Amlodepine induced gingival enlargement med oral patol oral cir. This paper presents a case of pigo hindering oral function and compromising oral hygiene and aesthetics, which was treated with a combination of nonsurgical and surgical periodontal therapies. Regardl ess of its cause, gingival enlar gement can cause problems in controlling pl aque, chewing, teething, speech and aesthetics 1. The gingival overgrowth often delays teeth eruption and may cause. Gingival enlargement produces aesthetic changes and clinical symptoms including.
Jan 15, 2015 the treatment of gingival enlargement is based on an understanding of the cause and underlying pathologic changes of this condition see chapter 16. Classification of gingival diseases is a significant part of an intraoral examination. Atul anand bajoria, department of oral medicine and radiology, sri hasanamba dental college and hospital, hassan. Gingival enlargement occurs primarily on the labial gingival mucosa and in between the teeth interdental papillae area. Gingival enlargement classificationdental health tips. Nonsurgical management of nifedipine induced gingival overgrowth. Files are available under licenses specified on their description page. Individualized treatment plan for gingival enlargement. Gingival enlargement is an unwanted adverse effect of. There are several types available, which will be discussed further down but two of the most important ones are the one induced by.
A case of diffuse gingival enlargement in acute myeloblastic leukemia aml m1 jadhav varsha sukhdeo1, jadhav avinash. Cyclosporineinduced gingival enlargement is more vascularized than phenytoin enlargement figures 1610 and 1611. In addition to gingival enlargement, cyclosporine induces other major side effects such as 1 nephrotoxicity 2 hypertension, and 3 hyperthricosis. The surgical treatment is the definitive therapy of the drug induced gingival overgrowth, although the recurrence is frequent even with well. Gingival enlargement and its treatment authorstream. The surgical treatment is the definitive therapy of the druginduced gingival overgrowth, although the recurrence is frequent even with well. Nonsurgical management of nifedipine induced gingival.
Clinical management of gingival enlargement caused by. Genetic disorders associated with gingival enlargement. Phenytoininduced gingival overgrowth management with. An increase in size of the gingiva is a common feature of gingival disease.
Gingival overgrowth go is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers. Gingival enlargement is a welldocumented and extensively researched condition in the field of dentistry but the diagnosis of this condition is complicated by a variety of interrelated factors in its etiology and progression. All structured data from the file and property namespaces is available under the creative commons cc0 license. The awareness in the medical community about this possible side effect of nifedipine is less when compared to the effects of phenytoin and. 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. Dental scaling, root planning, periodontal surgery or gingivectomy that is removal of excess gingival tissue is done for treatment of gums enlargement. Systemically related gingival enlargements include, but are not limited to, scurvy, leukemia, puberty, pregnancy, multisystem syndromes and selected drugs andor agents. Dental plaqueinduced gingival diseases classification of gingival diseases is a significant part of an intraoral examination. Gingival enlargement is one of the frequent features of gingival diseases.
Kalla c a department of oral medicine and radiology, jodhpur dental college, jodhpur national. Gingival hyperplasia as an early manifestation of acute. A patients diagnosis and treatment rely on proper classification of gingival diseases. Oral manifestations are more common in patients with acute leukemia. Gingival enlargement can be caused by a wide variety of etiologies. Pdf drug induced gingival enlargement researchgate. Gingival enlargement is the most common adverse drug drug effect in the young adults and children receiving phenytoin as antiepileptic drug therapy. There are several causes of gingival enlargement and they can be grouped into four categories.
Gingival enlargement or gingival overgrowth, a common trait of gingival disease, is characterized by an increase in the size of gingiva. 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. Create healthcare diagrams like this example called gingival enlargement in minutes with smartdraw. Systemic and clinical treatment of gingival hyperplasia. Gingival enlargement as an adverse effects of drugs has been found to be long associated with the use of anticonvulsants.
