Gingivitis classification is useful for diagnosis, prognosis and treatment planning. Pdf treatment of gingival enlargement researchgate. There are several causes of gingival enlargement and they can be grouped into four categories. A customized decision tree is designed, which will help clinicians to keep a broad view when formulating a differential diagnosis of localized isolated, discrete, regional or generalized gingival enlargement and arrive at a particular diagnosis is an easy and systematic manner. One such syndrome is jones syndrome, which is associated with gingival enlargement and progressive hearing loss. Plaque induced inflammation appears to be a general stimulating effect regardless of the mechanism of gingival enlargement. Nov 15, 2014 in this video, dr kuljeet mehtaperiodontist, demonstrates periodontal gingival overgrowth enlargement treated by periodontal surgery. Gingival enlargement the currently accepted terminology for an increase in the size of the gingiva, is a common feature of gingival disease. Untypical amlodipineinduced gingival hyperplasia hindawi. Gingival overgrowth enlargement, hyperplasia is benign painless condition. Pregnancy induced gingival enlargementa case report. Cyclosporineinduced gingival enlargement is more vascularized than phenytoin enlargement figures 1610 and 1611.
International journal of oral health dentistry, july september, 2015. Gingival enlargement is an increase in the size of the gingiva gums. Pdf gingival enlargement is one of the frequent features of gingival diseases. Diffuse, fibrotic gingival enlargement with partial coverage of the tooth crowns in a patient taking phenytoin for seizures. Gingival enlargement is one of the frequent features of gingival diseases. When the gingival condition is fibrotic, it might not subside completely, which results. In recent years,flap surgery have been used more often to treat gingival enlargement than gingivectomy. Licensed under creative commons attribution cc by unilateral gingival enlargement an unusual case report motazatia1, yosra ali2, yasiryousif3. Phenytoin is an anticonvulsant which is seen to cause gingival enlargement in human patients with a reported incidence of 50%. Gingival enlargement an overview sciencedirect topics. Bds, mfdrcsi, msckhatroum university, paedodontics national ribat university, sudan. Idiopathic gingival enlargement and its management. Pdf drug induced gingival enlargement researchgate. Usual allergens known to be associated with this lesion could be, e.
However, the skills of a clinician is put to test when arriving at a particular diagnosis among the myriad of. The classification presented below is from development of a classification system for periodontal diseases and conditions by gc armitage, dds 1999 and is used by the american academy of periodontology aap. Currently, more than 20 prescription medications are associated with gingival enlargement,1 and an estimated 5% of the elderly outpatient population in the united states is taking these medications. Surgical management of gingival overgrowth pocket dentistry. Gingival fibromatosis is a rare and heterogeneous group of disorders that develop as slowly progressive, local or diffuse enlargements within marginal and attached gingiva or interdental papilla. D icd usual allergens known to be associated with this lesion could be, e. Gingival enlargement may cause discomfort, interfere with speech or chewing, result in halitosis and unilateral gingival enlargement a case report kalburge j v, metgud rashmi abstract a 14 year old female patient suffered from unusual unilateral gingival enlargement on left. Calcium channel blockers, gingival overgrowth, nifedipine. Management of druginduced gingival enlargement australian. Gingival enlargement is the most common adverse drug drug effect in the young adults and children receiving phenytoin as antiepileptic drug therapy. Jan 17, 2015 having read this chapter, the reader should be aware of the contemporary surgical techniques used for the surgical management of gingival overgrowth. Gingival fibromatosis, gingival enlargement, gingivectomy. Nifedipineinduced gingival enlargement sage journals.
Jul 21, 2019 gingival enlargement or gingival overgrowth, a common trait of gingival disease, is characterized by an increase in the size of gingiva. Introduction gingival enlargement is a common feature of gingival disease and may be caused by fibrous overgrowth or gingival inflammation or a combination of two. This is strictly a clinical description of the condition and avoids the erroneous pathologic connotations of terms used in the past such as hypertrophic gingivitis or gingival hyperplasia. Rosenberg, james torosian, in esthetic dentistry third edition, 2015. Results a total of 1187 cases of lges affecting 1187 patients represented 6. Gingival enlargement classificationdental health tips. Unilateral gingival enlargement an unusual case report. Signs and symptoms related to gingival enlargement are seen within 24 mo of initiation of drug intake. In severe cases, the excess tissue may cover the crowns of the teeth, thus causing functional, esthetic, and periodontal problems, such as bone loss and bleeding, due to the presence of pseudopockets. The differential diagnosis included enlargement due to drugs e.
