, India
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49
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Anjali Makkar
- Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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50
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Babu SPKK, Ramesh V, Samidorai A, Charles NSC. Cytochrome P450 2C9 gene polymorphism in phenytoin induced gingival enlargement: A case report. J Pharm Bioallied Sci 2013; 5:237-9. [PMID: 24082701 PMCID: PMC3778594 DOI: 10.4103/0975-7406.116828] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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: 12/21/2012] [Revised: 12/26/2012] [Accepted: 02/18/2013] [Indexed: 11/17/2022] Open
Abstract
Gingival enlargement comprises any clinical condition in which an increase in the size of the gingiva is observed. Among the drugs that induce gingival enlargement, the antiepileptic agent phenytoin has been widely related to this condition. The Cytochrome P450(CYP) superfamily is the most commonly involved enzymes in metabolism of drugs. Common coding region CYP variants that affects drug elimination and response has been studied in great detail. Pharmacogenetic influences on drug metabolism have been widely reviewed and gene polymorphism of cytochrome P450 2C9 appeared to be responsible for much of the interindividual variability on drug elimination. Genetic variation in the CYP2C9 gene can affect metabolism, leading to altered phenotypes. Individuals with poor metaboliser alleles of CYP2C9 gene were shown to have a reduced metabolism of phenytoin compared with wild-type alleles. Thus identification of patients genotype prior to anti-epileptic drug administration could potentially prevent higher serum drug concentrations leading to adverse side effects such as gingival enlargement. This case report addresses the influence of CYP2C9 genetic polymorphism on Phenytoin drug metabolism thereby causing gingival enlargement.
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Affiliation(s)
- S P K Kennedy Babu
- Department of Periodontics, Mahatma Gandhi Post Graduate Institute of Dental Sciences, Indira Nagar, Gorimedu, Pondicherry, India
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