Gingival enlargement can be caused by a number of various stimuli. Gingival gum enlargement, also known as gingival hyperplasia or hypertrophy, is an abnormal overgrowth of gingival tissues. This is a common symptom that aids in the diagnosis of leukemia and warrants dental consultation. The treatment of gingival enlargement is based on an understanding of the cause and underlying pathologic changes of this condition see chapter 16. May 22, 2014 inflammatory gingival enlargement, drug induced enlargement, conditioned gingival enlargement, and systemic gingival enlargement were considered in the differential diagnosis. Gingival enlargements are of special concern to the patient and the dentist because they pose problems that involve plaque control, function including mastication, tooth eruption, and speech, and aesthetics. Reliability of two measurement indices for gingival. Start studying perio gingivitis and gingival enlargement. Drug induced gingival overgrowth digo statpearls ncbi. Gingival enlargement in acute myeloblastic leukemia. These are strictly clinical descriptive terms, and they avoid the erroneous pathologic connotations of terms used in the past, such as hypertrophic gingivitis and gingival hyperplasia.
The fact that gingival hyperplasia are sometimes the first manifestation of the disease implies that dental professionals must be sufficiently familiarized with the clinical manifestations of systemic diseases. Idiopathic gingival enlargement is a proliferative fibrous lesion of the gingival tissue that causes esthetic and functional problems. 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. Gingival enlargement also known as gingival overgrowth is defined as increase in the size of gingiva. Both gingival enlargement indices analyzed are reliable, complementary and applicable for measuring gingival overgrowth.
Chronic inflammatory gingival enlargement international. 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. Perio gingivitis and gingival enlargement flashcards quizlet. The accepted current terms for this condition are gingival enlargement and gingival overgrowth. Druginduced gingival overgrowth remains the most widespread unwanted effect of systemic medication on the periodontal tissues. Pregnancy induced gingival enlargementa case report t. Signs and symptoms related to gingival enlargement are seen within 24 mo of initiation of drug intake. Academy report 1424 a n increasing number of medications are associated with gingival enlargement. Plaqueinduced inflammatory gingival enlargements resolve with debridement of plaque and calculus and improved oral hygiene, where the gingival tissue is. There are many anticonvulsants, immunosuppressants and calcium channel blockers that may lead to gingival enlargement in varied presentations table table1 1 and figure figure7. Gingival enlargement may result from acute or chronic inflammatory changes. Hence, the identification of these factors and precise diagnosis forms the key to proper treatment planning. Many of the lifethreatening diseases may present with oral lesions as the initial manifestation.
Pregnancy induced gingival enlargement a case report t. Initial periodontal therapy and replacement of cyclosporin a with tacrolimus, with continued nifedipine usage, were performed. As gingival enlargement develops, it affects the normal oral hygiene practice and may interfere with masticatory functions. Gingival enlargement in leukemia occurs due to infiltration of premature leukocytes. Also a prominent remission was observed in gingival hyperplasia after chemotherapy together with peripheral blood values. Pdf gingival enlargement leading to the diagnosis of. Hereditary gingival fibromatosis hgf is a rare genetic condition characterized by slow and progressive gingival enlargement. Introduction a number of genetic disorders present with gingival manifestations which may be in the. Go is characterized by the accumulation of extracellular matrix in gingival connective tissues, particularly collagenous components, with varying degrees of inflammation.
Leukaemia cell gingival infiltrate is not observed in edentulous individuals, suggesting that local irritation and trauma associated with the presence of teeth may play a role in the pathogenesis of this abnormality 6,7. Gingival enlargement the currently accepted terminology for an increase in the size of the gingiva, is a common feature of gingival disease. Go is more pronounced on the labial aspect of the maxillary gingiva and in the interdental papillae. 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, the currently accepted terminology for an increase in the size of the gingiva, is a common feature of gingival disease. Localized gingival enlargementa diagnostic dilemma. However, the mbi shows, with fewer measurements, a greater sensitivity than the goi for the detection of the early stages of gingival enlargement, being adequate for the screening of large populations at risk. Gingival hyperplasia is a medical condition in which the gums increase in size. The case described here had adequate local factors which are the predisposing factor for gingival enlargement. 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.
