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Objetivo: La sífilis es una enfermedad de transmisión sexual con una incidencia creciente a nivel mundial. En la sí- filis secundaria, las lesiones orales son frecuentes, siendo a veces la única manifestación. El objetivo de este artículo es presentar una serie de casos clínicos de sífilis con localización predominante o exclusivamente gingival, destacando las ca- racterísticas clínicas más relevantes para su diagnóstico. Casos clínicos: Esta serie de casos clínicos incluyó nueve casos de sífilis secundaria con manifestaciones gingi- vales. El diagnóstico se realizó mediante pruebas serológicas (VDRL, TPPA, FTA-ABS y MHA-TP), y se describieron le- siones tanto gingivales como extragingivales. En la encía se observó sífilis secundaria afectando principalmente la región anterior tanto superior como inferior, presentándose pla- cas rojas o blancas. Algunos casos también presentaban le- siones en otros sitios intraorales, tenían síntomas como dolor o sensación de ardor, o presentaban enfermedad periodontal dependiente de placa. El diagnóstico diferencial de sífilis se- cundaria gingival con condiciones periodontales inespecíficas es fundamental para un diagnóstico adecuado. Por lo tanto, se debe considerar el diagnóstico de sífilis secundaria cuando se enfrentan casos gíngivo-periodontales atípicos en la práctica diaria (AU)
Aim: Syphilis is a sexually transmitted disease with growing incidence worldwide. In secondary syphilis, oral le- sions are common, sometimes being the only manifestation. Gingival features of syphilis are rare and usually present mul- tiple oral lesions. The aim of this article is to present a series of clinical cases of syphilis with predominantly or exclusively gingival localization, highlighting the most relevant clinical characteristics for its diagnosis. Clinical cases: This clinical case series included nine cases of secondary syphilis with gingival manifestations. The diagnosis was made using serological tests (VDRL, TPPA, FTA-ABS, and MHA-TP), and both gingival and extragingi- val lesions were described. Secondary syphilis was observed in the gum, mainly affecting the anterior region both up- per and lower, depicting red or white plaques. Some cases also presented lesions in other intraoral sites, had symptoms such as pain or burning sensation, or showed plaque induced periodontal disease. The differential diagnosis of second- ary syphilis considering non-specific periodontal conditions with gingival involvement is essential for a proper diagnosis. Thus, the diagnosis of secondary syphilis should be consid- ered when dealing with atypical gingivo-periodontal cases in everyday practice (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Oral Manifestations , Syphilis/complications , Gingival Diseases/etiology , Argentina/epidemiology , Schools, Dental , Dental Service, Hospital , Diagnosis, DifferentialABSTRACT
ABSTRACT The gingival cyst of the adult (GCA) is a rare odontogenic cyst, consisting of 0.3% of all odontogenic cysts. This case report, based on CARE guidelines for case reports, aims to present a case of a 52-year-old female patient with a symptomatic translucent nodule in the upper left anterior gingiva, measuring approximately 6mm. Excisional biopsy was performed, and the histological examination revealed multiple cystic cavities lined by the squamous epithelium of varying thickness with focal areas of nodular thickenings. The presence of clusters of cells with clear cytoplasm within epithelial thickenings was observed. PAS staining was negative in clear cells. The diagnosis of the GCA was established. Despite its rarity, GCA should be considered in the differential diagnosis of gingival lesions. Conservative surgical treatment proved to be effective, with no signs of recurrence.
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Abstract Despite the recognized impact of diet on non-communicable diseases, the association between the Mediterranean diet and periodontal diseases is still uncertain. This study aimed to determine the association between adherence to the Mediterranean Diet Index (MDI) and self-reported gingival health status in Chilean adults, exploring the feasibility of using validated web-based survey questionnaires. Methodology Cross-sectional data were collected from a representative sample of a population of Chilean adults (18-60 years old) using a low-cost and time-saving methodology. By the PsyToolkit platform, anonymous survey data were downloaded and analyzed in bivariate (crude) and backward stepwise selection multivariate logistic regression models adjusted for sociodemographic determinants, smoking, and dental attendance using STATA 17. Odds ratios (OR) [95% confidence intervals] were estimated. Results In total, 351 complete statistical data were mostly obtained from female university students who had never smoked and reported having visited a dentist in the previous year. Multivariate regression models showed an association between MDI and very good/good gingival health status (OR 1.18 [95% CI 1.04-1.34], p=0.013), absence of bleeding on toothbrushing (OR 1.12 [95% CI 1.01-1.25], p=0.035), and absence of clinical signs of gingival inflammation (OR 1.24 [95% CI 1.10-1.40], p<0.001), after controlling for age, sex, educational level, smoking, and dental attendance. Conclusions We associated adherence to the Mediterranean diet with better self-reported gingival health status in a population of Chilean adults in an entirely web-based research environment. Longitudinal studies with random sampling are required to establish the effect of diet on gingival and periodontal health. Nevertheless, this evidence could contribute to the design of low-cost surveillance programs to reduce the burden of periodontal disease and related "common risk factors".
