Generalized bone, soft tissue, and pulp necrosis resulted in multiple extractions. Gingival hypertrophy and anemiadiagnosis hematology. Miranda, brunet, roset, berini, farre, mendieta 10 performed a cross sectional study and compared the nifedipineinduced gingival growth to controls who had never received the drug. Gingival enlargement is the term now used to describe medicationrelated gingival overgrowth or gingival hyperplasia, a common reactionary. The most common causes of localized gingival enlargement, which is defined as fibrous epulis, include subgingival plaque, tartar, and inappropriate restoration margins. Gingivectomy is a lowcost, lowrisk procedure for taking care of damaged gum tissue or to change the appearance of your smile. Gingival hyperplasia, also known as gingival enlargement, is a swelling of the gum tissue gingiva. Druginduced gingival overgrowth does not originate in the periodontium, but it occurs exclusively in periodontal. Gingival hyperplasia is secondary to infiltration of the gingival tissue with leukemia cells and is well described in the literature. Combining any of these agents with cyclosporine will likely produce an. Gingival hyperplasia typically refers to the increase in the number of cells, whereas gingival hypertrophy deals with the increase in cell size.
This condition is also known as gingival overgrowth, hypertrophic gingivitis or gingival hypertrophy. Connective tissue metabolism and gingival overgrowth. There are several types available, which will be discussed further down but two of the most important ones are the one induced by. Aspects of druginduced gingival enlargement prevalence the prevalence of gingival overgrowth varies with drugs. Anticonvulsants are drugs that can modify the gingival tissues response to inflammatory processes in the presence of dental plaque, inducing gingival overgrowth. The gingival enlargement can be localised around one tooth, but is more commonly generalised throughout the whole mouth. The causative factors may range from inflammation due to local factors to. An enlargement of the gingiva due to an increase in the size of cells according to the glossary of periodontal terms, 4th edition, 2001. Most published studies focus on reac tive lges 36 i. Gingival hyperplasia treatment, symptoms, causes, pictures.
It was also proved that increased drug dosage showed increased gingival enlargement, so the physician can consider altering the dose of nifedipine or combine it. Unusual clinical presentation of generalised gingival. Genetic disorders associated with gingival enlargement. Pdf gingival enlargement can occur by taking certain medications, leading to problems in speech, eating, teething functions and aesthetics find, read and cite all the research you need on. There are several causes of gingival enlargement and they can be grouped into four categories. Gingival hyperplasia is an overgrowth of gum tissue around the teeth. If vitamin c deficiency is prolonged, scurvy may cause cardiovascular events and even death. This enlargement may be caused by overreaction to plaquebiofilm, infections or side effects of systemic conditions or medications. The most common oral problem experienced during pregnancy is gingival inflammation and hypertrophy, often referred to as pregnancy gingivitis figure 72. What is the most common chronic disease of childhood. Gingival enlargement is an increase in the size of the gingiva gums. Gingival enlargement, commonly known as hyperplasia or hypertrophy, is pathologic overgrowth of the gingiva.
The clinical presentation of the gingiva was similar to that of hereditary gingival hyperplasia but did not have a contributory medical or family history. Plaque induced inflammation appears to be a general stimulating effect regardless of the mechanism of gingival enlargement. The extent of gingival enlargements were defined as either localized or generalized. To be considered a gingival enlargement resulting from medications, the size. An overgrowth or increase in size of the gingiva gingival hyperplasia. Prescription of calcium channel blockers is relatively common, making it difficult to determine the true incidence of druginduced gingival enlargement. Gingival enlargement is one of the frequent features of gingival diseases. Gingival hyperplasia in a cat taking cyclosporine for feline.
Gingival enlargement is an overgrowth or increase in size of gingiva. Gingival enlargement ge is defined as an abnormal overgrowth of gingival tissues. A case series shivanand aspalli, shirin a mulla, reetika gaddale and nagappa g department of periodontics and oral implantology, ames dental college and hospital, raichur, karnataka, india her medical history. Hyperplasia specifically means an increase in the number of cells in the gum tissue. Gingival hyperplasia complicating acute myelomonocytic. Gingival enlargement can be caused by a number of factors, including inflammatory conditions and. Gingiva hypertrophy an overview sciencedirect topics.
Chronic inflammatory gingival enlargement associated with. Medical ifpossible,discontinuecalciumchannelblockers,anticonvulsants,or immunosuppressants. The present case report describes a case of long standing gingival enlargement. Clocheret k, dekeyser c, carels c, willems g 2003 idiopathic gingival hyperplasia and orthodontic treatment.
