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1.
Eur J Orthod ; 42(1): 78-85, 2020 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-31111882

RESUMO

OBJECTIVES: To compare the use of diode laser with conventional surgery evaluating the effectiveness of gingivectomy as an adjunct to non-surgical periodontal treatment in the management of gingival enlargement (GE) during orthodontic treatment. TRIAL DESIGN: Prospective three-arm parallel group randomized clinical trial with 1:1:1 allocation ratio. METHODS: Sixty subjects (33 males and 27 females), with a mean age of 14.4 ± 1.9 years, were selected according to inclusion criteria: overgrown gingivae on the labial side of the anterior teeth secondary to fixed appliance therapy, six maxillary anterior teeth present, and healthy non-smokers patients. Patients were enrolled in the study and randomly assigned to three groups by a computer-generated randomization list and by a block size of 4. The allocation information was concealed in opaque and sealed envelopes by the statistician. In the first group, all subjects underwent a conventional scalpel gingivectomy of the maxillary anterior sextant. In the second group, all subjects were treated using laser-assisted gingivectomy; while subjects assigned to the third group underwent only non-surgical periodontal treatment and served as control group (CG). The observer who performed all the measurements was blinded to the group assignment. Blinding was obtained by eliminating from the elaboration file every reference to patient group assignment. Intergroup comparisons of changes in the periodontal parameters were conducted at 1, 3, and 6 months using ANOVA with repeated measures and Tukey's post hoc tests. The significance level was set at P <0.05. RESULTS: After 1 month, the TGs showed a significant improvement of all periodontal parameters when compared with the CG. No statistically significant differences were observed between the two TGs. At the 3-month observation, a relapse occurred in the TGs, while the CG showed the greater improvement of soft tissue health. In the 6-month versus 3-month evaluation, no significant differences between the three groups were found for any periodontal measurements. In the long-term evaluation (6 months versus baseline), a significant greater reduction of pockets were found in the TGs when compared with the CG. CONCLUSIONS: The adjunct use of both scalpel gingivectomy and laser gingivectomy was more effective in controlling gingival inflammation than non-surgical periodontal treatment alone at 1, 3 and 6 months. In the control group, greater improvement in the periodontal parameters were observed within 3 months, depending on a self-care approach for the management of GE. LIMITATIONS: This study was a short-term study (6-month follow-up). TRIAL REGISTRATION: ClinicalTrials.gov (registration number: NCT03514316).


Assuntos
Gengivectomia , Gengivite , Aparelhos Ortodônticos , Adolescente , Criança , Feminino , Gengivite/etiologia , Gengivite/cirurgia , Humanos , Masculino , Aparelhos Ortodônticos/efeitos adversos , Estudos Prospectivos
2.
J Feline Med Surg ; 21(12): 1165-1171, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30663939

RESUMO

OBJECTIVES: The aim of this study was to determine whether feline chronic gingivostomatitis (FCGS) is more prevalent in shared vs single-cat households, whether the number of cohabiting cats or outdoor access represent risk factors for FCGS and whether the number of cohabiting cats is a useful prognostic indicator for standard surgical treatment. METHODS: Cats diagnosed with FCGS (study group) in the past 5 years at a referral institution were identified. The number of cohabiting cats, outdoor access, number of other cohabiting cats diagnosed with FCGS, ⩾6 month surgical outcome, when applicable, and historical signs of upper respiratory disease among any of the cohabiting cats, as well as patient demographic information, were recorded. Data were collected from medical records and by means of a telephone interview with the owners. The same information was collected from a group of cats of similar demographic characteristics diagnosed with periodontal disease but free of FCGS (control group). RESULTS: Seventy-six cats were included, of which 36 (47%) had FCGS and 40 (53%) served as controls. Bivariate analysis showed that cats with FCGS were significantly more likely to come from shared households, and had significantly more total cats per household compared with controls. Multivariate analysis also showed that cats in shared households had a significantly increased odds of FCGS compared with those from single-cat households. Historical signs of upper respiratory disease and outdoor access among cats within the same household were not associated with FCGS. The number of cohabiting cats was not associated with surgical outcome. CONCLUSIONS AND RELEVANCE: Cats with FCGS are more likely to live in shared households. The risk of FCGS correlates with the number of cohabiting cats. The epidemiological features of FCGS may support an infectious etiology. The number of cohabiting cats within a household is not a useful prognostic indicator for standard surgical treatment of FCGS.