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Las lesiones orales de tejido blando son infrecuentes en los recién nacidos, pueden conducir a una alimentación, crecimiento, y desarrollo cognitivo inapropiados. El fibroma osificante periférico es una lesión reactiva de la encía, con solo cinco casos reportados en recién nacidos. Objetivo: Reportar un caso de fibroma osificante periférico en un recién nacido, y discutir las complicaciones asociadas a dientes natales/neonatales. Caso clínico: Masculino de 4 meses de edad, mexicano, presentó dos dientes natales que fueron extraídos a los quince días de nacimiento. Posteriormente, se observó un crecimiento de tejido blando en esta área, con dos zonas radiopacas identificadas radiográficamente. Con el diagnóstico presuntivo de lesión reactiva, se procedió a la biopsia excisional, con evolución satisfactoria durante el seguimiento. Conclusiones: El fibroma osificante periférico debe considerarse como una potencial complicación por la presencia o extracción de dientes natales/neonatales, y debe tratarse oportunamente debido a sus repercusiones clínicas.
Lesões de tecidos moles orais são raras em recém-nascidos e podem levar a alimentação inadequada, crescimento e desenvolvimento cognitivo. O fibroma ossificante periférico é uma lesão reativa da gengiva, com apenas cinco casos relatados em recém-nascidos. Objetivo: Relatar um caso de fibroma ossificante periférico em recém-nascido e discutir as complicações associadas aos dentes natais/neonatais. Caso clínico: Um menino mexicano de 4 meses de idade apresentou dois dentes natais que foram extraídos quinze dias após o nascimento. Posteriormente, observou-se crescimento de tecidos moles nesta área, com duas zonas radiopacas identificadas radiograficamente. Com o diagnóstico presuntivo de lesão reativa, foi realizada biópsia excisional, com evolução satisfatória durante o seguimento. Conclusões: O fibroma ossificante periférico deve ser considerado como uma complicação potencial devido à presença ou extração de dentes natais/neonatais, devendo ser tratado prontamente devido às suas repercussões clínicas.
Oral soft tissue injuries are rare in newborns and can lead to inappropriate feeding, growth, and cognitive development. Peripheral ossifying fibroma is a reactive lesion of the gingiva, with only five cases reported in newborns. Objective: To report a case of peripheral ossifying fibroma in a newborn, and to discuss the complications associated with natal/neonatal teeth. Clinical case: A 4-month-old Mexican male presented two natal teeth that were extracted fifteen days after birth. Subsequently, soft tissue growth was observed in this area, with two radiopaque zones radiographically identified. With the presumptive diagnosis of reactive lesion, an excisional biopsy was performed, with satisfactory evolution during follow-up. Conclusions: Peripheral ossifying fibroma should be considered as a potential complication due to the presence or extraction of natal/neonatal teeth, and should be treated promptly due to its clinical repercussions.
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La sonrisa gingival (SG) es una condición clínica de etiología multifactorial, caracterizada por la sobreexposición de la encía maxilar, mayor de 3 mm, mientras el paciente sonríe. Es considerada una de las alteraciones más comunes en la población con una prevalencia de 10,5-29%, 7% en hombres y 14% en mujeres, en el grupo etário de 20-30 años. La literatura científica reporta diversos tratamientos quirúrgicos invasivos y mínimamente invasivos que pueden ser acompañados con planificación digital. El objetivo de este reporte de caso fue describir el tratamiento de SG por erupción pasiva alterada tipo I, subcategoría A e hipermovilidad de músculo elevador del labio superior, en paciente femenino corregido con procedimientos quirúrgicos y métodos conservadores como la toxina botulínica planificado digitalmente. El uso de planificación digital en la reducción de SG acompañada de técnicas conservadoras como toxina botulínica permiten realizar procedimientos con postoperatorios favorables, disminución en errores de la técnica con resultados predecibles, seguros, rápidos y consistentes de acuerdo a las expectativas del paciente
Gummy smile (GS) is a clinical condition of multifactorial etiology, characterized by overexposure of the maxillary gingiva greater than 3mm while the patient smiles. It is considered one of the most common alterations among the population with a prevalence between 10,5-29%, 7% in men and 14% in women, in the age group of 20-30 years-old. The scientific literature reports several invasive and minimally invasive surgical treatments that can be accompanied with digital planning. The aim of this case report was to describe the treatment of GS due to altered passive eruption type I subcategory A and levator labii superioris muscle hypermobility in a female patient corrected with surgical procedures and conservative methods such as digital planned botulinum toxin. The use of digital planning in GS reduction accompanied by conservative techniques such as botulinum toxin allows performing procedures with favorable postoperative results, less technical errors with predictable, safe, fast and consistent results according to patient's expectations.
