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At least 613 records · Page 34Linked to original sources
PubMed2002

Treatment of gingival overgrowth induced by manidipine administration. A case report.

BACKGROUND: It is well known that severe gingival overgrowth (GO) is induced in patients taking certain calcium channel blockers (CCB) for the treatment of hypertension, angina pectoris, and other diseases. No case has been reported to date of severe GO induced by manidipine hydrochloride (manidipine), a second generation CCB. This case report describes severe GO induced by manidipine in a female patient (43 years old) with hypertension and Sjögren syndrome (SS). The patient was administered manidipine and carteolol hydrochloride (carteolol) as antihypertensive drugs, together with bromhexine hydrochloride for the treatment of SS. METHODS: At the initial periodontal examination, probing depth (PD, average 4.83 mm), plaque control record (PCR, 84.3%), bleeding on probing (BOP, 100%), and gingival overgrowth index (GOI, 2.42) were assessed. The patient received periodontal treatment without cessation or replacement of the causative drug. Initial treatment included oral hygiene and scaling and root planing (SRP) under local anesthesia. As corrective therapy, remaining pockets were surgically removed and fixed bridges placed to establish proper occlusion. RESULTS: Obvious reductions in PCR (10.0%), PD (1.93 mm), GOI (0.02), and BOP (4.7%), together with a disappearance of GO, were obtained. Salivary secretion was increased after the periodontal and prosthetic treatments. Histological features were similar to those of nifedipine-induced GO. CONCLUSIONS: This case indicated that manidipine may act as a potent inducer of severe GO, and that conventional periodontal treatments without a major change of the causative drugs can yield satisfactory clinical responses.

Adult↗
PubMed2003

Surgical crown lengthening: evaluation of the biological width.

BACKGROUND: Previous surgical crown lengthening studies have investigated positional changes of the free gingival margin but not the biological width. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biological width. However, very little work has been done in humans. Therefore, the purpose of this study was to evaluate the positional changes of the periodontal tissues, particularly the biological width, following surgical crown lengthening in human subjects. METHODS: Twenty-three (23) patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening) and adjacent teeth with adjacent and non-adjacent sites: plaque and gingival indexes, free gingival margin, probing depth, attachment level, bone level, direct bone level, and biological width. During surgery, the bone level was reduced based on the future prosthetic margin and predetermined biological width; flaps were placed at the bony crest. Patients were examined at baseline and at 3 and 6 months postoperatively. RESULTS: Eighteen patients completed the study. Overall, the amount of bone resected was 1 to 5 mm. At 90% of treated sites, > or = 3 mm of bone was removed. At 3 months, the apical displacement of the free gingival margin at non-adjacent, adjacent, and treated sites was 2.46 +/- 0.25 mm, 2.68 +/- 0.20 mm, and 3.07 +/- 0.16 mm, respectively. There was no significant change in the position of the free gingival margin from 3 to 6 months. The biological width at all sites was smaller at 3 and 6 months compared to baseline (P<0.05) except for the treated sites, which were not significantly different from baseline at 6 months. CONCLUSIONS: During surgical crown lengthening, the bone level was lowered for placement of the prosthetic margin and reestablishment of the biological width. The biological width, at treated sites, was reestablished to its original vertical dimension by 6 months. In addition, a consistent 3 mm gain of coronal tooth structure was observed at the 3- and 6-month examinations.

Adult↗
PubMed2005

Amelogenesis imperfecta and unusual gingival hyperplasia.

BACKGROUND: Amelogenesis imperfecta (AI) is a group of hereditary conditions that primarily involves the defective formation and/or calcification of enamel. The association of AI with gingival enlargement-like lesions has also been reported. METHODS: This paper reports a case of a hypoplastic AI associated with unusual generalized gingival hyperplasia. RESULTS: Histological aspect of the gingival growth was characterized by a dense connective tissue with a mild mononuclear inflammatory infiltrate, calcified bodies, and islands of odontogenic epithelium. CONCLUSION: The present case represents a very interesting demonstration of the fact that, although rare, AI may be associated with generalized gingival enlargement.