Assuntos
Doenças do Gato/epidemiologia , Gengivite/veterinária , Estomatite/veterinária , Animais , Doenças do Gato/diagnóstico , Doenças do Gato/cirurgia , Gatos , Doença Crônica/epidemiologia , Feminino , Gengivite/diagnóstico , Gengivite/epidemiologia , Gengivite/cirurgia , Masculino , New York/epidemiologia , Propriedade , Densidade Demográfica , Prevalência , Prognóstico , Fatores de Risco , Estomatite/diagnóstico , Estomatite/epidemiologia , Estomatite/cirurgia
3.
J Am Dent Assoc ; 148(11): 834-839.e8, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28434556

RESUMO

BACKGROUND AND OVERVIEW: "Pink esthetics," which are considered to be as important as "white esthetics," have attracted increasing attention. To date, clinicians rarely have applied computer-aided design and computer-aided manufacturing (CAD/CAM) techniques in the rebuilding of the contour of the marginal gingiva in the esthetic zone. CASE DESCRIPTION: In this case report, the authors describe a female patient who had gingival inflammation and an asymmetrical contour of the marginal gingiva of the anterior maxillary teeth because previously placed ceramic crowns violated the biological width. The authors used a 3-dimensional-printing surgery template to guide precise crown-lengthening surgery to expose subgingival shoulders and to obtain an ideal marginal gingival contour. Then the authors used interim CAD/CAM crowns to induce the growth of the interdental papilla by 0.5 to 1.5 millimeters. Finally, the patient had a symmetrical and well-balanced contour of the marginal gingiva. In addition, the authors reduced the patient's "black triangle" areas to the greatest possible extent. CONCLUSIONS AND PRACTICAL IMPLICATIONS: This case report illustrates that CAD/CAM products, including 3-dimensional-printing surgery templates and CAD/CAM interim crowns, are helpful in shaping and rebuilding the ideal contour of the marginal gingiva in the esthetic zone, such as the anterior maxillary teeth.


Assuntos
Desenho Assistido por Computador , Aumento da Coroa Clínica/métodos , Coroas , Adaptação Marginal Dentária , Gengivite/cirurgia , Gengivoplastia/métodos , Impressão Tridimensional , Adulto , Planejamento de Prótese Dentária , Feminino , Humanos , Maxila
4.
Int J Paediatr Dent ; 27(3): 231-235, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27914098

RESUMO

BACKGROUND: Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a distinct subtype of inflammatory gingival hyperplasia that shows lack of response to traditional periodontal treatment, and after surgical excision, recurrence rate of 6-16% has been reported. CASE REPORT: Two girls (11- and 9-year-old) with multifocal red patches along the maxillary and mandibular labial gingiva showed no regression of the lesions after basic periodontal treatment. Surgical excision of focal lesion in each case was performed, which showed typical features of LJSGH. In both cases, the lesions presented recurrence. Hence, cryotherapy sessions in all lesions were performed. CONCLUSION: Cryotherapy appears to be successfully in LJSGH and well received by paediatric patients.


Assuntos
Criocirurgia/métodos , Hiperplasia Gengival/cirurgia , Criança , Feminino , Gengivite/cirurgia , Humanos , Mandíbula/cirurgia , Maxila/cirurgia , Recidiva , Reoperação
5.
J Periodontol ; 87(10): 1186-94, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27677810

