Gingival hyperplasia is a medical condition in which the gums increase in size. This case report addresses the diagnosis and treatment of a case of idiopathic gingival enlargement in a yearold female. Jun 10, 2014 druginduced gingival enlargement gingival enlargement is a well known consequence of administration of drugs such as anticonvulsants immunosuppressants calcium channel blockers clinical features 1. An increase in size of the gingiva is a common feature of gingival disease.
The accepted current terms for this condition are gingival enlargement and gingival overgrowth. Learn the shocking truth about uterine fibroids, drugs and surgeries. Extramedullary involvement of leukemia can occur in up to 40% of patients. Drugs associated with ge can be grouped into anticonvulsant drugs phenytoin 3 5, potent immunosuppressants cyclosporin 6 8, and. 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. A remarkable decrease in the number of living epithelial cells, starting after 24 hours and continuing during the whole experiment, was observed when 10. Nonsurgical techniques can limit the occurrence of this unwanted affect, reduce the extent of plaqueinduced gingival inflammation and reduce. In some instances, gingival hyperplasia is drug induced or may exist as an isolated abnormality or as part of a. Prescription of calcium channel blockers is relatively common, making it difficult to determine the true incidence of druginduced gingival enlargement. May 22, 2014 inflammatory gingival enlargement, drug induced enlargement, conditioned gingival enlargement, and systemic gingival enlargement were considered in the differential diagnosis.
There are several types available, which will be discussed further down but two of the most important ones are the one induced by. Discussion systemic medications are the most common causes of gingival enlargement. Gingival enlargement induced by felodipine resolves with a. This condition is also known as gingival overgrowth, hypertrophic gingivitis or gingival hypertrophy. Gingiva overgrowth an overview sciencedirect topics.
A case of acute monocytic leukemia in a 25 year old pregnant lady who reported with gingival enlargement is presented here. In a study, 25 patients were monitored during and after treatment with fixed orthodontic appliances. Gingival enlargement as oral manifestation in acute myeloid. One of the rarest sites of extramedullary involvement is the oral cavity, with only 5% or less of all patients with aml present with gum infiltration. Nov 19, 2010 idiopathic gingival enlargement is a proliferative fibrous lesion of the gingival tissue that causes esthetic and functional problems. 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. The periodontal flap technique used for the treatment of. Gingival enlargement definition of gingival enlargement. Gingival enlargements are quite common and may be either inflammatory, non inflammatory or a combination of both. 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, leukemia, oral manifestations. Gingival enlargement is a common clinical feature of gingival and periodontal diseases.
Plaque induced inflammation appears to be a general stimulating effect regardless of the mechanism of gingival enlargement. Gingival enlargement resolution by means of nonsurgical. The role of oral lesions as a diagnostic indicator is. Aug 09, 2016 flap technique for gingival enlargement. Systemically related gingival enlargements include, but are not limited to, scurvy, leukemia, puberty, pregnancy, multisystem syndromes and selected drugs andor agents. Increase of gingival volume is a common characteristic of gingival disease. Treatment of gingival enlargement by dr harshavardhan patwal. General histological findings include normal overlying epithelium, rete pegs extending deep into underlying connective tissues with some areas of hyperplasia. Recently it is known that gingival overgrowth may be a consequence of the administration of three groups of medicaments anticonvulsants 2, calcium channel blockers. Gingival enlargement commonly occurs in patients treated with fixed orthodontic appliances. One of the main drugs associated with go is the antiepileptic. Smartdraw includes s of professional healthcare and anatomy chart templates that you can modify and make your own. The lesion may involve the interproximal spaces, and become so extensive that the teeth are displaced and their crowns covered. Gingival gum enlargement, also known as gingival hyperplasia or hypertrophy, is an abnormal overgrowth of gingival tissues.
To come up with proper care and treatment, the root cause of the problem should be established. In most cases, the enlargement results because of local irritations. 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. Acute myeloid leukemia aml is a bone marrow cancer, a malignant disease that triggering the cells develops into. Gingival enlargement is a well recognized unwanted effect associated mainly with anticonvulsant drugs, immunosuppressant drugs and calcium. Go is characterized by the accumulation of extracellular matrix in gingival connective tissues, particularly collagenous components, with varying degrees of inflammation. Gingival enlargement ge is a frequent finding in many gingival and periodontal diseases with or without associated systemic conditions. Management of druginduced gingival enlargement australian. Gingival enlargement an overview sciencedirect topics. Druginduced gingival overgrowth or enlargement occurs in whole or in part from systemic drug use. It is an undesirable side effect seen in patients on. Gingival enlargement is often associated with calcium channel blockers and ciclosporin.
Diffuse, fibrotic gingival enlargement with partial coverage of the tooth crowns in a patient. The term gingival overgrowth go only provides a topographic description of the lesion but no histological diagnosis. Unusual clinical presentation of generalised gingival enlargement. Contents definition etiology classification clinical picture treatment questions 1262014 2 3. Gingival hyperplasia can be seen in patients with familial gingival enlargement, pregnancy and leukemia. There are several types available, which will be discussed further down but two of the most important ones are the one induced by different medication and the one.