Adolescent↗
PubMed2005

Use of a subepithelial connective tissue graft to treat an area pigmented with graphite.

BACKGROUND: Pigmentations of the oral cavity are commonly noted in clinical practice and may have physiologic, non-physiologic, or pathologic etiologies. The most common non-physiologic localized pigmentation is the amalgam tattoo; another, less common, non-physiologic pigmentation is the graphite tattoo. Graphite tattoos may easily be confused with amalgam tattoos but have only infrequently been reported in the literature. METHODS: This case report discusses a patient with a localized pigmented lesion involving the free gingiva, attached gingiva, and alveolar mucosa. The patient was referred for esthetic enhancement of the area in question. Dental history revealed trauma to the area involving falling on a pencil as a child. The lesion was excised and submitted for histologic examination; a subepithelial connective tissue graft was harvested and utilized to prevent an esthetic defect. RESULTS: Histologic evaluation confirmed graphite within the soft tissue as the etiology of the discoloration. At the 2-month postoperative appointment, a highly esthetic outcome was obtained utilizing a connective tissue graft. CONCLUSIONS: Although less common than the amalgam tattoo, the graphite tattoo may be encountered in the course of routine dental examinations and should be included in a differential diagnosis of any localized pigmented lesion. Although histologic evaluation is necessary to rule out pathology, if the dental history is consistent with the clinical impression of a nonpathologic lesion, such as the graphite tattoo in this case report, treatment with an autogenous connective tissue graft at the time of excision can produce a highly esthetic result and avoid additional surgical procedures in the future.

Adolescent↗
PubMed2006

Hereditary gingival fibromatosis: a systematic review.

Generalized gingival enlargement can be caused by a variety of etiological factors. It can be inherited (hereditary gingival fibromatosis [HGF]); associated with other diseases characterizing a syndrome; or induced as a side effect of systemic drugs, such as phenytoin, cyclosporin, or nifedipine. HGF, previously known as elephantiasis gingivae, hereditary gingival hyperplasia, and hypertrophic gingiva, is a genetic disorder characterized by a progressive enlargement of the gingiva. This review will focus on diagnosis, treatment, and control of HGF. The pattern of inheritance, the histopathologic characteristics, and the known biologic and genetic features associated with HGF are also emphasized.

Fibroblasts↗
PubMed1990

[Treatment and analysis of a clinical case of gingival pigmentation around the restored teeth].

A remarkable gingival pigmentation around the restorated teeth was successfully treated by simple surgical removal; incision & coagulasion of deposits by electrosurgery. Before the treatment, a biopsy from the pigmented gingiva was histopathologically examined, and a lot of small pigment deposits were found in the lamina propria with no inflammation, but not in the epitherium. Elements constructing the deposits were also determined by means of an electron probe X-ray microanalyser. Silver was found to be the principal element of the deposits, but not found at all in the crown metal. These results suggested that the cause of the pigmentation was implantation of metal fragments from metal cores during abutment teeth preparation. Therefore, the surgical removal was performed. Relapses have not occurred for 3 years since the treatment.

Electron Probe Microanalysis↗
PubMed1978

Peridontal status following surgical-orthodontic alignment of impacted teeth.

Treatment of impacted teeth is often a combination between oral surgery and orthodontics. This study evaluates the gingival condition of impacted teeth after surgical-orthodontic treatment, where two different surgical methods were used. In one group (n = 11) the teeth were radically exposed and orthodontically moved to their final position. In the other group (n = 11) the teeth were partially exposed by raising a mucoperiosteal flap. Orthodontic traction was then applied; whereafter the flap was sutured back into place. The results showed that one of the teeth in the partial exposure group and seven in the radical exposure group showed loss of attachment. This study indicates that a combination of mucoperiosteal flap technique and applied orthodontic traction is prefered to minimize the loss of attachment in cases of displaced impacted teeth.

Adolescent↗
PubMed1997

Tissue characteristics of root resorption areas in transplanted maxillary canines.