RESUMO

BACKGROUND: Oscillating-rotating power toothbrushes have been proven to be clinically efficacious. To the best of the authors' knowledge, a clinical evaluation of the safety of these toothbrushes after surgical root coverage procedures has not been published. The aim of this study is to evaluate the gingival margin (GM) stability with the use of an oscillating-rotating toothbrush compared with a manual toothbrush. METHODS: Sixty healthy individuals with at least one Miller Class I or II gingival recession underwent a surgical root coverage procedure. Soft-bristle manual and powered toothbrushes were given to participants randomly assigned to control and test groups, respectively. Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depth (PD), and recession depth (RD) were recorded at baseline and 1, 3, and 6 months after completion of the surgical procedure. Data analyses were performed using linear random-intercept models to take into account within-participant correlations over time. Temporal trend differences across treatments by including treatment-time interaction terms were then tested using a global Wald test. RESULTS: Use of a powered toothbrush resulted in a significantly greater reduction of recorded periodontal clinical indices compared with a manual device (FMPS, P = 0.05; FMBS, P = 0.005; RD, P = 0.004). No significant differences were noticed between the two experimental groups both for PD (P = 0.03) and clinical attachment level (P = 0.11). Complete root coverage was significantly higher in participants who used the powered toothbrush compared with the manual toothbrush at 6 months (control, 66.67%; test, 96.67%; P = 0.002). CONCLUSION: Use of an oscillating-rotating powered toothbrush with a soft-bristle head resulted in higher GM stability after root coverage procedures compared with the use of a manual soft-bristled toothbrush.


Assuntos
Índice de Placa Dentária , Gengivite/cirurgia , Mucosa Bucal/cirurgia , Cirurgia Plástica , Escovação Dentária , Placa Dentária , Desenho de Equipamento , Humanos , Método Simples-Cego
6.
J Periodontol ; 86(2): 254-63, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25299388

RESUMO

BACKGROUND: Periodontal flap surgery is frequently used to remove subgingival deposits, yielding consequential reductions in gingival inflammation and probing depth (PD) with a gain in clinical attachment level (CAL) to treat advanced periodontal disease. However, clinical studies have reported diminished periodontal healing in smokers compared with non-smokers. The aim of the present systematic review and meta-analysis was to assess the impact of cigarette smoking on clinical outcomes following periodontal flap surgical procedures. METHODS: A systematic electronic review of articles relevant to periodontal flap surgical procedures in smokers was conducted from 1977 to March 2014 inclusive, using predefined, optimized search strategies. Meta-analyses were done separately for changes in the two primary outcomes of PD and CAL. RESULTS: The initial search yielded 390 titles and abstracts. After screening, eight controlled clinical studies were finally selected. Three studies were assessed as having a low risk of bias, two as having moderate risk of bias, and three as having a high risk of bias. Qualitative assessment of the articles consistently showed an improved treatment effect among non-smokers versus smokers. The reduction in PD in smokers and non-smokers ranged from 0.76 to 2.05 mm and 1.27 to 2.40 mm, respectively. For CAL, the gain in non-smokers versus smokers ranged from 0.29 to 1.6 mm and 0.09 to 1.2 mm, respectively. Meta-analysis on eight studies reporting on 363 study participants demonstrated an increased reduction in mean (95% confidence interval) PD of 0.39 (0.33 to 0.45) mm. Similar results were found for mean gain in CAL (0.35 [0.30 to 0.40] mm, n = 4 studies). CONCLUSIONS: Considering the relatively homogenous information available, the authors conclude that active smokers could be candidates for periodontal flap surgical procedures. However, the magnitude of the therapeutic effect is compromised in smokers compared with non-smokers. Therefore, cigarette smokers should be: 1) encouraged to abstain from smoking; and 2) thoroughly informed preoperatively of substantial reduction in clinical outcomes compared with non-smokers.


Assuntos
Doenças Periodontais/cirurgia , Fumar , Retalhos Cirúrgicos/cirurgia , Gengivite/cirurgia , Humanos , Perda da Inserção Periodontal/cirurgia , Bolsa Periodontal/cirurgia , Resultado do Tratamento
7.
Drug Metabol Drug Interact ; 27(2): 113-8, 2012 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-22706234