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Abstract: Periodontal diseases are considered a worldwide public health problem, owing to their high prevalence in developed and developing countries. Periodontitis may lead to tooth loss, which can impact oral health-related quality of life. Gingivitis and periodontitis have been extensively studied regarding their etiopathogenesis, epidemiology, prevention and treatment outcomes. However, most of these aspects are studied and discussed globally, which may hamper a clear interpretation of the findings and the design of effective plans of action for specific regions or populations. For example, in Latin America, epidemiological data about the distribution of periodontal diseases is still scarce, mainly when it comes to nationwide representative samples. This Consensus aimed to address the following topics related to periodontal diseases in Latin America: a) The impact of the global burden of periodontal diseases on health: a global reality; b) Periodontal diseases in Latin America; c) Strategies for the prevention of periodontal diseases in Latin America; d) Problems associated with diagnosis of periodontal conditions and possible solutions for Latin America; e) Treatment of Periodontitis. This consensus will help to increase awareness about diagnosis, prevention and treatment of periodontal diseases, in the context of Latin American countries.
Subject(s)
Humans , Male , Female , Periodontal Diseases/therapy , Consensus Development Conferences as Topic , Periodontal Diseases/diagnosis , Periodontal Diseases/epidemiology , Periodontitis/diagnosis , Periodontitis/therapy , Periodontitis/epidemiology , Quality of Life , Oral Health , Global Burden of Disease , Gingivitis , Gingivitis/diagnosis , Gingivitis/epidemiology , Latin America/epidemiologyABSTRACT
Background: The lip stabilization technique (LipStaT®) is a novel surgical approach for the management of gummy smile. It is an outpatient technique, minimally invasive, with low risk of morbidity and low incidence of complications. The goal of the technique is to reduce the excessive gingival display during smile. Objective: to describe the LipStaT® technique including its indications, preoperative evaluation, surgical approach and patient post procedure care instructions. Clinical Cases: the authors present two female patients, aged 20 and 31 years, with excessive gingival display (over 3mm) and with experiences of failures with other procedures. The LipStaT® technique allowed to achieve aesthetic, harmonic and functional results. Conclusion: The LipStaT® technique is a safe outpatient procedure that allows to obtain predictable results, which are well accepted by patients.
Introducción: La técnica de estabilización labial (LipStaT®), es un novedoso abordaje quirúrgico para el manejo de la sonrisa gingival. Es una técnica ambulatoria, mínima-mente invasiva, con baja morbilidad e incidencia de complicaciones. La meta de la técni-ca es reducir la excesiva cantidad de encía que se visualiza durante la sonrisa. Objetivo:Describir la técnica LipStaT® incluyendo sus indicaciones, evaluación preoperatoria, abordaje quirúrgico y las indicaciones posteriores a la intervención. Presentación del caso: Los autores presentan dos pacientes, mujeres, entre 20 y 31 años, con visuali-zación excesiva de la encía de más de 3mm al sonreír y con experiencias de fracasos con otros procedimientos. La técnica LipStaT® permitió lograr un resultado estético, armónico y funcional. Conclusión: Este es un procedimiento seguro, ambulatorio, que permite obtener resultados predecibles y bien aceptados por los pacientes.
Subject(s)
Humans , Gingival Overgrowth , Ambulatory Surgical Procedures , Esthetics, Dental , Gingival Diseases , Jaw AbnormalitiesABSTRACT
ABSTRACT A 16-days-old female patient exhibiting an exophytic nodular lesion located at anterior maxilla on the alveolar ridge since birth. The clinical hypothesis of congenital granular cell epulis (CGCE) was established, and the patient underwent excisional biopsy. Microscopically, a sheet-like proliferation of eosinophilic cells with granular cytoplasm was observed in a stroma of vascularized fibrous connective tissue. The immunohistochemical analysis for S100 evidenced the absence of immunostaining. The CGCE hypothesis was confirmed and, after six months, the patient showed no signs of recurrence of the lesion.
RESUMEN Niña de 16 días de edad, presentaba una lesión exofítica de aspecto nodular ubicada en la región de la cresta alveolar maxilar anterior desde su nacimiento. Se estableció la hipótesis clínica de épulis congénito de células granulares, y la paciente se sometió a una biopsia por escisión. Microscópicamente se ha observado una proliferación laminar de células eosinofílicas con citoplasma granular en medio de un estroma de tejido conectivo fibroso vascularizado. El análisis inmunohistoquímica para S100 reveló ausencia de inmunomarcación. La hipótesis de épulis congénito ha sido confirmada, y, después de seis meses, la paciente no mostró señales de recidiva de la lesión.
RESUMO Paciente do sexo feminino, 16 dias de idade, exibiu lesão exofítica de aspecto nodular localizada em região anterior do rebordo alveolar maxilar desde o nascimento. A hipótese clínica de epúlide de células granulares congênita (ECGC) foi estabelecida, e a paciente foi submetida à biópsia excisional. Microscopicamente, observou-se a proliferação em lençol de células eosinofílicas com citoplasma granular em meio a um estroma de tecido conjuntivo fibroso vascularizado. A análise imuno-histoquímica para S100 evidenciou ausência de imunomarcação. A hipótese de ECGC foi confirmada e, após seis meses, a paciente não apresentou sinais de recidiva da lesão.
