Gingival Enlargement
Describe the etiology of chronic inflammatory gingival enlargement. Write management of drug induced gingival hyperplasia.
Answer.
Etiology of Chronic inflammatory Enlargement
- Prolonged exposure to dental plaque.
- Factors which favors the plaque accumulation i.e. poor oral hygiene.
- Irritation due to anatomic abnormalities.
- Due to improper restorative and orthodontic appliances.
- Gingival changes which are associated with mouth breathing such as gingivitis and gingival enlargement.
- Maxillary anterior region is the common site due to irritation from surface dehydration.
Management of Drug-induced Gingival Hyperplasia
Three different types of drug are associated with gingival enlargement that is anticonvulsants, calcium-channel blockers and immunosuppressant.
Read And Learn More: Periodontics Question And Answers
Gingival Enlargement Treatment First Step
- Oral hygiene reinforcement, chlorhexidine gluconate rinses, scaling and root planning.
- Possible drug substitution: When it is attempted it is necessary to allow at least a period of 6 to 12 months between discontinuation of offending drug and possible resolution of gingival enlargement.
- Professional recalls.
- Azithromycin decreases the severity of cyclosporine induced gingival enlargement.
- Folic acid supplementation significantly decreases the incidence of gingival overgrowth.
- Periodic recall visits.
Causes Of Gingival Enlargement
Gingival Enlargement Treatment Second Step
- If enlargement persists after following the above steps: Surgical therapy is indicated. There are two surgical options available based on feature it presents.
- Small areas of enlargement with no attachment loss or bone loss and has good keratinized tissue, gingivectomy is treatment of choice.
- Large areas of enlargement with presence of osseous defects and limited keratinized, gingival, periodontal flop surgery are indicated.
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