Treatment of gingival enlargement by dr harshavardhan patwal. Fibrous enlargement is most common in areas of maxillary and mandibular. 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. Study 43 gingivitis and gingival enlargement flashcards from matthew l. Gingiva yang sehat berwarna merah muda dengan tepi yang tajam menyerupai krah baju, konsistensi kenyal dengan adanya stipling.
Relasi gigi molar klas 2 terhadap gingival enlargement. Gambaran klinisnya disebut hipertropi gingivitis atau hiperplasi ngan warna merah, konsistensi lunak, tepi tumpul dan tidak adanya stipling halus. Originally published in veterinary practice news, october 2016 download as a pdf gingival hyperplasia and hypertrophy are histologic terms used often to describe the clinical appearance of gingival enlargement, an increase in the size or thickness of the gingiva. Magnification of an existing inflammation initiated by dental plaque 2. The extent of gingival enlargements were defined as either localized or generalized. The differential diagnosis included enlargement due to drugs e. Gingival enlargement is one of the frequent features of gingival diseases. Hgf is characterized as a benign, slowly progressive, nonhemorrhagic, fibrous enlargement of keratinized gingiva. The most common causes of localized gingival enlargement, which is defined as fibrous epulis, include subgingival plaque, tartar, and inappropriate restoration margins.
It usually takes few weeks to resolve the gingival lesions 34,35 but response to this method varies 36. Three classes of drugs known to cause ge are anticonvulsants, antihypertensives specifically calciumchannel blockers, and immunosuppressants 2,3. Gingival enlargement is an overgrowth or increase in size of gingiva. It can cover teeth in various degrees, and can lead to aesthetic disfigurement. Drugs are the commonest reason behind gingival enlargement. 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. A case of a 19yearold male presenting with maxillary and mandibular chronic inflammatory gingival enlargement associated with prolonged orthodontic therapy is reported here. Pada tugas ini akan dibahas mengenai defenisi, etiologi terjadinya, serta klasifikasi pembesaran gingival.
Management of druginduced gingival enlargement australian. Prevalence of gingival overgrowth induced by antihypertensive. Gingival overgrowth, hypertrophic gingivitis, gingival. As gingival enlargement develops, it affects the normal oral hygiene practice and may interfere with masticatory functions. Severe druginduced gingival enlargement and periodontitis. Gingival hyperplasia typically refers to the increase in the number of cells, whereas gingival hypertrophy deals with the increase in cell size. The possibility of druginduced enlargement was ruled out based on the medical history. 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. Sep 14, 2019 epulis gravidarum adalah pdf posted on september 14, 2019 by admin epulis gravidarum is a quite rare gingival disorder occurring in to 5% of pregnant women, and it affects more commonly the anterior region of the upper. The simplified taxonomy of gingival conditions includes. On palpation, gingiva was soft and oedematous without stippling and was tender on palpation.
False gingival enlargement as a diagnostic problem. Usually reduction in gingival overgrowth is noticed where a structurally different calcium channel blocker is used. Cyclosporin is an immunosuppressant which has been reported to cause gingival enlargement in 2580% of patients. In severe cases, the excess tissue may cover the crowns of the teeth, thus causing functional, esthetic, and periodontal problems, such as bone loss and bleeding, due to the presence of. There are a number of causes for this condition, but its often a symptom of poor oral hygiene or a side effect of using.
Enlargement gingiva adalah pertumbuhan gingival yang berlebihan yang disebabkan oleh pertambahan besar selsel yang dikandungnya hipertrofi, atau pertambahan selsel hyperplasia. Nonsurgical management of nifedipine induced gingival. 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. Congenital gingival hyperplasia in a neonate with foetal valproate syndrome.
Gingival enlargement gingival enlargement or overgrowth is usually caused by local inflammatory conditions such as poor oral hygiene, food impaction, or mouth breathing. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician. It is being reported with three main groups of drugs like calcium channel blockers ccbs, immunosuppressants, and anticonvulsants. Gingival hyperplasia is a disease in which the gum tissues overgrow abnormally. Pembesaran gingiva gingival enlargement, merupakan hasil dari adanya faktor iritan. Feb 21, 2017 the enlargement can be inflammatory,fibrotic or a combination of both. Gingival enlargement can be caused by a number of factors, including inflammatory conditions and the side effects of certain medications.
Aug 12, 2014 gingival enlargement associated with systemic diseases many systemic diseases can develop oral manifestations that may include gingival enlargement these systemic diseases andor conditions can affect the periodontium by two different mechanisms as follows. In this paper, inflammatory gingival enlargement and treatment was presented. Gingivectomy 00109 abstract gingival enlargement is a common feature in gingival disease. Gingival enlargement or gingival overgrowth, a common trait of gingival disease, is characterized by an increase in the size of gingiva. Systemic conditions such as hormonal changes, drug therapy, or tumor infiltrates may also cause or contribute to the severity of gingival enlargement. To be considered a gingival enlargement resulting from medications, the size. Gingival enlargement, also synonymous with the terms gingival hyperplasia or hypertrophy, is defined as an abnormal overgrowth of gingival tissues.