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Objective@#To evaluate and compare the clinical effects of three surgical procedures for the periodontal treatment of root surface exposure after resection of epulis.@*Methods@#Thirty patients with epulis were selected in this study and the exposed root surfaces of the patients′ teeth were covered with laterally transposition flap, laterally pedicled transposition flap or coronally advanced flap combined with a connective tissue graft in the treatments of epulis. At the time of follow-up during the operation, 3 months after operation and 6 months after operation, respectively, the color, shape and quality of the gum in the operation area and the coordination of the diaphragm and diaphragm were observed, and the root surface exposure (recession depth, RD) and angle were recorded. Keratinized tissue height (KTH), root coverage rate (RC) and patients′ satisfaction with the surgery were also recorded.@*Results@#The flap widths in groups of laterally pedicled transposition flap and coronally advanced flap combined with a connective tissue graft were significantly wider than that in the group of laterally transposition flap at three-month and six-month follow-ups after the surgery. The width of keratoderma [(2.70±1.16) mm] in the group of laterally transposition flap was significantly lower at 6 months postoperatively than that in the other two groups [(4.80±1.14) and (4.90±1.66) mm, respectively] (P<0.01). At the 6th month after surgery, the root flap coverage was at the lowest level [(24±43)%] in the group of laterally transposition flap, and it was significantly lower than that in the other two groups [(80±23)% and (86±24)%, respectively] (P<0.01). There was no significant difference of the root flap coverage between groups of laterally pedicled transposition flap and coronally advanced flap combined with a connective tissue graft. At the time of follow-up, patients were satisfied with the aesthetic effects of the three surgical procedures.@*Conclusions@#After the resection of the gingival tumor, the defect of the gingiva is caused. The laterally pedicled flap and pedicled flap combined with connective tissue transplantations for soft tissue repairing can achieve satisfactory aesthetic effects which are superior to the effect of simple flap technique.
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A doença periodontal é um grupo de doenças de natureza inflamatória/infecciosa, considerada um problema de saúde pública, devido à alta prevalência. O objetivo do presente estudo foi determinar a ocorrência das doenças gengivais e periodontais entre os pacientes atendidos em um Centro Universitário do Nordeste Brasileiro, identificando quais doenças periodontais são as mais prevalentes e observando os possíveis fatores de risco relatados nas anamneses. A pesquisa foi realizada no Centro Universitário Cesmac de Maceió-AL, na qual foram incluídos prontuários de pacientes atendidos nessa mesma clínica escola, de ambos os sexos, na faixa etária de 11 a 85 anos, no período de 2010 a 2016. Os dados coletados foram tabulados em um banco de dados feito no Microsoft Excel (Microsoft Corporation, USA), onde registrou-se o número do paciente, gênero (biológico); idade; etnia; data do exame periodontal; diagnóstico periodontal; prognóstico periodontal; presença ou ausência de doença sistêmica relatada pelo paciente através da anamnese presente em seu prontuário. A análise dos dados obtidos foi realizada através dos testes de Qui-quadrado, de Mann-Whitney, de Kruskal-wallis e Dunn. E os softwares utilizados foram o BioEstat 5.0 e o GraphPad Prism 7.0. De acordo com os resultados obtidos nesta pesquisa observa-se a alta ocorrência de doenças gengivais e periodontais. Devido a metodologia utilizada não houve dados suficientes que comprovassem a relação da doença com a condição sistêmica (AU)
The periodontal diseaseis a groupo inflammatory / infectio us diseases considered a public health problem dueto its high prevalence. The aim of the present study was to determine the occurrence of gingival and periodontal diseases among the patients attending in a University Center at Brazil's Northeast, identifying which periodontal diseases are the most prevalente and observing the possible risk factors reported in the anamneses. The study was carried out at the Centro Universitário Cesmac de Maceió-AL, in which the medical records of patients attending the same school clinic of both sexes, aged between 11 and 85 years, were included in the period from 2010 to 2016. The data collected were tabulated in a data base made in Microsoft Excel (Microsoft Corporation, USA), where the patient's number, gender (biological) was recorded; age; ethnicity; date of periodontal examination; periodontal diagnosis; periodontal prognosis; presence orabsence of systemic disease reported by the patient through the anamnes is present in his medical record. Data analysis was performed using the Chi-square, Mann-Whitney, Kruskal-wallis and Dunn tests. And the software used was BioEstat 5.0 and GraphPad Prism 7.0. According to the results obtained in this research the high occurrence of gingival and periodontal diseases is observed. Dueto the methodology used, there were insufficient data to prove the relation ship between the disease and the system condition. (AU)
Subject(s)
Humans , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Periodontal Diseases , Periodontics , Periodontitis , Gingival Diseases , GingivitisABSTRACT