RESUMO

BACKGROUND: One of the most recommended methods of systemic antibiotic administration in periodontics is the combination of amoxicillin and metronidazole, which has great inhibitory effect on periodontal pathogens. The aim of this study is to determine the local concentrations of these drugs in gingiva and compare its distribution in healthy and inflamed tissues. METHODS: The study population was selected from patients referred to our department. Fifteen subjects were referred for crown lengthening, and another 15 subjects required flap surgery because of severe periodontitis. All 30 patients received three doses of amoxicillin 500 mg plus metronidazole 250 mg before surgery. Tissue samples were gathered during surgery, and chemotherapy was continued for 7 days with 8-h intervals. After 7 days, during the second appointment, the next samples were collected. Samples were sent to the laboratory to determine the drug concentration with the use of high-performance liquid chromatography. RESULTS: Amoxicillin concentration in healthy gingival tissue was not detectable. The concentrations after 24 h and 7 days of administration were 25.9±4.1 and 124.8±18 µg/mL, respectively. The values for metronidazole were 28.86±1.7, 1.70±0.3, and 36.0±1.5 µg/mL. CONCLUSIONS: The combination of systemic amoxicillin and metronidazole for 7 days has sufficient gingival connective tissue concentration much more than the minimum inhibitory concentration in healthy and inflamed tissue.


Assuntos
Amoxicilina/farmacocinética , Antibacterianos/farmacocinética , Gengiva/metabolismo , Gengivite/metabolismo , Metronidazol/farmacocinética , Administração Oral , Cromatografia Líquida de Alta Pressão , Combinação de Medicamentos , Gengivite/cirurgia , Humanos , Bolsa Periodontal , Periodontite/metabolismo , Periodontite/cirurgia
8.
Braz. dent. j ; 23(6): 758-763, 2012. ilus
Artigo em Inglês | LILACS | ID: lil-662439

RESUMO

One of the main purposes of mucogingival therapy is to obtain full root coverage. Several treatment modalities have been developed, but few techniques can provide complete root coverage in a class III Miller recession. Thus, the aim of this case report is to present a successful clinical case of a Miller class III gingival recession in which complete root coverage was obtained by means of a multidisciplinary approach. A 17-year-old Caucasian female was referred for treatment of a gingival recession on the mandibular left central incisor. The following procedures were planned for root coverage in this case: free gingival graft, orthodontic movement by means of alignment and leveling and coronally advanced flap (CAF). The case has been followed up for 12 years and the patient presents no recession, no abnormal probing depth and no bleeding on probing, with a wide attached gingiva band. A compromised tooth with poor prognosis, which would be indicated for extraction, can be treated by orthodontic movement and periodontal therapy, with possibility of 100% root coverage in some class III recessions.


Um dos principais objetivos da terapia mucogengival é atingir a cobertura completa da raiz. Diversas modalidades de tratamento têm sido desenvolvidas, mas poucas técnicas podem obter a cobertura total da raiz em uma recessão gengival classe III de Miller. Assim, o objetivo deste relato é apresentar um caso de sucesso clínico de uma recessão gengival classe III de Miller na qual foi obtida a cobertura completa da raiz por meio de uma abordagem multidisciplinar. Uma jovem de 17 anos sexo feminino, leucoderma, foi encaminhada para tratamento de uma recessão gengival no incisivo central inferior esquerdo. Para a cobertura radicular foi planejado: enxerto gengival livre, movimento ortodôntico por meio de alinhamento e nivelamento e retalho reposicionado coronariamente (CAF). Este caso tem sido acompanhado por 12 anos e o paciente apresenta ausência de recessão, sem profundidade de sondagem anormal e sem sangramento à sondagem com ampla faixa de gengiva inserida. Dentes comprometidos e com mau prognóstico, que seriam extraídos em muitos casos, podem ser tratados por meio de movimento ortodôntico e terapia periodontal. 100% de cobertura da raiz é possível e pode ser conseguida em alguns casos de recessão gengival classe III.


Assuntos
Adolescente , Feminino , Humanos , Retalhos de Tecido Biológico/transplante , Gengiva/transplante , Retração Gengival/cirurgia , Técnicas de Movimentação Dentária/métodos , Autoenxertos , Perda do Osso Alveolar/cirurgia , Terapia Combinada , Estética Dentária , Seguimentos , Gengiva/patologia , Retração Gengival/classificação , Gengivite/cirurgia , Incisivo/cirurgia , Má Oclusão/terapia , Retalhos Cirúrgicos/transplante , Resultado do Tratamento , Raiz Dentária/cirurgia
9.
J Periodontol ; 80(2): 253-9, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19186965