The aim of the present study was to describe some histopathologic features of tissues collected from root resorption areas of maxillary canines after transalveolar transplantation surgery. In 8 of 101 transplanted canines, complications including cervical root resorption occurred between 6 and 11 years after treatment. The resorptive processes were located at the supra-alveolar portions of the distal and/or mesial aspects of the teeth and were scheduled for treatment involving surgical exploration. The resorption cavities, which extended from the cementoenamel junction to a position immediately below the bone crest, were filled with a granulation tissue. In four of the diagnosed complication cases, this granulation tissue was carefully excised concomitant with the adjacent gingival tissue after flap elevation and placed in a buffered fixative. After proper soft-tissue healing, the cavities were filled with a glass-ionomer material. The collected biopsy specimens were, after fixation and, in one case, decalcification in ethylenediaminetetraacetic acid, dehydrated and embedded in Epon. Sections 3 microns thick were produced, stained in periodic acid-Schiff and toluidine blue, and used for histometric and morphometric analyses. The histologic analysis showed that the dissected tissue harbored well-encapsulated areas of inflammatory infiltrates. The lesions comprised a relatively low volume of collagen and a large number of inflammatory cells, predominantly lymphocytes.

Adult↗
PubMedDate not supplied

Squamous cell carcinoma of the gingiva. Histological classification and grading of malignancy.

A histological classification and grading of malignancy has been performed on the initial biopsies from 124 patients with squamous-cell carcinoma of the gingiva treated during the period 1958-69 at the Karolinska hospital. Six different morphological parameters were evaluated with respect to the tumour cell population and the tumour-host relationship estimated in terms of a four-point scale. This permitted grading with total points ranging from 6-24. A strong correlation was found between the degree of histological malignancy and the fatal outcome of the disease. Thus a tumour with a point value of 16 almost always led to the death of the patient while the best results were achieved with surgery alone in the group of small cancers (T1 + T2) with low total malignancy points.

Adult↗
PubMedDate not supplied

Treatment of gingival pigmentation: a case series.

A smile expresses a feeling of joy, success, sensuality, affection and courtesy, and reveals self confidence and kindness. The harmony of the smile is determined not only by the shape, the position and the color of the teeth but also by the gingival tissues. Gingival health and appearance are essential components of an attractive smile. Gingival pigmentation results from melanin granules, which are produced by melanoblasts. The degree of pigmentation depends on melanoblastic activity. Although melanin pigmentation of the gingiva is completely benign and does not present a medical problem, complaints of 'black gums' are common particularly in patients having a very high smile line (gummy smile). For depigmentation of gingiva different treatment modalities have been reported like- Bur abrasion, scraping, partial thickness flap, cryotherapy, electrosurgery and laser. In the present case series bur abrasion, scraping, partial thickness flap (epithelial excision) cryotherapy and electrosurgery have been tried for depigmentation, which are simple, effective and yield good results, along with good patient satisfaction. The problems encountered with some of these techniques have also been discussed.

Adult↗
PubMedDate not supplied

Hereditary gingival fibromatosis and growth retardation.

OBJECTIVE: To describe two patients with hereditary gingival fibromatosis (HGF) and growth hormone deficiency and to review the literature on HGF and related endocrine abnormalities. METHODS: We present case reports of two patients (first cousins)-an 8-year-old girl and a 13-year-old boy-with an existing diagnosis of HGF, who were assessed because of presumed growth failure. Both patients underwent growth hormone stimulation testing and more in-depth endocrine evaluation, including measurement of morning cortisol, adrenocorticotropic hormone (ACTH), and prolactin levels as well as thyroid function tests. An ACTH stimulation test was also performed. Radiologic evaluation included assessment of bone age and magnetic resonance imaging of the brain. RESULTS: In addition to HGF, both patients had short stature, subnormal growth velocity, and delayed bone age but no abnormalities on magnetic resonance imaging of the brain. Serum prolactin levels and results of thyroid function tests were normal. Subnormal growth hormone response was noted during hypoglycemia and pharmacologic stimuli with clonidine and levodopa. The female patient, who also had recurrent hypoglycemic episodes, had a suboptimal cortisol and ACTH response during hypoglycemia. On the ACTH stimulation test, she showed an inadequate cortisol response at 30 minutes but a normal response at 60 minutes. The male patient had normal morning cortisol and ACTH levels plus a normal response to ACTH stimulation. Both patients are responding well to treatment with growth hormone. The girl is also receiving cortisol replacement and has had no further episodes of hypoglycemia. CONCLUSION: Although HGF has been described as an isolated finding, it can occur as part of a syndrome, including infrequent endocrine abnormalities such as growth hormone insufficiency. The cause of the growth hormone deficiency remains unclear in these two patients. We believe that patients with HGF should be monitored carefully for a prolonged period for growth as well as other endocrine abnormalities.