Abstract Objective: To determine the frequency distribution of gingivitis and oral hygiene in individuals with Down syndrome. Material and Methods: This study used a cross-sectional descriptive method and the subjects were 174 individuals with Down syndrome aged ≥14 years attending type C (intellectual disability) special needs schools in Jakarta. Gingivitis was measured using the gingival index, and oral hygiene was measured using the Simplified Oral Hygiene Index (OHI-S). The measurement of the two components of plaque and calculus was completed on six teeth on different surfaces, including the facial side of three maxillary teeth, the lingual side of the two posterior mandibular teeth, and the labial side of one anterior mandibular tooth. Descriptive statistics were used to calculate the absolute and relative frequencies Results: 3.4% had no gingivitis, 47.2% had mild gingivitis, 40.8% had moderate gingivitis, and 8.6% had severe gingivitis. Regarding oral hygiene, 28.2% had good hygiene, 49.4% had fair, and 22.4% had poor hygiene Conclusion: Individuals with Down syndrome had a frequency distribution of gingivitis mainly in the mild and moderate categories, and a majority of subjects had fair OHI-S.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Oral Hygiene/education , Oral Health/education , Down Syndrome , Dental Plaque/prevention & control , Intellectual Disability , Cross-Sectional Studies/methods , Data Interpretation, Statistical , Gingival Diseases/etiology , Gingivitis , Health Services Needs and DemandABSTRACT
Objective: To determine the prevalence of gingivitis among Malian children in Bamako, Mali. Material and Methods: This cross-sectional study evaluated 2640 children aged between 3 to 14 years old and two examiners collected the data. The gingival index was used to determine the degree of gingival. Gingival inflammation has been classified localized and / or generalized according to site rate achieved. Descriptive statistics were used to calculate the absolute and relative frequencies. Results: The prevalence of gingivitis was 87.5%. Regarding the distribution according to sex, the girls presented 60.6% while the boys 39.4%, with a sex ratio of 0.6. The most represented age group was 11-14 years old with 52.5% of cases. Plaque-induced gingivitis was the most common (58.2%), while moderate gingival inflammation affected 67% of the students with localized gingival inflammation involving 64.7% of the participants. Conclusion: The prevalence of gingivitis was high, so that early and correct management of this condition in children avoids complications and requires good oral hygiene.
Subject(s)
Humans , Male , Female , Child , Adolescent , Dental Plaque Index , Epidemiology , Gingivitis/etiology , Mali , Cross-Sectional Studies/methodsABSTRACT
Antecedentes: En ocasiones, las retracciones gingivales se asocian a altas fuerzas tensionales de los músculos y a vestíbulos poco profundos. Dichas retracciones generan problemas periodontales a los pacientes por la dificultad de limpiar estas zonas. La vestibuloplastia por medio de la técnica de Edlan Mejchar permite, en una sola intervención y un solo campo quirúrgico, controlar los factores etiológicos y una inserción trepadora de la encía al eliminar las fuerzas tensionales. Objetivo: Describir la efectividad de la técnica de Edlan Mejchar empleada para solucionar retracciones gingivales producidas por fuerzas tensionales en cuatro casos clínicos. Descripción de los casos: Se presentaron cuatro pacientes con retracciones gingivales en dientes incisivos inferiores con poca encía adherida debida a fuerzas tensionales del frenillo labial inferior. Como tratamiento se usó la técnica de Edlan Mejchar que incluyó una incisión supraperióstica y relajantes internas en el tejido conjuntivo. Resultados: El porcentaje de cobertura radicular logrado después del procedimiento fue de aproximadamente el 60 % y se eliminaron inserciones anómalas del frenillo. Conclusiones: La técnica de Edlan Mejchar de vestibuloplastia mostró resultados favorables en los casos descritos en los cuales el frenillo labial ejercía fuerzas tensionales sobre el periodonto de dientes anteriores inferiores.
Background: Sometimes gingival retractions are associated with high muscular tensional forces and shallow vestibules. Such retractions cause periodontal problems to patients due to the cleaning access limitations. Edlan Mejchar vestibuloplasty technique allows controlling, in one intervention and a single surgical field, etiological factors and a creeping gingival attachment by eliminating tensional forces. Purpose: To describe the effectiveness of Edlan Mejchar technique to solve gum retractions caused by tensional forces in four clinical cases. Description of cases: Four patients with gingival retractions in lower incisors and little adhered gingiva due to lower lip frenulum tension seek dental treatment. Edlan Mejchar vestibuloplasty was the surgical treatment chosen, which consisted of supraperiosteal incisions and internal dissections in connective tissue. Results: The percentage of root coverage achieved was close to 60 % and abnormal frenulum insertions were eliminated. Conclusion: Vestibuloplasty through Edlan Mejchar technique showed favorable results in the cases described in which the labial frenum exerted tensional forces on the periodontium of lower anterior teeth.
