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Drug-associated gingival enlargement: case report and review of aetiology, management and evidence-based outcomes of treatment.

"Gingival enlargement" is the term now used to describe medication-related gingival overgrowth or gingival hyperplasia (AAP, 2004), a condition commonly induced by three main classes of drugs: anticonvulsants, antihypertensive calcium antagonists and the immunosuppressant cyclosporin. It is important that the health practitioner is aware of the potential aetiologic agents and characteristic features in order to be able to accurately diagnose and successfully manage patients who present with a condition such as outlined in the following case presentation.

Adult↗

Using a diode laser to uncover dental implants in second-stage surgery.

A soft tissue diode laser offers an alternative technique for uncovering dental implants. This article presents two cases in which four dental implants were uncovered using a soft tissue laser. This technique provides an efficient and patient-friendly method to perform second-stage implant surgery, safely allowing a faster rehabilitative phase.

Dental Abutments↗

Orthodontic extrusion with or without circumferential supracrestal fiberotomy and root planing.

The aim of this randomized clinical trial was to carry out a biometric comparison between the orthodontic extrusion (OE, group B) technique and OE combined with fiberotomy and root planing (OEFRP, group A). Twenty single-root teeth were extruded and assigned to two different groups. In both groups, fixed orthodontic appliances were activated weekly during the course of 3 weeks. After activation, the extruded teeth were maintained in retention for a period of 8 weeks. In group A, along with weekly activation, fiberotomy and root planing were carried out on the top of the alveolar bone crest. Statistical analysis revealed that the amount of dental structure exposed was greater in group A, where the gingival margin and bone tissue remained stable (P < .05). Group B presented coronal migration of the gingival tissue and bone tissue of 2 mm and 1.5 mm, respectively.

Adult↗

Management of excessive gingival display following adult orthodontic treatment: a case report.

A common cause for the condition described as excessive gingival display is the phenomenon known as altered passive eruption, a coronally situated gingival complex that failed to recede normally during eruption of an otherwise healthy and normal dentition. Orthodontic movement in such conditions may set the stage for additional coronal growth of hyperplastic gingival complex. The objective of this article is to describe, through a detailed case presentation, the surgical methods used to achieve healthy and aesthetic gingival contours in such conditions.

Adult↗

Canine impactions: incidence and management.

Impacted teeth present many problems for the orthodontist. They can compromise tooth movement, esthetics, and functional outcomes. The second most commonly impacted tooth, after the maxillary third molar, is the maxillary canine, with an incidence from 1% to 2.5%. Maxillary canines can be impacted facially or palatally and are more common in female patients than in male patients. Therefore, the purpose of this paper is to address the incidence and etiology associated with impacted maxillary canines, the clinical and radiographic evaluation of the situation, and the techniques for managing this problem. Papers related to this topic were identified and reviewed thoroughly. A decision tree involving the various techniques employed to expose impacted canines is presented, together with methods used to identify the location of impacted canines. The impacted canine can be properly managed with proper diagnosis and technique.

Alveolectomy↗

Laser-assisted gingival tissue procedures in esthetic dentistry.

Soft tissue lasers are increasing in popularity among clinicians in part due to their potential value in preprosthetic gingival procedures. The ability of soft tissue lasers to control moisture and facilitate hemostasis appears particularly promising for clinicians excising gingival tissues, performing esthetic crown lengthening, and using resective techniques for gingival troughing--and these applications will grow as practitioners become more familiar with such technologies. This presentation highlights the use of the 810 nm diode laser for perio-restorative procedures in the anterior maxilla.

Crown Lengthening↗

Long-term uncontrolled hereditary gingival fibromatosis: a case report.

Hereditary gingival fibromatosis (HGF) is a rare condition characterized by varying degrees of gingival hyperplasia. Gingival fibromatosis usually occurs as an isolated disorder or can be associated with a variety of other syndromes. A 33-year-old male patient who had a generalized severe gingival overgrowth covering two thirds of almost all maxillary and mandibular teeth is reported. A mucoperiosteal flap was performed using interdental and crevicular incisions to remove excess gingival tissues and an internal bevel incision to reflect flaps. The patient was treated 15 years ago in the same clinical facility using the same treatment strategy. There was no recurrence one year following the most recent surgery.

Adult↗

The challenge of cost restrictions in smile design.

This article demonstrates a method for smile enhancement involving the familiar "gummy" smile as well as irregular incisor gingival emergence levels. In this case study, financial considerations limited a comprehensive restorative treatment plan, restricting changes to several anterior teeth. Despite the restrictions, a solution was found.

Adult↗