This entails thorough examination of the oral mucosa, gingiva, teeth, tongue and. Gingival enlargement ge, also known as gingival overgrowth or hyperplasia, has a multifactorial aetiology including inflammation, neoplastic conditions, systemic disorders, and medications. Gingival hyperplasia in acute leukemia stanford medicine 25. 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. The clinical presentation of the gingiva was similar to that of hereditary gingival hyperplasia but did not have a contributory medical or family history. Gingival enlargement the currently accepted terminology for an increase in the size of the gingiva, is a common feature of gingival disease. Media in category gingival enlargement the following 3 files are in this category, out of 3 total.
The nickel concentration in gingival tissues with and without overgrowth, histopathology of gingival overgrowths, and epithelial cell proliferation response to different nickel concentrations were analysed. Inflammatory enlargement was ruled out as the inflammatory component plaque and calculus was not significant to the severity of the presented gingival enlargement. Wed like to understand how you use our websites in order to improve them. Regardl ess of its cause, gingival enlar gement can cause problems in controlling pl aque, chewing, teething, speech and aesthetics 1. 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 overgrowth go is the abnormal enlargement of maxillary and mandibular gingiva. Inhibitorfree enzyme catalyzes the cleavage of collagen fibrils and soluble. Patient is advised to come for followup every 3 months for a period of oneyear. Feb 21, 2017 the enlargement can be inflammatory,fibrotic or a combination of both. Gingival enlargement in leukemia occurs due to infiltration of premature leukocytes. This is most likely the result of the angle sna can be used to evaluate the a fracture in an all ceramic crown may be caused by 1. Gingival hyperplasia in acute leukemia stanford medicine.
In fact, elements of granulation tissue are frequently observed, as are giant cells, mesenchymal cells combined or not with fibroblasts, collagen. Both genetically and pharmacologically induced forms of gingival enlargement exist. Gingival overgrowth go is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers. Nevertheless, the overgrowth involves the gingival margin with extension to the interdental papilla. Acute monocytic leukemia, acute myeloid leukemia, gingival enlargement, immunophenotyping. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician.
Signs and symptoms related to gingival enlargement are seen within 24 mo of initiation of drug intake. This is a common symptom that aids in the diagnosis of leukemia and warrants dental consultation. There are several causes of gingival enlargement and they can be grouped into four categories. The aim of this study was to investigate the role of nickel in orthodontic treatmentinduced gingival hyperplasia. Gingival enlargement, chronic myeloid leukemia, zimmermannlaband syndrome. Acute myelomonocytic leukemia presenting with gingival enlargement as the only clinical manifestation. Deffinition gingival enlargement refers to excessive growth of the gums, and may also be known as gingival hyperplasia or hypertrophy. Gingival hyperplasia is most commonly seen with the aml subtypes acute monocytic leukemia m5 66. 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. Leukemia is a malignancy of white blood cells, which may result in significant morbidity and mortality. Druginduced gingival enlargement gingival enlargement is a well known consequence of administration of drugs such as anticonvulsants immunosuppressants calcium channel blockers clinical features 1.
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. Gingival enlargement and its treatment authorstream. Pdf gingival enlargement and resolution during and after. Aug 12, 2010 in some pathological conditions, gingivitis caused by plaque accumulation can be more severe, with the result of an overgrowth. On palpation, gingiva was soft, edematous, devoid of stippling and tender on palpation. Surgical treatment of gingival overgrowth with 10 years of. Gingival enlargement is an increase in the size of the gingiva gums. Idiopathic gingival enlargement is a proliferative fibrous lesion of the gingival tissue that causes esthetic and functional problems. Gingival enlargement may result from the administration of. Gingival enlargement extended on to onethird to onehalf of the crown portion of teeth. It is an unwanted side effect of certain systemic drugs given for nondental treatment. Gingival enlargement is one of the frequent features of gingival diseases.
Gingival enlargement can be caused by a number of factors, including inflammatory conditions and the side effects of certain medications. Predisposing factors include inflammation, leukemia hormonal disturbances, uncontrolled diabetes and drug use 1. Gingival enlargement can be caused by a number of various stimuli. Gingival enlargement, the currently accepted terminology for an increase in the size of the gingiva, is a common feature of gingival disease. After many caries free years a 78 year old patient develops multiple root surface caries. Idiopathic gingival hyperplasia has been described in several case reports. Feb 29, 2016 gingival enlargement ge, also known as gingival overgrowth or hyperplasia, has a multifactorial aetiology including inflammation, neoplastic conditions, systemic disorders, and medications.
Gingival bleeding on slight provocation was also appreciated. It is being reported with three main groups of drugs like calcium channel blockers ccbs, immunosuppressants, and anticonvulsants. Cyclosporineinduced gingival enlargement is more vascularized than phenytoin enlargement figures 1610 and 1611. In recent years,flap surgery have been used more often to treat gingival enlargement than gingivectomy. 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. Create healthcare diagrams like this example called gingival enlargement in minutes with smartdraw. Oral contraceptives induced gingival overgrowth a clinical. Digo is a common clinical problem that often requires intervention. Patient revealed that she no longer experienced discomfort while brushing or sensitivity to hot and cold.
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