Subject(s)
Humans , Surgery, Oral , Periodontal Diseases , Periodontics/methods , Dentistry/methodsABSTRACT
Gingival Stillman's cleft is a mucogingival triangular- shaped defect which influence on health and appearance of gingiva. Due to a lack of clinical reports, five cases of gingival Stillman's cleft were recruited in the present study. The treatment methods were selected according to the etiological factors of the defect in each patient. Satisfactory treatment responses were achieved in all cases during a 6 to 20 month follow up after the treatments. In this study, we summarized the treatment strategies in various types of gingival Stillman's cleft, so as to provide the reference for clinicians.
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El agrandamiento gingival (AG) es el aumento de volumen anormal de la encía que genera cambios estéticos y síntomas clínicos como sangrado gingival espontáneo o inducido, trastornos periodontales y migración patológica dentaria, entre otros. Este proceso patológico puede ser un efecto secundario a ciertos fármacos como anticonvulsivantes, bloqueadores de canales de calcio e inmunosupresores. Se presenta el caso de un paciente sexo masculino de 74 años de edad con antecedentes de trasplante renal, en tratamiento con ciclosporina, que acude por aumento del volumen intraoral, clínicamente compatible con agrandamiento gingival. Se realiza tratamiento basado en exodoncias, biopsia y control de placa. A los 2 meses se pudo observar una regresión de la lesión, y se confirma el diagnóstico con el estudio histopatológico. El manejo actual del tratamiento de esta enfermedad se basa en el control de la placa. Se sugiere dar un enfoque multidisciplinario y crear protocolos para derivar oportunamente antes de la expresión más agresiva de la enfermedad.
Gingival enlargement is an abnormal increased volume of the gum that induces cosmetic changes and clinical symptoms, such as gingival bleeding, periodontal disorders, pathological tooth migration, among others. This condition can be a side effect of certain drugs such as anticonvulsants, calcium channel blockers, and immunosuppressants. A 74 year-old male patient with a medical record of kidney transplant secondary to chronic renal failure receiving cyclosporine for the past 14 years is referred to our Hospital with the chief complaint of gingival enlargement. The treatment is based on tooth extractions, biopsy and periodontal treatment. A complete regression of the lesion was observed after two months. The current approach to treat this disease is focused on plaque control. A multidisciplinary approach should be used and clinical protocols prepared that allow early treatment and avoidance of more aggressive disease expression.
Subject(s)
Humans , Male , Aged , Cyclosporine/adverse effects , Gingival Hyperplasia/chemically induced , Gingival Hyperplasia/therapy , Immunosuppressive Agents/adverse effects , Kidney TransplantationABSTRACT
ABSTRACT Objectives: The aim of this study is to investigate the prevalence and severity of gingival inflammation and associated risk indicators in South American adults. Material and Methods: Multi-stage samples totaling 1,650 adults from Porto Alegre (Brazil), Tucumán (Argentina), and Santiago (Chile) were assessed. The sampling procedure consisted of a 4-stage process. Examinations were performed in mobile dental units by calibrated examiners. A multivariable logistic regression model was utilized for associating variables as indicators of gingival inflammation (GI) (Gingival Index ≥0.5). Statistical significance was set at 0.05. Results: A total of 96.5% of the adults have GI. Regarding the severity of GI, 22.5% of participants examined have mild GI, 74.0% have moderate GI, and 3.6% have severe GI. The multivariate analyses identify the main risk indicators for GI as adults with higher mean of Calculus Index (OR=18.59); with a Visible Plaque Index ≥30% (OR=14.56); living in Santiago (OR=7.17); having ≤12 years of schooling (OR=2.18), and females (OR=1.93). Conclusions: This study shows a high prevalence and severity of gingival inflammation, being the first one performed in adult populations in three cities of South America.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Gingivitis/pathology , Gingivitis/epidemiology , Periodontitis/etiology , Socioeconomic Factors , South America/epidemiology , Severity of Illness Index , Sex Factors , Epidemiologic Methods , Risk Factors , Age Factors , Sex Distribution , Age Distribution , Dental Plaque/epidemiology , Gingivitis/etiologyABSTRACT
A gengivite descamativa caracteriza-se por eritema doloroso, perda da camada superficial de queratina, com ou sem ulceração, na gengiva aderida. Não cede às medidas profiláticas convencionais. Paciente do sexo feminino, 55 anos, caucasiana, compareceu na FMDUP, com dor e ardência nas gengivas. Após diagnóstico clínico de gengivite descamativa iniciámos tratamento convencional. Foi realizada biópsia incisional para despiste: líquen plano, pênfigo, penfigóide e lúpus eritematoso. O resultado da biópsia revelou lesão liquenóide com infiltrado linfoplasmocitário e presença de corpo estranho. A histologia, e o facto de a doente não apresentar melhoras com a aplicação de corticóide tópico, à excepção da zona biopsada, favoreceu a hipótese de gengivite descamativa por corpo estranho. Paciente foi aconselhada a fazer controlos trimestrais. Pacientes com estas manifestações deverão proceder a um bom controlo de placa bacteriana e descartar outras fontes de inflamação. A remissão da doença, só se consegue totalmente com a eliminação cirúrgica da gengiva afectada.