Treatment of gingival overgrowth is based on cause of gums enlargement and underlying pathological change which has occurred. Phenytoininduced gingival overgrowth pigo is a common complication of the continuous use of medications. Gingival enlargement represents an overexuberant response to a variety of local and systemic conditions 1. Gingival enlargement an overview sciencedirect topics. 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. More than 20 prescription medications are associated with gingival overgrowth. Pregnancy induced gingival enlargementa case report. Idiopathic gingival enlargement and its management ncbi. Prescription of calcium channel blockers is relatively common, making it difficult to determine the true incidence of druginduced gingival enlargement. Gingival enlargement leading to the diagnosis of acute lymphoblastic leukemia in an 8year old girl. Druginduced enlargement is associated with a patients genetic predisposition. Inflammatory enlargement was ruled out as the inflammatory component plaque and calculus was not significant to the severity of the presented gingival enlargement.
Management of druginduced gingival enlargement australian. Treatment of gingival enlargement pocket dentistry. Smartdraw includes s of professional healthcare and anatomy chart templates that you can modify and make your own. Anticonvulsants are drugs that can modify the gingival tissues response to inflammatory processes in the presence of dental plaque, inducing gingival overgrowth. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician. 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. Gingival enlargement is a wellknown conscquence ot the administration of some anticonvulsants, immunosuppressants. Discussions chapter iv histological study of fibrotic gingival enlargement 1. Drug induced gingival enlargement periodontal disease. Gingival enlargement can be caused by a number of factors, including inflammatory conditions and the side effects of certain medications. Identifying gingival overgrowth as an initial oral manifestation of leukemic infiltration is extremely important for establishing an early diagnosis of acute leukemia.
The modern word for this disorder is a gingival enlargement or gingival overgrowth. Unusual clinical presentation of generalised gingival. Druginduced gingival overgrowth is frequently associated with three particular drugs. Jan 14, 2014 silverstain et al 1995 nifidepine induced gingival enlargements has been reported around dental implants yoon angela et al in 2006 myeloid sarcoma occurring concurrently with drug induced gingival enlargement frederic duffau in 2007 gingival enlargement originating from medication and tooth migration 48. Gingival enlargement is the term now used to describe medicationrelated gingival overgrowth or gingival hyperplasia, a common reactionary. In addition, fibrotic gingival enlargement has been reported and is believed to be the result of a genetic predisposition for example hereditary or familial gingival enlargement. Gingival enlargement can be hereditary or acquired.
One of the main drugs associated with go is the antiepileptic. Phenytoin is an anticonvulsant which is seen to cause gingival enlargement in human patients with a reported incidence of 50%. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Drugs are the commonest reason behind gingival enlargement. 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. Gingival enlargement is an increase in the size of the gingiva gums. Treatment of gums enlargement, treatment of gingival. 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. Healthy gums are pale pink or pigmented, and wrap tightly around the neck of the teeth.
Drug induced gingival enlargement by rajesh hosadurga. Oral contraceptives induced gingival overgrowth a clinical. Pathogenic ways involved in gingival enlargement personal contributions motivation and study premises objectives of the study chapter iii clinical study of fibrotic gingival enlargement 1. This condition is also known as gingival overgrowth, hypertrophic gingivitis or gingival hypertrophy. Gingival changes in a druginduced gingival overgrowth patient. 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. 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. 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. Gingival hyperplasia treatment, symptoms, causes, pictures. This paper presents a case of pigo hindering oral function and compromising oral hygiene and aesthetics, which was treated with a combination of.
801 951 363 53 162 693 918 1169 452 1081 668 1447 680 607 773 532 850 1264 435 1540 783 60 661 521 682 330 1356 1568 1452 635 1664 229 137 702 731 999 1033 434 4 336 6 669 1181