Gingival enlargement an overview sciencedirect topics. Propranolol induced gingival hyperplasia with nager syndrome. Gingival overgrowthhyperplasia can be attributed to several causes, but drug induced gingival overgrowthhyperplasia arises secondarily to prolonged use of antihypertensive drugs, anticonvulsants and immunosuppressants. This is why there are specialists who prefer not to use either of these two terms but rather choose gingival enlargement as the final diagnosis. Non plaqueinduced gingival lesions npigl encompass a group of pathologies that are not primarily caused by plaque and usually do not disappear after plaque removal, even when the severity of. Update on gingival overgrowth by cyclosporine a in renal transplants. One of the main drugs associated with go is the antiepileptic. Gingival overgrowth go comprises any clinical condition in which an increase in the size of the gingiva is observed. 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. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. The simplified taxonomy of gingival conditions includes. Gingival enlargement is an increase in the size of the gingiva gums. Mechanism of druginduced gingival overgrowth revisited.
A patients diagnosis and treatment rely on proper classification of gingival diseases. This hypothesis purports that the biochemical pathway for digo is influenced by bacterial plaque which causes gingival inflammation which. Pdf drug induced gingival enlargement is a well documented side effect with the use of phenytoin, cyclosporine and calcium channel blockers. Gingival enlargement resolution by means of nonsurgical. Health, general anticonvulsants health aspects chronic myeloid leukemia case studies gingivitis care and treatment causes of diagnosis gum diseases nifedipine complications and side. The condition though is recurrent but with thorough and meticulous maintenance of the mouth and teeth health through modification of the drug regime, selfcare and dentist care, drug induced gingival enlargement can be successfully treated. Medically induced gingival hyperplasia or gingival overgrowth is a. According to the medical literature, there are five different types of gingival hyperplasia. Treatment of gums enlargement, treatment of gingival. Plaqueinduced gingival inflammation appears to enhance this interaction. Treatment of gingival enlargement pocket dentistry. I treatment of druginduced gingival enlargement with er.
Amlodipine a novel offender of gingival overgrowtha. Pdf drug induced gingival enlargement researchgate. Propranololinduced gingival hyperplasia with nager syndrome. Apr 09, 2018 the outlook for the drug induced gingival enlargement is good.
To get the facts on exactly how to eliminate your uterine fibroids from the root 100% naturally and permanently and achieve lasting freedom from pcos related symptoms without spending your hardearned money on drugs and over the counters. 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. Unusual clinical presentation of generalized gingival enlargementa report of 3 cases. The management is complex in nature considering the multitude of factors involved such as substitution of drug strict plaque control along with excision of the tissue to be. May 19, 2006 drug induced gingival overgrowth is a frequent adverse effect associated principally with administration of the immunosuppressive drug cyclosporin a and also certain antiepileptic and antihypertensive drugs. Pdf gingival enlargement in antihypertensive medication. 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. Gingival enlargement and its treatment authorstream. Pdf gingival enlargement can occur by taking certain medications, leading to. The most common drugs causing gingival enlargement are. Oct 26, 2012 gingival enlargement, an abnormal growth of the periodontal tissue, is mainly associated with dental plaque related inflammation and drug therapy. 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. The plaque biofilm colonization and maturation in implant pockets initiates inflammation.
They are different in risk factors such as bacterial plaque, doses, patient age and gender, prescription and. Healthy gums are pale pink or pigmented, and wrap tightly around the neck of the teeth. As with medication induced gingival enlargement, effective oral hygiene measures will reduce the risk of developing gingival enlargement. Gingiva overgrowth an overview sciencedirect topics.
Medically induced gingival hyperplasia mayo clinic proceedings. Pregnancy induced gingival enlargementa case report t. Novel concepts in its role in druginduced gingival. Although gingival overgrowth has been traditionally recognised as an adverse effect of. Many cases of drug induced gingival overgrowth develop within the first 1 to 3 months of. Drug induced gingival enlargementsignssymptomscauses. Gingival hyperplasia is a disease in which the gum tissues overgrow abnormally. Gingival enlargement classificationdental health tips. Analysis of proliferative activity in oral gingival.
Pdf gingival enlargement is an increase in the size or inflammation of the gingiva. Signs and symptoms related to gingival enlargement are seen within 24 mo of initiation of drug intake. Additional instructions and trouble shooting are included with the game. 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. Tissue enlargement may progress to the point that the tissue obscures the teeth and may interfere with occlusion enlargement tissue appear firm fibrotic, pale pink and resilient, has little tendency to bleed, and has lobed surface appearance enlargement usually through out the mouth and appear more pronounced in the. Gingival enlargement is one of the frequent features of gingival diseases. Among the cause for drug induced ge, phenytoin is the most common agent. Its true incidence in the general population is unknown. Unusual clinical presentation of generalised gingival. Unusual clinical presentation of generalized gingival.