Desquamative gingivitis is a descriptive term that refers to an erythematous appearance of the gingiva, characterized by loss of keratin, with or without ulceration, and painprophylactic measures won´t restrain symptoms. 55 year-old woman, caucasian, came to FMDUP with pain and burn on the gingiva. Clinical diagnosis of desquamative gingivitis was followed by convencional treatment. Incisional biopsy was performed after verifying the insuccess of convencional measures: lichen planus, pemphigus, pemphigoid, lupus erythematosus were considered. The biopsy unfolded a lichenoid lesion with lymphocytic infiltrate and presence of foreign body. This diagnosis in association with the lack of improvement after topic application of corticosterois, favored the hypothesis of desquamative gingivitis associated with foreign body. The patient was advised to attend to quarterly appointments. Patients with these clinical manifestations, must have a perfect plaque control, allowing to discard other sources of inflammation. Cure is only complete with surgical removal of the affected gingiva.
Subject(s)
Humans , Female , Middle Aged , Iatrogenic Disease , Gingival Diseases , Granuloma , Foreign-Body ReactionABSTRACT
Introduction: Fixed orthodontic appliances patients suffer limitations on the effective control of biofilm by mechanical methods, bringing the need of a coadjutant in the control of inflammation and oral health improvement.Objective: The aim of this prospective split-mouth blind study was to analyze the effect of a 40% chlorhexidine (CHX) varnish on gingival growth of patients with orthodontic fixed appliances. Methods: Healthy teenage patients with fixed orthodontic appliances and increased gingival volume were recruited (n = 30). Each individual was his own control, having in the maxilla one control side and one treatment side. An application of varnishes occurred on the vestibular area of the upper premolars and first molar crowns, on the control side (placebo varnish) and on the experimental side (EC40(r) Biodentic CHX varnish). The varnishes and sides were randomly chosen and its identification and group was kept by a third party observer and it was not revealed to the researchers and participants until the end of study. In order to establish a baseline registration, digital photographs were taken by a trained photographer before varnish application at baseline (T0), as well as 14 days (T14) and 56 days (T56) after the application. The gingival volume was calculated indirectly using the vestibular areas (mm2) of the upper second premolars' clinical crowns by RapidSketch(r) software, at all study times. The data were analyzed using ANOVA and the Turkey-Krammer test.Results:It was observed, in the final sample of 30 individuals, that at T0, the control and treatment groups were similar. At T14 and T56, a progressive reduction of the clinical crown area was seen in the control group, and an increase in the average area was detected in the experimental group (p < 0,05).Conclusions: The use of 40% CHX varnish decreases the gingival overgrowth in patients undergoing orthodontic treatment. Further studies are necessary to set the action time and frequency of application.
Introdução: pacientes com aparelhos ortodônticos fixos sofrem limitações no controle efetivo de biofilme por métodos mecânicos, trazendo a necessidade de um coadjuvante no controle na inflamação e melhora na saúde bucal.Objetivo:esse estudo cruzado prospectivo randomizado teve como objetivo analisar o efeito do verniz de clorexidina (CHX) a 40% no crescimento gengival de pacientes com aparelhos ortodônticos fixos.Métodos:indivíduos adolescentes com aparelhos ortodônticos fixos e aumento de volume gengival foram recrutados para a pesquisa (n = 30). Cada participante atuou como seu próprio controle, tendo, na maxila, um lado controle e um tratamento. No lado controle, aplicou-se verniz placebo e no lado experimental, o verniz EC40(r) Biodentic CHX, ambos na face vestibular das coroas dos pré-molares e primeiro molar superiores. Os vernizes e lados foram escolhidos de forma aleatória e a identificação deles e a que grupo pertenciam foi mantida por um terceiro observador, não sendo revelada aos pesquisadores nem aos participantes até o final do estudo. Fotografias digitais foram tiradas por um fotógrafo treinado, antes da aplicação do verniz no tempo inicial (T0), bem como 14 dias (T14) e 56 dias (T56) após a aplicação. O volume gengival foi calculado indiretamente, por meio das áreas vestibulares (mm2) das coroas dos segundos pré-molares superiores, com o softwareRapidSketch(r), em todos os tempos de estudo. Os dados foram analisados usando ANOVA e teste de Turkey-Krammer.Resultados:na amostra final de 30 indivíduos, observou-se que, em T0, os grupos controle e tratamento foram semelhantes. Já em T14 e T56, foi observada uma progressiva redução na área da coroa clínica no grupo controle, e um aumento na área média do grupo experimental (p< 0,05).Conclusão:o uso do verniz de CHX a 40% diminui o excessivo crescimento gengival em pacientes sob tratamento ortodôntico. Estudos futuros são necessários para se determinar o tempo de ação e a frequência de aplicação.