Druginduced gingival enlargement was first observed in patients who were taking phenytoin for epilepsy, with approximately 50% having gingival overgrowth. Jan, 2018 epulis is growth or enlargements of gums or alveolar mucosa. Surgical approach to drug induced gingival enlargement in renal transplant patients case report christina popova, antoaneta mlachkova department of periodontology, faculty of dental medicine, medical university sofia, bulgaria journal of imab annual proceeding scientific papers 2007, vol. Gingival enlargement can be caused by a variety of etiological factors like inflammation, drugs, and systemic diseases or can be presented as a part of a syndrome. Unusual clinical presentation of generalized gingival. Individualized treatment plan for gingival enlargement. This is an atypical case report of a 20yearold male patient who suffered from unusual unilateral, gingival enlargement together with rapidly progressive alveolar bone loss.
Nov 30, 2018 cyclosporineinduced gingival enlargement is more vascularized than the phenytoin enlargement, occurs in approximately 30% of patients receiving the ding, is more frequent in children, and its magnitude appears to be related more to the plasma concentration than to the patients periodontal status. Academy report 1424 a n increasing number of medications are associated with gingival enlargement. Gingival enlargement or gingival overgrowth, a common trait of gingival disease, is characterized by an increase in the size of gingiva. The possibility of druginduced enlargement was ruled out based on the medical history.
Unusual clinical presentation of generalized gingival enlargement a report of 3 cases. Thousands of patients have been described in the literature, but the actual prevalence is unknown. Feb 21, 2017 the enlargement can be inflammatory,fibrotic or a combination of both. Management of druginduced gingival enlargement barbara anne taylor, department of periodontics, united dental hospital of sydney, sydney synopsis healthy gums are pale pink or pigmented, and wrap tightly around the neck of the teeth. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Gingival enlargement can be caused by a number of factors, including inflammatory conditions and the side effects of certain medications.
The new tissue is similar to the normal healthy tissue. The following grades were scored in 6 points around each tooth. Pregnancy induced gingival enlargement a case report t. Every case of gingival enlargement should be treated in a stepwise manner inclusive of consultation with patients physician, substitution of the drug, nonsurgical and surgical therapy.
Cyclosporin is an immunosuppressant which has been reported to cause gingival enlargement in 2580% of patients. The management of druginfluenced gingival enlargement. Gingival overgrowthenlargement by drugsperiodontal surgery. Dec 23, 2014 gingival enlargement also known as gingival hyperplasia, gingival hypertrophy, gingival overgrowth, hypertrophic gingivitis which is caused with the increase in the size of gingiva is called as gingival enlargement.
There are many anticonvulsants, immunosuppressants and calcium channel blockers that may lead to gingival enlargement in varied presentations table table1 1 and figure figure7. Diffuse gingival enlargement is defined as an excessive growth of periodontal tissue. Gingival gum enlargement, also known as gingival hyperplasia or hypertrophy, is an abnormal overgrowth of gingival tissues. Idiopathic gingival enlargement and its management pawan kumar 1, saindhyatora sonowal 2 1 unit of periodontics, oral health science centre, post graduate institute of medical education and research, chandigarh, india 2 department of periodontics, regional dental college, bhangagarh, guwahati, assam, india. The usual form of enlargement is inflammatory enlargement which is seeded by the plaque adjacent to the gingiva. Drug induced gingival enlargement periodontal disease. Health, general anticonvulsants health aspects chronic myeloid leukemia case studies gingivitis care and treatment causes of diagnosis gum diseases nifedipine complications and side. Her familial and past medical history were non contributory. Gingival enlargement in a case of variant jones syndrome. Gingiva overgrowth an overview sciencedirect topics. Prevalence of gingival overgrowth induced by antihypertensive drugs.
Gingival enlargement definition of gingival enlargement by. In addition to gingival enlargement, cyclosporine induces other major side effects such as 1 nephrotoxicity 2 hypertension, and 3 hyperthricosis. Genetic disorders associated with gingival enlargement. Healthy gums are pale pink or pigmented, and wrap tightly around the neck of the teeth. Dhwanit thakore free download as powerpoint presentation. Perio gingivitis and gingival enlargement flashcards quizlet.
Gingival enlargement is an unwanted adverse effect of some drugs such as. Aug 12, 2014 treatment of gingival enlargement in puberty gingival enlargement in puberty is treated by performing scaling and curettage, removing all sources the use of escharotic drugs has been recommended in the past for the removal of gingival enlargements of irritation, and controlling plaque. Gingival enlargement is frequently seen in day to day practice and its proper therapy includes the analysis of the cause of the enlargement. There is a clear demarcation between normal and involved gingival figure. Gingival enlargement and its treatment authorstream.