Gingival enlargement is the term now used to describe medicationrelated gingival overgrowth or gingival hyperplasia, a common reactionary. Gingival enlargement pembesaran gingiva pertumbuhan gingiva yang berlebihan yang disebabkan oleh pertambahan besar size selsel yang dikandungnya hipertrofi, atau pertambahan selselnya hiperplasia. Peradangan timbul tanpa tergantung dari pengangkatan plak secara efektif. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Gingival enlargement and its treatment authorstream. Gingival overgrowth may vary from isolated mild enlargement of interdental papilla or a uniform enlargement which may affect either one or both jaws. Amlodipine is a commonly prescribed drug with the prevalence of gingival hyperplasia being reported as high as 33. Treatment can be in the form of allowing for spontaneous resolution once the etiology is removed, instituting proper dental hygiene, nonsurgical treatment, andor surgical treatment. In recent years,flap surgery have been used more often to treat gingival enlargement than gingivectomy. It is an unwanted side effect of certain systemic drugs given for nondental treatment. Generalized inflamed nonfibrotic gingival tissues, bleeds readily on probing, patient reports pain, fever, marked fatigue occurs in 30% of acute and 10% of chronic leukemia cases, inflammation pronounced even with little dental plaque, starts in papillae and then involves marginal and attached gingiva, gingival tissues frequently show initial clinical signs of leukemia with a sudden onset. Gingival overgrowth go is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers.
Gingival gum enlargement, also known as gingival hyperplasia or hypertrophy, is an abnormal overgrowth of gingival tissues. Gingival enlargement is an increase in the size of the gingiva gums. Abvp and elizabeth mcmorran, drmedvet for the education center. Gingival enlargement pembesaran gingiva pertumbuhan gingiva. The advantage of this term is that it allows for part of, or the entire enlargement to be due to increased production of connective tissue matrix or collagen fibre deposition.
Apr 21, 2019 epulis gravidarum adalah pdf epulis gravidarum is a quite rare gingival disorder occurring in to 5% of pregnant women, and it affects more commonly the anterior region of the upper. Pertambahan ukuran gingiva adalah hal yang umum pada penyakit gingiva. Terminologi untuk kondisi ini adalah gingival enlargement atau gingival overgrowth. Extramedullary involvement of leukemia can occur in up to 40% of patients. Larger areas of gingival enlargement more than 6 teeth or areas where attachment loss and osseous defect are present should be treated by the flap technique, as should any situation in which the gingivectomy may create a mucogingival problem. Drug induced gingival overgrowth digo statpearls ncbi. Periodontal flap method for treatment of gingival enlargement. Druginduced enlargement is associated with a patients genetic predisposition. Mar 08, 2020 epulis gravidarum adalah pdf march 8, 2020 epulis gravidarum is a quite rare gingival disorder occurring in to 5% of pregnant women, and it affects more commonly the anterior region of the upper. Hereditary gingival fibromatosis hgf, also known as idiopathic gingival hyperplasia, is a rare condition of gingival overgrowth.
Gingival enlargement pembesaran gingiva pertumbuhan gingiva yang berlebihan yang disebabkan oleh pertambahan besar size selsel yang dikandungnya hipertrofi, atau. Gingival enlargement can be induced by three main causes stemming from 1 inflammation, 2 medication, and 3 systemic disease. Gingival fibromatosis is a rare and heterogeneous group of disorders that develop as slowly progressive, local or diffuse enlargements within marginal and attached gingiva or interdental papilla. Gingivektomi adalah pemotongan jaringan gingiva dengan membuang dinding lateral poket yang bertujuan untuk menghilangkan poket dan. The periodontal flap technique used for the treatment of.
Pdf the aesthetic management of gingival enlargement and. Surgical therapy was carried out to provide a good. Gingival enlargement is a common clinical feature of gingival and periodontal diseases. In most cases, the enlargement results because of local irritations. These microscopic distinctions are both indicative of a disease process.
Gingival enlargement the currently accepted terminology for an increase in the size of the gingiva, is a common feature of gingival disease. Top causes of gingival enlargement and treatment options. Gingival enlargements generalised pocket dentistry. Gingival overgrowth overgrowth is a term used to overcome some of the shortcomings of the above two terms, because it is less specific. Gingivitis dapat bersifat kronis dan akut, yang lebih sering terjadi adalah. His oral hygiene was poor with presence of local factors. Cyclosporineinduced gingival enlargement is more vascularized than phenytoin enlargement figures 1610 and 1611. Gingival was bluish in colour with presence of ecchymosis in the floor of the mouth figure 2. Bukan enlargement sebenarnya, merupakan pembesaran yg tampak ok bertambahnya ukuran tulang dibawahnya atau bentukan gigi permanen dibawahnya developmental enlargement contoh ukuran tl yg bertambah adalah pd.