RESUMO

BACKGROUND: The aim of this study was to evaluate clinically, histologically, and ultrastructurally the integration process of the acellular dermal matrix used to increase the band of keratinized tissue while achieving gingival inflammation control. METHODS: Ten patients exhibiting a mucogingival problem with bands of keratinized tissue

Assuntos
Colágeno , Retração Gengival/cirurgia , Gengivoplastia/métodos , Pele Artificial , Vestibuloplastia/métodos , Adulto , Membrana Basal/ultraestrutura , Condrogênese , Células Epiteliais/ultraestrutura , Feminino , Gengiva/citologia , Gengiva/fisiologia , Gengiva/ultraestrutura , Gengivite/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Regeneração , Adulto Jovem
13.
J Contemp Dent Pract ; 9(3): 135-41, 2008 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-18335130

RESUMO

AIM: The purpose of this report is to present a case of surgical and prosthetic treatment of a woman with inflammatory fibrous hyperplasia (IFH) and her evaluation during a six month period. BACKGROUND: IFH is a benign pathology, prevalent in female patients, and principally associated with ill-fitting prosthetic devices in need of adjustment. It is common for patients to require surgical removal of the hyperplastic tissue and fabrication of a new prosthesis. CASE REPORT: A 55-year-old female with a history of smoking presented with a chief complaint of missing the scheduled adjustment of her maxillary complete denture and the presence of moveable tissue under the denture. Surgical excision of the hyperplastic tissue followed with fixation of the prosthesis for six months to guide the healing of the soft tissue and to reshape the contours of the maxillary supporting tissues. SUMMARY: Surgical removal of hyperplasic soft tissue is a routine procedure, and the fixation of the prosthesis for the support of tissue during healing improves intraoral conditions for the fabrication of a new prosthesis in the future.


Assuntos
Parafusos Ósseos , Retenção de Dentadura/instrumentação , Prótese Total Superior/efeitos adversos , Hiperplasia Gengival/etiologia , Hiperplasia Gengival/cirurgia , Vestibuloplastia , Feminino , Gengivite/etiologia , Gengivite/cirurgia , Humanos , Pessoa de Meia-Idade , Palato Duro/cirurgia
14.
Lasers Med Sci ; 23(4): 459-65, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17972011

RESUMO

Esthetics is an important factor for patients seeking orthodontic treatment, and not always is the orthodontist able to make adjustments on the gingival contour, and this aspect is neglected. Many orthodontists are familiar with the name laser. However, there is a lack of information regarding their application on the orthodontic practice. There are several options for the use of CO(2) lasers on surgical procedures of interest to orthodontists, especially on soft tissues. There is no evidence that the use of the CO(2) laser has any side effect or contraindication on surgical procedures. This paper reports a series of surgical procedures carried out on orthodontic patients. It is concluded that the carbon dioxide laser not only allows surgeons to enhance current surgical options for treatment but also have contributed to the evolution of a variety of new procedures that are now commonplace in oral surgery, and its use shows several benefits for the orthodontic patient.


Assuntos
Estética Dentária , Gengivite/cirurgia , Terapia a Laser , Lasers de Gás , Ortodontia/instrumentação , Doenças Dentárias/cirurgia , Dente/efeitos da radiação , Adolescente , Criança , Feminino , Gengiva/efeitos da radiação , Gengivite/terapia , Humanos , Masculino
15.
Minerva Stomatol ; 55(1-2): 67-75, 2006.
Artigo em Inglês, Italiano | MEDLINE | ID: mdl-16495874

RESUMO

Bacillary angiomatosis is a rather frequent infectious pathology appearing mainly in the skin but can also affect the liver, spleen, heart, bones, lungs, muscles, central nervous system and other organs. The localization of the lesion in the oral cavity is rather rare, as it is evident in the literature. Bacillary angiomatosis can be clinically similar to the Kaposi's sarcoma and histologically confused with angiosarcoma, epitheloid hemangioma and pyogenic granuloma. A case of bacillary angiomatosis of the oral cavity in an immuno-competent patient is described. The high tendency to relapse, the capability in migration and to involve several localizations at the same time have induced the authors to deepen the research to exclude the possibility that it could be a Kaposi's sarcoma or a pyogenic granuloma and to get to an accurate diagnosis in order to resolve the disease.