Gingival enlargement associated with systemic conditions usually resolves when the underlying condition is treated or in the case of pregnancy, delivery of the child. However, understanding of the pathogenesis of gingival overgrowth is incomplete at. Regardl ess of its cause, gingival enlar gement can cause problems in controlling pl aque, chewing, teething, speech and aesthetics 1. Gingival enlargement definition of gingival enlargement by. Several cause of gingival enlargement is known, and the most recognized is drug induced gingival enlargement. Treatment of gingival overgrowth is based on cause of gums enlargement and underlying pathological change which has occurred. It is located in the facial aspect of the attached gingiva and thus distinguished from plaqueinduced gingivitis 6. Gingival enlargement and its treatment authorstream presentation.
Phenytoin is an anticonvulsant which is seen to cause gingival enlargement in human patients with a reported incidence of 50%. Gingival enlargement induced by drugs springerlink. Drug induced gingival overgrowth or enlargement occurs in whole or in part from systemic drug use. Dental plaqueinduced gingival conditions request pdf. Gingival hyperplasia treatment, symptoms, causes, pictures.
It is characterized by a marked increase in the thickness of the epithelial layer and accumulation of excessive amounts of connective tissue. Gingival enlargement, the currently accepted terminology for an increase in the size of the gingiva, is a common feature of gingival disease. Phenytoin induced gingival overgrowth pigo is a common complication of the continuous use of medications. Laserassisted periodontal management of druginduced. It occurs as a side effect following the administration of drugs used mainly for nondental treatments and thus, the overgrowth cannot be explained as a variation of the intended pharmacological action of the drug. These results are consistent with a significant role of oestrogen during primate pregnancy in the fig. The case was resolved with use of non surgical periodontal therapy. 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. Dental plaqueinduced gingival diseases classification of gingival diseases is a significant part of an intraoral examination.
Gingival enlargement or hypertrophy are the two other terms used to describe the condition. Plaque induced inflammation appears to be a general stimulating effect regardless of the mechanism of gingival enlargement. 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. Such enlargement can be caused by a multitude of stimuli and stands as a singular complaint in the dental office. There are many anticonvulsants, immunosuppressants and calcium channel blockers that may lead to gingival enlargement in varied presentations table table1 1 and figure figure7. Pregnancy induced gingival enlargementa case report. Cyclosporineinduced gingival enlargement is more vascularized than phenytoin enlargement figures 1610 and 1611. Gingival overgrowth, cyclosporine a, renal transplantation. Feb 21, 2017 the enlargement can be inflammatory,fibrotic or a combination of both. Treatment of druginduced gingival enlargement with er. Gingival enlargements free download as powerpoint presentation. It exhibits slow and painless progression and can be exacerbated by hormonal causes or use of drugs. In recent years,flap surgery have been used more often to treat gingival enlargement than gingivectomy. This type of gingival enlargement is sometimes termed drug induced gingival enlargement.
Cyclosporin is an immunosuppressant which has been reported to cause gingival enlargement in 2580% of patients. Learn the shocking truth about uterine fibroids, drugs and surgeries. Gingival enlargement can be caused by a number of factors, including inflammatory conditions and the side effects of certain medications. 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. A rare adverse drug reaction syed ahmed raheel 1, omar bashar kujan 1, bassel tarakji 1, dilshad umar 2, salah ibrahim 2. The present article studies the case of a patient afflicted with gingival enlargement and gingival lesions induced by bacterial plaque. Gingival enlargement produces aesthetic changes, pain, gingival bleeding and periodontal disorders. Unusual clinical presentation of generalised gingival enlargement a report of 3 cases smitha rani thada, vineetha r, keerthilatha m pai. Gingivitis classification is useful for diagnosis, prognosis and treatment planning. Management of druginduced gingival enlargement australian. Go is characterized by the accumulation of extracellular matrix in gingival connective tissues, particularly collagenous components, with varying degrees of inflammation. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician.
They are different in risk factors such as bacterial plaque, doses, patient age and gender, prescription and host genetics. Gingival overgrowth go is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers. Drug induced gingival enlargement was first observed in patients who were taking phenytoin for epilepsy, with approximately 50% having gingival overgrowth. Drug induced gingival enlargement manifests as an abnormal growth of the. Dental scaling, root planning, periodontal surgery or gingivectomy that is removal of excess gingival tissue is done for treatment of gums enlargement.
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