Chronic inflammatory gingival enlargement associated with. Treating patients with druginduced gingival overgrowth. The enlargement can be inflammatory,fibrotic or a combination of both. In severe cases, the excess tissue may cover the crowns of the teeth, thus causing functional, esthetic, and periodontal problems, such as bone loss and bleeding, due to the presence of pseudopockets. Pdf false gingival enlargement as a diagnostic problem. 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. Gingival enlargement ge is a condition in which the size of the gingiva increases, which can be caused by inflammation, systemic disease, or certain medications. Among calcium channel blockers, nifedipine causes gingival hyperplasia in about. Definition increase in size of gingiva or gingival overgrowth. The awareness in the medical community about this possible side effect of nifedipine is less when compared to the effects of phenytoin and. Pembengkakan gingival hampir secara universal hasil akumulasi cairan dalam jaringan yaitu edema. In july, 2015 the aap announced a focused update that addresses three specific areas of.
One of the main drugs associated with go is the antiepileptic. Niemiec, dvm davdc favd for decades, the beveled gingivectomy has been the standard for treatment of gingival enlargement. Gingival enlargement is often associated with calcium channel blockers and ciclosporin. A case report of gingival enlargement associated with. Hiperplasi adalah penambahan jumlah sel dan hipertropi adalah peningkatan ukuran sel. Recognition and treatment of amlodipine norvasc induced. However, the pseudo pockets formed by gingival enlargement make the maintenance of good oral hygiene difficult, perpetuating a cycle of inflammation and fibrosis the involved. Gingival enlargement or hypertrophy are the two other terms used to describe the condition.
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. Go is characterized by the accumulation of extracellular matrix in gingival connective tissues, particularly collagenous components, with varying degrees of inflammation. 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. The purpose of this study was to report the case of a 6yearold male patient who showed persistent and severe hemorrhage after a tooth extraction and generalized gingival enlargement over a short. This is the most effective treatment of druginduced gingival enlargement. Oral signs of leukemia and dental management literature. Figure 1 it consists of creating bleeding points at the level of normal gingiva and then excising the tissue using a 45 degree external beveled incision.
Individualized treatment plan for gingival enlargement. Gingival enlargements inflammation mouth free 30day. Gingival enlargement pembesaran gingiva pertumbuhan. Hereditary gingival fibromatosis hgf adalah suatu keadaan yang tidak biasa yang ditandai oleh diffuse gingival enlargement, kadangkadang menutupi sebagian besar permukaan atau seluruh gigi. Chronic inflammatory gingival enlargement and treatment. Ge ok pubertas relatif sama dgn inflamasi gingiva kronis, namun yg membedakan ge pubertas dgn ge inflamasi kronis adalah, pd ge pubertas bersifat rekurent walaupun deposit plak relatif sedikit. In patients presenting with periodontitis and gingival. If gingival enlargement isnt treated, it may some aesthetic problems, plaque accumulation, gingival bleeding, and periodontitis.
Gingival hyperplasia is an overgrowth of gum tissue around the teeth. Gingival enlargement, also mistakenly used synonymously with gingival hypertrophy and gingival hyperplasia, describes a condition that occurs when the size of the gingiva increases. Calcium channel blockerinduced gingival enlargement. Perawatan druginduced gingival enlargement perawatan pembesaran gingiva akibat pemakaian obat direncakan berdasarkan medikasi yang dipakai dan kondisi klinis pasien. Prevalence and clinical aspects of druginduced gingival.
In most instances, inflammatory gingival enlargement begins at an area poor oral hygiene food impaction, or other local irritation that can be readily controlled. The inflammatory enlargement is clinically called hyperthropic gingivitis or gingival. The gingival enlargement can be localised around one tooth, but is more commonly generalised throughout the whole mouth. Gingival enlargements are quite common and may be either inflammatory, non inflammatory or a combination of both. Pembesaran gingiva pada rongga mulut dentias notes. Pertambahan ukuran gingiva merupakan tanda paling umum dari penyakit gingiva.
There are many anticonvulsants, immunosuppressants and calcium channel blockers that may lead to gingival enlargement in varied presentations table table1 1 and figure figure7. Gingivitis classification is useful for diagnosis, prognosis and treatment planning. There are several causes of gingival enlargement and they can be grouped into four categories. 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. It tends to affect the anterior teeth more severely. 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. Gingival hyperplasia in acute leukemia stanford medicine. Gingival enlargement definition of gingival enlargement by. Gingival enlargement an overview sciencedirect topics. Iya ada karena dengan adanya relasi molar yang menyebabkan maoklusi ini dapat menyebabkan proses pembersihan gigi geligi menjadi kurang sempurna sehingga akumulasi plak,impaksi makanan dan kalkulus menjadi banyak sehingga menyebabkan gingival enlargement akibat inflamasi. Perio gingivitis and gingival enlargement flashcards quizlet. Plaque induced inflammation appears to be a general stimulating effect regardless of the mechanism of gingival enlargement. Druginduced gingival overgrowth is frequently associated with three particular drugs. The druginduced gingival enlargement could be detected clinically as early as months following the initial dose of ccb.
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