There are many anticonvulsants, immunosuppressants and calcium channel blockers that may lead to gingival enlargement in varied presentations table table1 1 and figure figure7. Systemic conditions such as hormonal changes, drug therapy, or tumor infiltrates may also cause or contribute to the severity of gingival enlargement. Gingival hyperplasia can occur as a direct result of inflammation. However, the effects of newergeneration antiepileptic drugs on oral health have not yet been studied. Individualized treatment plan for gingival enlargement. Pdf druginduced gingival overgrowth digo remains a significant problem for the. Gingival swelling and hemorrhage and bone disease due to subperiosteal bleeding are common. Druginduced gingival enlargement dige is a fibrotic condition associated with systemic.
Druginduced gingival enlargement is the term now used to describe medicationrelated gingival hypertrophy or hyperplasia, a condition commonly induced by three main classes of drugs. Pdf gingival hyperplasia and calcium channel blockers. While the overgrowth itself does not bleed, it is easily traumatised by the patient and will prevent adequate oral hygiene thus allowing the buildup of plaque. Systemic and clinical treatment of gingival hyperplasia. Gingival hyperplasia for a problem that is so common, there is really not very much in the veterinary literature on this odd condition, so it seems time for me to tell you a bit about my understanding of gingival hyperplasia, what brings it about, why it is a concern and how we manage it. The mammary gland in mucosal and regional immunity. A case of a 19yearold male presenting with maxillary and mandibular chronic inflammatory gingival enlargement associated with prolonged orthodontic therapy is reported here. 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.
There are a number of causes for this condition, but its often a symptom of poor oral hygiene or a side effect of using. Relationship between amphetamine ingestion and gingival. The effects of antiepileptic drugs on oral health jcda. Surgical management of druginduced gingival overgrowth digo. Idiopathic gingival hyperplasia has been described in several case reports. Clinical importance of druginduced gingival overgrowth druginduced gingival overgrowth is a sideeffect and unwanted outcome of systemic medication and is limited to gingival tissues. Gingivectomy using electrocautery coag 2030 25w blendcut 2030 w. Namely, idiopathic gingival enlargement, lysosomal storage disorders, vascular disorders and those associated with characteristic dental abnormalities table table2. Idiopathic gingival enlargement is also referred to as. Calcium channel blockerinduced gingival hyperplasia. This increase in gingival cells has many different causes, but one of the most common is druginduced gingival hyperplasia. Druginduced gingival hyperplasia digh is a periodontal side effects of certain drugs, causing swelling, bleeding, and problems with chewing, aesthetics, and pronunciation.
Inflammatory gingival enlargement, also synonymous with the terms gingival hyperplasia or gingival hypertrophy, can be defined as an abnormal growth of gingival tissues. The simplified taxonomy of gingival conditions includes. Many types of gingival enlargements have been reported and can be classified according to etiologic factors and pathologic changes as inflammatory enlargement, enlargements associated with systemic diseases or conditions, neoplastic enlargements, and druginduced enlargement. Patients taking carbamazepine or phenytoin had alveolar bone loss. In more severe cases, it can cause high mobility and detachment of the teeth due to alveolar bone absorption. A case report of gingival enlargement associated with. They can be divided into 4 primary categories based on their etiology, clinical features and histology.
Gingival hyperplasia is a medical condition in which the gums increase in size. Top causes of gingival enlargement and treatment options. In recent years,flap surgery have been used more often to treat gingival enlargement than gingivectomy. It tends to affect the anterior teeth more severely. A national oral health curriculum the society of teachers of family medicine stfm group on oral health third edition examination items note. Gingival gum enlargement, also known as gingival hyperplasia or hypertrophy, is an abnormal overgrowth of gingival tissues. Brunet l, miranda j, farre m, berini l, mendieta c 1996 gingival enlargement induced by drugs. Gingival enlargement, also synonymous with the terms gingival hyperplasia or hypertrophy, is defined as an abnormal overgrowth of gingival tissues. General histological findings include normal overlying epithelium, rete pegs extending deep into underlying connective tissues with some areas of hyperplasia. Phenytoin activates smad3 phosphorylation and periostin. Druginduced gingival overgrowth is a wellestablished adverse event. Localized gingival enlargements e321 introduction localized gingival enlargements lges are common in clinical practice 1,2 and are usually of reactive origin 1,2 developing as a response to chronic local irrita tion or trauma 3. The enlargement can be inflammatory,fibrotic or a combination of both.
The inflammation is often caused by plaque buildup on the teeth from food, bacteria, and poor hygiene practices. Surgical therapy was carried out to provide a good. Gingival enlargement or overgrowth is a common disease of gingiva. It doesnt take long to recover and the outcome is often positive. On the cellular and molecular mechanisms of druginduced. The condition may arise from hormonal changes leading to an increased blood flow to the gingival tissues, coupled with the presence of local irritants, such as plaque and calculus. Gum health and disease can have an effect on general health.
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