Subject(s)
Humans , Male , Female , Child , Adolescent , Chlorhexidine/administration & dosage , Chlorhexidine/therapeutic use , Gingival Overgrowth/drug therapy , Bicuspid/drug effects , Orthodontic Brackets/adverse effects , Gingivitis/etiology , Gingivitis/drug therapy , Anti-Infective Agents, Local/administration & dosage , Anti-Infective Agents, Local/therapeutic use , Molar/drug effectsABSTRACT
Se presentó una paciente femenina de 37 años de edad, sin antecedentes generales de interés, con hábito de onicofagia desde la niñez, que presentaba aumento de volumen localizado en la papila interdentaria entre incisivo lateral y canino maxilar derecho, de aproximadamente dos años de evolución, que le ocasionaba molestias y sangramiento durante el cepillado dentogingival. La lesión se presentó con aspecto de una pieza dentaria, de coloración rosa a rojo, superficie lisa, base sésil, no doloroso a la palpación, rebasaba el borde incisal, sin interferir con la oclusión y sobrepasaba el ancho vestíbulo lingual de los dientes contiguos en aproximadamente dos milímetros. Radiográficamente se observó reabsorción superficial de la cresta del tabique interdentario entre ambos dientes y espaciamiento del trabeculado óseo. Se realizó la escisión quirúrgica y posterior examen anatomopatológico, el cual confirmó la presencia de granuloma periférico gigante celular completamente resecado, lo cual corroboró el diagnóstico presuntivo. Se apreció una satisfactoria evolución postquirúrgica.
A female patient of 37 years old with no history of general interest, nail biting habit from childhood, which had increased volume within the interdental papilla between lateral incisor and maxillary right canine about two years of evolution was presented, which caused discomfort and bleeding during dentogingival brushing. The lesion appeared with appearance of a tooth, pink color to red, smooth, sessile base, not painful on palpation, exceeded the incisal margin, without interfering with the occlusion and surpassing the broad lingual hall of the contiguous teeth in approximately two millimeters. The radiographic exam evidenced superficial reabsorption of the crest of the interdental partition between both teeth and bone-like spacing of the trabeculate. The lesion was eliminated by surgical excision. The histologic test confirmed the presence of peripheral giant cell granuloma completely eliminated. A satisfactory post-surgical evolution was observed.
ABSTRACT
Objetivo: Explanar sobre o RPS (Registro Periodontal Simplificado), um método simples e de fácil aplicação para a detecção precoce da doença periodontal, desenvolvido pela Academia Americana de Periodontologia (AAP) junto à Associação Dental Americana (ADA) em 1992. Métodos: Foi realizada uma revisão da literatura sobre o RPS em periódicos e artigos científicos nas bases de dados LILACS, BBO e SciELO. Resultados: Através do RPS pode-se avaliar o grau de necessidade de tratamento periodontal, tornando o exame periodontal inicial mais rápido e prático, além de favorecer a elaboração de uma estratégia de tratamento mais segura. O exame é realizado com a sonda periodontal preconizada pela Organização Mundial de Saúde, onde a boca do paciente é dividida em seis sextantes, os quais recebem códigos numerados (0 a 4) de acordo com a visibilidade da sonda no sulco e com determinadas características clinicas. O método parece encontrar grande valia, principalmente, quando se deseja otimizar o intervalo de tempo entre diagnóstico e tratamento. Conclusão: o RPS é um método rápido, simples, de baixo custo e eficiente na detecção precoce das doenças periodontais e, consequentemente, na prevenção de suas formas avançadas; contudo, em determinadas situações, não substitui o exame periodontal completo.
Aim: To explain about the PSR (Periodontal Screening and Recording), a simple and easy method to apply for early detection of periodontal disease, developed by the American Academy of Periodontology (AAP) and the American Dental Association (ADA) in 1992. Methods: A review was conducted on the RPS in journals and scientific articles in the databases LILACS, BBO and SciELO. Results: Through the PSR the degree of necessity of periodontal treatment can be evaluated, becoming the examination initial periodontal quicker and practical, beyond favoring the elaboration of a treatment strategy safer. The examination is carried through with the periodontal sounding recommended by the World Health Organization, where the patient's mouth is divided in six sextants that receive codes with numbers (0 from 4) with in accordance the visibility of the sounding lead in the gingival sulcus and with determined clinical features. The method seems to find very useful especially when it is desired to optimize the time interval between diagnosis and treatment. Conclusion: The PSR is rapid, simple, inexpensive and efficient to the early detection of periodontal diseases and, consequently, for the prevention of the advanced periodontal disease. However, it doesn't replace a complete periodontal examination.