Assuntos
Angiomatose Bacilar/diagnóstico , Gengivite/diagnóstico , Adolescente , Adulto , Ampicilina/análogos & derivados , Ampicilina/uso terapêutico , Angiomatose Bacilar/tratamento farmacológico , Angiomatose Bacilar/microbiologia , Angiomatose Bacilar/cirurgia , Bartonella henselae/patogenicidade , Bartonella quintana/patogenicidade , Criança , Clorexidina/uso terapêutico , Terapia Combinada , Diagnóstico Diferencial , Feminino , Neoplasias Gengivais/diagnóstico , Gengivite/tratamento farmacológico , Gengivite/microbiologia , Gengivite/cirurgia , Granuloma Piogênico/diagnóstico , Hemangioendotelioma Epitelioide/diagnóstico , Hemangiossarcoma/diagnóstico , Humanos , Masculino , Gravidez , Complicações Neoplásicas na Gravidez/diagnóstico , Recidiva , Sarcoma de Kaposi/diagnóstico , Extração Dentária
16.
Can Vet J ; 46(6): 530-2, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16048015

RESUMO

A 12-year-old male neutered short haired cat was presented due to difficulty eating and pawing at the face. Examination revealed severe gingivitis and stomatitis throughout the oral cavity. Gingival biopsy provided a diagnosis of lymphoplasmacytic stomatitis. Extraction of all premolars and molars resulted in elimination of all clinical signs.


Assuntos
Doenças do Gato/patologia , Gengivite/veterinária , Estomatite/veterinária , Extração Dentária/veterinária , Animais , Doenças do Gato/cirurgia , Gatos , Assistência Odontológica/métodos , Assistência Odontológica/veterinária , Gengivite/patologia , Gengivite/cirurgia , Masculino , Estomatite/patologia , Estomatite/cirurgia , Resultado do Tratamento
17.
Vet Clin North Am Small Anim Pract ; 35(4): 891-911, vii, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15979518

RESUMO

Gingivostomatitis (GS) with various patterns of disease may require antiviral therapy, steroids, laser fulguration, immunomodulation drugs, or nonsteroidal anti-inflammatory drugs. The use of cyclosporine as an immunomodulation drug has long-term benefits in reduction of the immunologic events that contribute to GS. Whole-mouth extraction or partial extraction (premolars and molars), with radiographic conformation that all root remnants have been removed, may be the most viable option in nonresponsive and or intractably painful stomatitis in noncompliant cats or dogs. Oral inflammation subsided after extraction without the need for further medication in approximately 70% of the cats from two studies with previous chronic unrelenting oral disease. The combination of immunomodulation with cyclosporine together with laser resection of proliferative tissue should be recommended if extraction of teeth is not desired. Removal of proliferative oral tissues by lasing (carbon dioxide laser) removes the tissue that maybe producing tissue antigens and the area where bacteria are sequestered. The use of anti-inflammatory medications is recommended in the management of GS. Therapeutic success is achieved when there is elimination of proliferative tissue and inflammation.


Assuntos
Doenças do Gato/tratamento farmacológico , Doenças do Cão/tratamento farmacológico , Gengivite/veterinária , Estomatite/veterinária , Animais , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Doenças do Gato/cirurgia , Gatos , Doenças do Cão/cirurgia , Cães , Gengivite/tratamento farmacológico , Gengivite/cirurgia , Estomatite/tratamento farmacológico , Estomatite/cirurgia , Extração Dentária/veterinária
19.
Intern Med ; 44(12): 1307-11, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16415555

RESUMO

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.


Assuntos
Hiperplasia Gengival/complicações , Gengivite/complicações , Osteoartropatia Hipertrófica Secundária/etiologia , Anticorpos Antinucleares/sangue , Biópsia , Diagnóstico Diferencial , Feminino , Seguimentos , Gengiva/patologia , Hiperplasia Gengival/patologia , Hiperplasia Gengival/cirurgia , Gengivite/patologia , Gengivite/cirurgia , Humanos , Pessoa de Meia-Idade , Osteoartropatia Hipertrófica Secundária/diagnóstico , Osteoartropatia Hipertrófica Secundária/imunologia , Extração Dentária
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