Adolescent↗
PubMed1998

Restorative and periodontal considerations of short clinical crowns.

The purpose of this review was to examine the periodontal and restorative factors related to restoring teeth with short clinical crowns. Modes of therapy are usually combined to meet the biologic, restorative, and esthetic requirements imposed by short clinical crowns. The complications presented by teeth with short clinical crowns demand a comprehensive treatment plan and proper sequencing of therapy to ensure a satisfactory result. Visualization of the desired result is a prerequisite of successful therapy. Short clinical crowns present many problems to the restorative dentist. Restorations should have proper form, function, and esthetics while promoting the maintenance of tissue health in the surrounding areas. However, adequate tooth structure for achieving these goals may not always be available. While it is difficult to precisely define minimum crown length, this study offers guidelines for defining a short clinical crown and suggests procedures for achieving a predictable result without compromising the periodontium. The consequences of placing a restoration on a tooth with insufficient crown length are discussed and various treatment methods are reviewed.

Alveolar Process↗
PubMed1976

Gingival crevicular fluid: a new diagnostic aid in managing the periodontal patient.

On the whole, the studies on GCF have demonstrated that the flow of this fluid is sufficiently indicative of the inflammatory state that it can be used under a variety of clinical conditions to monitor and control gingival inflammation. Since gingivitis is extremely common, and since some cases of gingivitis presumably do not progress to periodontitis, the question could be posed whether or not a concerted effort to control inflammation (i.e. trying to achieve a GCF flow as near to zero as possible) would be clinically significant. Until there is evidence to the contrary, the answer must be "yes", since few cases are known where periodontitis occurs without being preceded by gingivitis. In other words, the control of all gingivitis, if feasible, should prevent most cases of periodontitis. Although control of all gingivitis would mean the treatment of many cases that would not progress to periodontal breakdown, such efforts would be worth-while if most periodontal destruction were prevented. Even the early destructive lesion exhibiting little or no inflammation may soon be identified, mainly because the minute volume of fluid collected from the gingival crevice can now be measured accurately. Accordingly, the concentration of various constituents in the GCF can be determined, which should lead to the development of tests to differentiate between pockets undergoing active destruction with minimal inflammation from the majority of active lesions that are intimately involved with frank inflammation. Thus, a clinician would measure sub-clinical gingival inflammation by measuring GCF flow, then differentiate destructive from quiescent lesions by analyzing the GCF sample for some constituent(s), chemical or microbial (Listgarten et al. 1975) indicative of the periodontal destructive process. Monitoring the flow of GCF might be of value in other clinical situations. For example, one could monitor the response of gingival tissues to various restorative and prosthetic procedures (Strauss et al. 1975) to ensure that these procedures do not aggravate the periodontal tissues and induce gingivitis or periodontitis. The education of the patient should be easier since patients can read their own numbers on the GCF meter at each examination and self-evaluate their personal periodontal condition and the effectiveness of their home care. Even the education of the dental student should be easier since he or she would have the means of self-evaluating the effectiveness of treatment, and not be as dependent upon the subjective assessment of his efforts by an instructor. Finally, monitoring GCF for various components could provide the dentist with a valuable means of easily screening patients for systemic disease. Obviously, this area of investigation is in its infancy, but does promise an exciting future for the oral diagnostician.

Ammonia↗