1/9. Extraction as a treatment alternative follows repeated trauma in a severely handicapped patient.Handicapped patients with protruding maxillary incisors are prone to repeated dental trauma. A 13-year-old girl with cerebral palsy, severe mental retardation and seizure disorder was referred to our department for restoring the traumatized anterior teeth. Despite drug combination, the frequency of seizure attack was around 10 times a month. The oral examination showed multiple caries, gingival hyperplasia, class II malocclusion with 14 mm overjet and deep overbite. During the first 3 years of a 7-year follow-up period, six episodes of anterior tooth trauma due to seizure attack occurred. The trauma-related treatment performed included endodontic therapy, multiple composite restorations, apical repositional flap, and finally extraction of all four upper incisors with fabrication of a semi-fixed band-retained denture. The denture restored normal overbite and overjet with improved esthetics. For 4 years following the fabrication of denture, no trauma occurred to the anterior teeth in later seizure attacks. Considering inadequate control of seizure disorder, little ability of the patient to receive comprehensive orthodontic treatment, poor prognosis of restorations, and possible future injuries, the removal of non-functional, nonesthetic, trauma-susceptible incisor teeth can be justified as an alternative to tooth preservation.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/9. felodipine-influenced gingival enlargement in an uncontrolled type 2 diabetic patient.BACKGROUND: The potential of calcium channel blockers (CCBs) to induce gingival enlargement (GE) as well as the influence of diabetes mellitus on periodontal tissues has been well documented. This case report documents a conservative clinical approach to the management of felodipine-influenced gingival enlargement and displays a clinical and histologic case of felodipine-influenced GE in an undiagnosed type 2 diabetic patient. methods: At the initial examination, a medical consultation was requested and two incisional biopsies were taken for pathological evaluation. The patient was diagnosed with uncontrolled type 2 diabetes. felodipine was withdrawn and the diabetes was controlled before dental treatment was initiated. The patient then underwent selective extractions and full-mouth scaling and root planing as well as oral hygiene instructions. No surgical therapy was indicated. RESULTS: The histological results demonstrated the presence of elongated rete pegs; fibrous hyperplasia; a low-grade chronic inflammatory infiltrate, predominantly consisting of lymphocytes; and collagen bundle groups randomly distributed. These features were similar to those present in other drug-influenced GE. Clinical results have demonstrated almost complete resolution of GE after the withdrawal of felodipine and the control of diabetes. Further improvements were seen after scaling and root planing and oral hygiene instructions. No recurrences were noted 12 months after initial therapy. CONCLUSIONS: This report demonstrated that the control of systemic factors seemed to have the most influence on success for this particular case. Since the control of diabetes was managed at the same time as the felodipine withdrawal, it remains difficult to speculate how these two factors impacted both the severity of the GE and the therapeutic results. More importantly, the conservative treatment rendered demonstrated the stability of periodontal status during maintenance phase and the avoidance of surgical interventions.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/9. Resolution of cyclosporin A (CsA)-induced gingival enlargement following reduction in CsA dosage.Gingival enlargement due to the immunosuppressive drug, cyclosporin A (CsA), will resolve following discontinuation of drug therapy or extraction of adjacent teeth. This report presents a clinical observation on a patient in whom CsA-induced gingival enlargement failed to resolve with improved plaque control and scaling, but resolved quickly following reduction in the daily dosage of CsA. Despite less than optimal plaque control, the CsA-induced gingival enlargement did not recur on the reduced drug dosage over a 2-year observation period. This finding raises the possibility that reduction of CsA dosage below a certain critical level may lead to resolution of CsA-induced gingival enlargement.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/9. Clubbed fingers in a patient with inflammatory gingival hyperplasia.The association of clubbing with miscellaneous diseases and its diagnostic implications are such that its detection should prompt consideration of the underlying etiology. We encountered a 48-year-old woman with clubbed fingers and a cauliflower-like gingival swelling on the hard palate of the upper jaw. There were no conventionally well-known causes for clubbing. Histological examination of gum biopsy specimen revealed a diagnosis of inflammatory gingival hyperplasia. As an etiology of clubbed fingers, gingivitis was suggested, since clubbing was regressed in parallel with remission of the gingivitis after the treatment by extraction of anterior teeth. Possible involvement of an autoimmune process in the pathogenesis was also considered, because of concomitant elevation of serum anti-double strand dna antibodies. We recommend examination of the oral cavity for search of an inflammatory disease in cases with clubbed fingers, particularly when other common causes are not apparent.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/9. nifedipine-induced gingival hyperplasia: case reports and literature review.nifedipine-induced gingival hyperplasia is a newly reported but relatively unknown side effect. We describe three cases of severe nifedipine-induced gingival hyperplasia that required dental extraction.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/9. Diphenylhydantoinate-induced hyperplasia of the masticatory mucosa in an edentulous epileptic patient.gingival hyperplasia caused by phenytoin sodium is rarely encountered in edentulous persons. A case of generalized palatal hyperplasia is reported in which retained roots and teeth were suspected of having perpetuated a preextraction lesion, whereas a subsequently placed complete denture initiated a midpalatal hyperplasia. The lesion remained in spite of nonuse of the denture for several years.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/9. The management of drug induced gingival hyperplasia in mentally retarded patients with hemophilia: a report of two cases.Two cases of hemophilia in severely mentally retarded patients with drug-induced gingival hyperplasia are presented. The method of management in each case is described. A conservative approach is recommended in which tissue removals and only selected extractions are performed. It is also suggested that the sequela of dilantin hyperplasia be considered when dilantin is used in patients with hemophilia or severely mentally retarded patients whose oral hygiene may be difficult to maintain. If feasible, as in the first case reported, discontinuance of the drug should be considered. In case 2 the patient is presently being weaned from dilantin therapy. It should be understood that the authors are concerned with the immediate clinical management of drug-induced gingival hyperplasia in mentally-retarded patients with hemophilia. Although this method of management has proved successful in the hands of the authors, we do not have data to show that it is the best form of treatment for these patients.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
8/9. Massive gingival enlargement and alveolar bone loss: report of two cases.We present two cases of massive gingival enlargement and osteolysis of alveolar bone in a 30-year-old female and a 36-year-old male. The etiology could not be established in either case. Histologically, both lesions contained hyperplastic fibrous connective tissue and intense plasma cell infiltrates. Both patients responded well to extensive gingivectomy, extraction of all teeth, and alveoplasty.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
9/9. Periodontal disease in three siblings with familial neutropenia.The periodontal status and treatment of three teenagers in a Finnish family with familial neutropenia is described. The mother was also diagnosed with neutropenia. At initial examination, the 15-year-old male and the 10-year-old female had severe periodontitis, whereas the 13-year-old male had oral ulcerations but no significant periodontal disease. The two siblings with periodontitis were treated and followed approximately 5 years. It was concluded that periodontal therapy including scaling, surgery, and use of antimicrobial agents can be successful in patients with familial neutropenia, and that such patients are not necessarily candidates for full mouth extraction. The role of granulocyte colony-stimulating factor in which was used in the treatment of these patients remains to be established.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |