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2.
BMC Oral Health ; 21(1): 473, 2021 09 26.
Artículo en Inglés | MEDLINE | ID: mdl-34565352

RESUMEN

BACKGROUND: Hereditary gingival fibromatosis (HGF) is rare in clinical practice, and the long-term results of the combined orthodontic-periodontal treatment of HGF are rarely reported. CASE PRESENTATION: This study reports for the first time the results of seven years of follow-up in a seven-year-old girl with HGF. The diagnosis was confirmed by clinical signs, family history and histopathological examination. First, periodontal scaling and oral hygiene reinforcement were performed regularly in the mixed dentition stage. Next, gingivoplasty was performed on the permanent dentition. Two months after the surgery, treatment with fixed orthodontic appliances was conducted. The teeth were polished on a monthly basis, and oral hygiene was reinforced to control gingival enlargement. Gingival hypertrophy recurred slightly, and gingivectomies were performed in the months following the start of orthodontic treatment. Follow-up was performed for 24 months with orthodontic retention, and gingival enlargement remained stable after the combined treatment. CONCLUSIONS: The risk of gingival hyperplasia recurrence during and after orthodontic treatment is high, but satisfying long-term outcomes can be achieved with gingivectomy, malocclusion correction, and regular follow-up maintenance.


Asunto(s)
Fibromatosis Gingival , Hiperplasia Gingival , Niño , Femenino , Fibromatosis Gingival/genética , Fibromatosis Gingival/cirugía , Estudios de Seguimiento , Gingivectomía , Humanos , Higiene Bucal
4.
Eur J Paediatr Dent ; 22(2): 159-162, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34238009

RESUMEN

AIM: Localised juvenile spongiotic gingival hyperplasia (LJSGH) is a benign lesion occurring in young patients as gingival erythema and overgrowth, typically localised on gingiva of maxillary incisors. The aim of this work is to report a case of LJSGH where complete spontaneous regression was achieved together with a review of the literature on the topic. CASE REPORT: An 8-year-old girl was referred for a gingival painless lesion, which had appeared spontaneously one year before and was refractory to periodontal treatment. Intraoral examination showed a well-defined, red gingival overgrowth involving the left maxillary central incisor, without involving the marginal gingiva. The clinical diagnosis of LJSGH was made, due to the pathognomonic aspect. The patient was periodically recalled for 43 months; at the last visit, the lesion was spontaneously resolved. RESULTS: LJSGH is not plaque-related and not responsive to periodontal treatment. Surgical removal of the lesions correlates with high recurrence, while spontaneous resolution over time has been hardly demonstrated. CONCLUSION: Follow-up of LJSGH may be an option of care, alternative to surgery, in selected cases.


Asunto(s)
Hiperplasia Gingival , Niño , Atención Odontológica , Femenino , Encía , Hiperplasia Gingival/cirugía , Humanos , Incisivo
5.
BMJ ; 373: n1571, 2021 06 21.
Artículo en Inglés | MEDLINE | ID: mdl-34154998
6.
Rev. cient. odontol ; 9(1): e051, ene.-mar. 2021. ilus
Artículo en Español | LILACS, LIPECS | ID: biblio-1254403

RESUMEN

La mucopolisacaridosis tipo VI, también conocida como síndrome de Maroteaux-Lamy, es un trastorno lisosómico autosómico recesivo, causado por la deficiencia de la enzima arilsulfatasa B, lo que conduce a la acumulación de dermatán sulfato en los tejidos y su excreción urinaria. La deposición de mucopolisacáridos genera un trastorno progresivo que afecta a múltiples órganos y que, a menudo, resulta en la muerte a temprana edad. Esta enfermedad tiene varias manifestaciones orales, entre las que destacan las complicaciones dentales, que pueden ser graves e incluir folículos similares a quistes dentígeros, maloclusiones, defectos condilares e hiperplasia gingival, además de características clínicas como cuello corto, opacidad corneal, macroglosia y agrandamiento del cráneo, dimensión anteroposterior larga y mano en garra. Se presenta el caso de un paciente de 14 meses de edad que acudió a consulta de odontopediatría por episodios de fiebre, bajo peso e hiperplasia gingival severa. El examen físico evidenció facies tosca, cuello corto, pectus excavatus, manos con disminución en agarre y retardo en el neurodesarrollo. El examen intraoral halló retardo de la erupción dental, hiperplasia gingival generalizada y paladar con poco crecimiento transversal. El examen radiográfico detectó órganos dentarios incluidos y mala posición en el sector anterior, molares superiores dentro del seno maxilar y caninos inferiores rotados. El paciente fue remitido a medicina para exámenes bioquímicos y genéticos para definir el diagnóstico. La bioquímica reveló MPS tipo VI, lo que fue confirmado mediante prueba molecular. Las manifestaciones clínicas en este caso corresponden a la forma clínica de progresión rápida reportada en estos pacientes: talla baja, malformaciones esqueléticas y alteraciones a nivel oral. Los niños con MPS VI grave comienzan temprano y progresan rápidamente, las radiografías óseas y la medición de GAG en orina son útiles para el diagnóstico con actividad de la enzima ARSB y genética. Es necesario fortalecer el conocimiento en odontología y la población en general sobre las características clínicas de mucopolisacáridos tipo VI para tener un diagnóstico temprano y un mejor manejo de patologías en estos pacientes. (AU)


Mucopolysaccharidosis type VI, also known as Maroteaux-Lamy syndrome, is an autosomal recessive lysosomal disorder, due to the deficiency of the enzyme arylsulfatase B that leads to the accumulation of dermatan sulfate in the tissues and its urinary excretion. Mucopolysaccharide deposition leads to a progressive disorder affecting multiple organs that often results in death at a young age. This disease has several oral manifestations, among which dental complications can be serious and include follicles similar to dentigerous cysts, malocclusions, condylar defects and gingival hyperplasia, in addition to a short neck, corneal opacity, macroglossia, skull enlargement, anteroposterior dimension long, claw hand is some of the clinical features. A case of a 14-month-old patient is presented, who attended a pediatric dentistry consultation for episodes of fever, low weight, severe gingival hyperplasia. Physical examination revealed coarse facies, short neck, pectus excavatus, hands with decreased grip, and neurodevelopmental delay. On intraoral examination, dental eruption delayed, generalized gingival hyperplasia, palate with little transverse growth. On radiographic examination, dental organs included and poor position in the anterior sector, upper molars within the maxillary sinus, rotated lower canines. He is referred to medicine for biochemical tests and genetics for diagnosis. Detailed biochemistry MPS type VI, confirmed by molecular testing. The clinical manifestations in this case correspond to the clinical form of rapid progression reported in these patients. They report: short stature, skeletal malformations and alterations at the oral level. Children with severe MPS VI start early and progress rapidly, bone radiographs and urine GAG measurement are helpful for diagnosis with genetic and ARSB enzyme activity. It is necessary to strengthen the knowledge in dentistry and the general population about the clinical characteristics of type VI mucopolysaccharides in order to have an early diagnosis and management of pathologies in these patients. (AU)


Asunto(s)
Humanos , Femenino , Lactante , Arilsulfatasas , Mucopolisacaridosis VI , Dermatán Sulfato , Hiperplasia Gingival , Glicosaminoglicanos
7.
BMC Oral Health ; 21(1): 84, 2021 02 24.
Artículo en Inglés | MEDLINE | ID: mdl-33627113

RESUMEN

BACKGROUND: The mechanism of gingival growth that may occur during fixed orthodontic treatment is not yet fully understood and the amount of dental plaque is often incriminated. The objective of this study was to evaluate the prevalence of gingival growth during multi-attachment orthodontic treatment and to prioritize its predicting factors, especially the quantity of biofilm. METHODS: This comprehensive cross-sectional descriptive study was conducted on orthodontic patients aged 9 to 30 years, in good health, treated by a fixed appliance. Periodontal clinical parameters such as plaque index, gingival index, probing pocket depth, periodontal phenotype and gingival enhancement index were recorded. Likewise, the brushing habits and the date of the last scaling were noted. The orthodontic parameters studied were the duration of the treatment, the type of bracket, the alloys used for the arches and the type of ligatures. Descriptive statistics were carried out, and variables presenting p value < 0.25 were included in a multivariate analysis to calculate the Odds Ratio (OR) of gingival enlargement". RESULTS: A total of 193 patients were included (16.38 ± 4.89 years). Gingival growth occurred for 49.7% of patients included. The predisposing factors for this pathology during fixed orthodontic treatment were conventional metal brackets (p = 0.021), mouth breathing (p = 0.040), male gender (p = 0.035), thick periodontal phenotype (p = 0.043), elastomeric ligations (p = 0.007), duration of treatment (p = 0.022) and presence of plaque (p = 0.004). After achievement of the logistic regression, only two factors remained related to gingival enlargement: metallic brackets (OR: 3.5, 95% CI: 1.1-10.55) and duration of treatment (OR: 2.03, 95% CI: 1.01-4.08). The amount of plaque would not be directly related to the development of gingival increase during orthodontic treatment. CONCLUSIONS: Among the predisposing factors that underlie gingival growth during multi-attachment therapy, the amount of plaque is not found. The qualitative assessment of the plaque and its evolution during treatment could clarify the role of the biofilm in the occurrence of gingival overgrowth.


Asunto(s)
Placa Dental , Hiperplasia Gingival , Soportes Ortodóncicos , Adolescente , Adulto , Biopelículas , Causalidad , Niño , Estudios Transversales , Índice de Placa Dental , Humanos , Masculino , Soportes Ortodóncicos/efectos adversos , Adulto Joven
8.
J Craniofac Surg ; 32(1): e85-e88, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32941214

RESUMEN

ABSTRACT: The Sturge-Weber syndrome (SSW) is a congenital neurocutaneous malformation, with angiomas involving the leptomeningea and facial skin. This syndrome is characterized by corticocerebral angiomatosis, cerebral calcifications, ocular affections, mental retardation, increased risk of stroke, counterlateral hemiplegia, and seizures. Another important feature of SSW is the flameus nevus on the face. In the oral cavity, SSW appears as hemangiomatous lesions affecting the mucous membranes and occasionally the dental pulp. Gingival hyperplasia may be present due to the use of anticonvulsant drugs. The present article reports the management of 2 female patients with Sturge-Weber syndrome who required oral surgery in regions affected by hemangiomatous lesions. In the first case, no hemostatic agents were necessary. On the other hand, the second case required the use of several hemostatic agents to control hemorrhage during surgery. Both patients recovered uneventfully without episodes of bleeding or infection.


Asunto(s)
Nevo , Procedimientos Quirúrgicos Orales , Neoplasias Cutáneas , Síndrome de Sturge-Weber , Femenino , Hiperplasia Gingival , Humanos
9.
Artículo en Inglés | MEDLINE | ID: mdl-33214091

RESUMEN

OBJECTIVE: Medication-induced gingival hyperplasia (MIGH) has been linked to several medications, with a reported prevalence ranging between 0.5% and 85%. The aim of this study was to systematically review the management approaches for MIGH and estimate recurrence rate and time to relapse. STUDY DESIGN: An electronic literature search was conducted using PICO questions (P = patients with medication-induced gingival hyperplasia; I = surgical and/or nonsurgical treatment options; C = no control is required; and O = partial or complete resolution and recurrence) and medical subject heading terms in the PubMed and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol up to December 2019. All English-language articles on MIGH surgical and nonsurgical management options were included. Eligible articles were systematically reviewed and assessed for bias using preset criteria and multiple levels of elimination. Data were extracted from eligible studies and analyzed. RESULTS: Twenty-two eligible articles were included in this study. Management approaches included discontinuation or change of the offending medication if medically feasible in addition to surgical and nonsurgical interventions. Nonsurgical approach included scaling and root planing, oral hygiene instructions, and antimicrobial mouthrinses. Persistent or relapsed cases had complete resolution with excision of hyperplastic gingiva. Laser-assisted surgeries combined with intensive plaque control measures demonstrated less risk of recurrence. CONCLUSIONS: Several treatment options for MIGH have been reported with variable outcomes. Duration and size of hyperplastic gingival tissue may have an effect on overall recurrence rate.


Asunto(s)
Hiperplasia Gingival , Hiperplasia Gingival/inducido químicamente , Hiperplasia Gingival/terapia , Humanos
10.
Artículo en Inglés | MEDLINE | ID: mdl-33309266

RESUMEN

OBJECTIVES: Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a recently described entity with distinct manifestations. Herein we report a comprehensive histopathologic study of 21 lesions and a literature review. Additionally, we propose a new term that we consider more appropriate. STUDY DESIGN: LJSGH cases were retrieved and their clinicopathologic characteristics were assessed. A review of all pertinent literature was also conducted. RESULTS: Eighteen patients with LJSGH (21 biopsied lesions) were identified. Microscopically, surface morphology was classified into exophytic/papillary, flat, and micropapillary (8, 7, and 6 lesions, respectively). Cases with parakeratinization (n = 9), no prominent spongiosis (n = 5), or epithelial atrophy (n = 4) were recorded. Increased vascularity, mixed inflammation with exocytosis, and cytokeratin-19 positivity were uniformly observed. Less frequent findings included pseudoepitheliomatous hyperplasia (n = 8), bacterial colonies (n = 5), acantholysis (n = 3), and dystrophic calcifications (n = 2). The literature review disclosed 201 patients with a mean age of 14.8 years (range, 3-72; 13.6% affecting adults), similar sex distribution (103:98, female:male), and predominance of the anterior maxilla (≈ 80%). Eighteen cases were multifocal (≈ 10%). CONCLUSIONS: Our data suggest that the terminology could be modified, because LJSGH may be multifocal, affect older individuals, or exhibit epithelial atrophy, and the entity's odontogenic origin (as highlighted by the histopathologic and immunohistochemical findings) needs to be emphasized.


Asunto(s)
Hiperplasia Gingival , Adolescente , Adulto , Anciano , Atrofia/patología , Niño , Preescolar , Edema/patología , Femenino , Humanos , Hiperplasia/patología , Masculino , Maxilar/patología , Persona de Mediana Edad , Adulto Joven
11.
Braz. dent. sci ; 24(1): 1-9, 2021. tab, ilus
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1141391

RESUMEN

Objective: Gingival hyperplasia (GH) is one of the side effects of anticonvulsant drugs. The aim of this study was to verify the prevalence of GH associated with the use of anticonvulsant, through a systematic review. Material and Methods: Systematic search was done at databases Pubmed and Embase between January 1984 and March of 2020 for identification of articles addressing the prevalence of GH associated with the use of anticonvulsant drugs. The methodological index for non-randomized studies (MINORS) was independently assessed for quality in the selected papers. Results: The search identified 4.471 references. Nine articles were selected and evaluated 632 participants. All of the studies included in the systematic review showed a low risk of bias. The anticonvulsants used by patients were carbamazepine, ethosuximide, phenytoin, primidone, phenobarbital, sodium valproate. The studies showed a correlation between different types of anticonvulsants and GH prevalence, with a range from 0% to 73%. Among the anticonvulsants used, phenytoin showed the greatest incidence of GH, varying between 15.61% and 73% in patients. Conclusion: In the analysis of the results obtained in the literature, it is possible to notice that the great majority of studies presented incidence of GH associated with anticonvulsant use. However, further studies are necessary to understand the anticonvulsant action mechanism inducing GH, as well as the prevention forms, given that GH is a significant side effect. (AU)


Objetivo: Hiperplasia gengival (HG) é um dos efeitos colaterais das drogas anticonvulsivantes. O objetivo deste estudo foi verificar a prevalência de HG associada ao uso de anticonvulsivantes, por meio de uma revisão sistemática. Material e Métodos: A busca sistemática foi realizada nas bases de dados Pubmed e Embase entre janeiro de 1984 e março de 2020 para identificação de artigos que abordassem a prevalência de HG associada ao uso de drogas anticonvulsivantes. Foi avaliado independentemente, o risco de viés através do "Methodological index for non-randomized studies" (MINORS), para análise da qualidade dos trabalhos selecionados. Resultados: A pesquisa identificou 4.471 referências. Nove artigos foram selecionados e avaliaram 632 participantes. Todos os estudos incluídos na revisão sistemática mostraram baixo risco de viés. Os anticonvulsivantes utilizados pelos pacientes foram carbamazepina, etossuximida, fenitoína, primidona, fenobarbital e valproato de sódio. Os estudos mostraram correlação entre os diferentes tipos de anticonvulsivantes e a prevalência de HG, com variação entre 0% a 73%. Entre os anticonvulsivantes utilizados, a fenitoína apresentou a maior incidência de HG, variando entre 15,61% e 73% em pacientes. Conclusão: Na análise dos resultados obtidos na literatura, é possível notar que a grande maioria dos estudos apresentou incidência de HG associada ao uso de anticonvulsivantes. No entanto, estudos adicionais são necessários para compreender o mecanismo de ação do anticonvulsivante para a indução da HG, bem como as formas de prevenção, dado que a HG é um efeito colateral significativo (AU)


Asunto(s)
Humanos , Fenobarbital , Fenitoína , Primidona , Carbamazepina , Prevalencia , Ácido Valproico , Etosuximida , Hiperplasia Gingival , Anticonvulsivantes
12.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-33370971

RESUMEN

A 12-year-old patient of thalassaemia major developed autoimmune cytopaenia after undergoing haematopoietic stem cell transplantation. She was started on cyclosporine (CsA) in view of poor response to steroids. She developed CsA toxicity manifesting as gum hyperplasia with multiple episodes of gum bleed. During endotracheal intubation for an elective splenectomy, she developed significant bleeding from gums requiring massive transfusion. Postoperatively the gum bleed persisted even after embolisation of facial artery and multiple transfusions. The catastrophic sequelae include transfusion-related lung injury, acute circulatory failure with subsequent cardiac arrest and death. Gum hyperplasia is a commonly reported toxic effect of CsA. Lethal presentations of this toxicity with such severity are limited in the medical literature. Evaluation of the patient's medical and laboratory records, along with a review of literature, was very helpful in understanding more about the toxicity of CsA.


Asunto(s)
Ciclosporina/efectos adversos , Hemorragia Gingival/diagnóstico , Hiperplasia Gingival/inducido químicamente , Paro Cardíaco/etiología , Inmunosupresores/efectos adversos , Lesión Pulmonar Aguda Postransfusional/etiología , Transfusión Sanguínea , Niño , Resultado Fatal , Femenino , Hemorragia Gingival/etiología , Hemorragia Gingival/terapia , Hiperplasia Gingival/complicaciones , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , Intubación Intratraqueal/efectos adversos , Pancitopenia/tratamiento farmacológico , Pancitopenia/inmunología , Índice de Severidad de la Enfermedad , Choque , Talasemia/terapia
13.
Rev. ADM ; 77(6): 316-320, nov.-dic. 2020. ilus, tab
Artículo en Español | LILACS | ID: biblio-1151346

RESUMEN

Se entiende por agrandamiento gingival el incremento en masa y volumen del tejido gingival. Se considera una condición benigna de la cavidad oral, por lo general de manejo rutinario, que logra regularse con medidas simples de control del biofilm microbiano. El agrandamiento gingival puede ser producido por diversas condiciones clínicas, hereditarias, deficiente higiene oral o fármacos. La epilepsia afecta a 1% de la población mundial y requiere el uso de fármacos antiepilépticos o anticonvulsivantes para lograr su control, dentro de éstos la fenitoína actúa como un bloqueador selectivo de los canales de sodio sensibles al voltaje y constituye uno de los fármacos más empleados por su capacidad en el control de crisis focales y generalizadas. La fenitoína se ha relacionado con los agrandamientos gingivales como uno de sus efectos adversos, los cuales se incluyen dentro de las enfermedades por fármaco inducidas en la cavidad oral. El objetivo de este artículo es brindar la información necesaria sobre el manejo correcto de pacientes con agrandamiento gingival producido por fenitoínas y a la vez poder conocer las consecuencias de estos fármacos en la cavidad oral (AU)


Gingival enlargement means the increase in mass and volumen of the gingival tissue. It is considered a benign condition of the oral cavity, usually of routine management, wich can be regulated with simple measures of biofilm control. The gingival enlargement can be produced by diverse clinical conditions, hereditary deficient oral higiene or drugs. Epilepsy affects 1% of the world population and requires the use of antiepileptic or anticonvulsant drugs to achieve its control, within these phenytoin acts as selective blocker or voltage ­ sensitive sodium channels and is one of the most used grugs for its ability to control focal and generalized crises. Phenytoin has been linked to gingival enlargement as one of its adverse effects which is included within the drug diseases induced in the oral cavity. The objective of this article is to provide the necessary information on the correct managment of patients with gingival enlargemen produced by phenytoins and at the same time to know the consequences of these drugs in the oral cavity (AU)


Asunto(s)
Humanos , Femenino , Adulto , Fenitoína/efectos adversos , Sobrecrecimiento Gingival/inducido químicamente , Hiperplasia Gingival/inducido químicamente , Facultades de Odontología , Electrocirugia/métodos , Hiperplasia Gingival/cirugía , Gingivectomía/métodos , Membranas Artificiales , México , Antibacterianos/uso terapéutico
14.
J Vet Dent ; 37(3): 141-148, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33241762

RESUMEN

Development of gingival enlargement and periodontitis is described in a young dwarf mongoose. Repeated treatments resulted in gingival resection and histologic evaluation however gingival enlargement was ultimately responsive to extraction of associated teeth. In cases such as these, surgical extraction of teeth associated with severe recurrent gingival enlargement should be considered to avoid the stress and risk of repeated immobilizations.


Asunto(s)
Hiperplasia Gingival , Herpestidae , Periodontitis , Animales , Hiperplasia Gingival/veterinaria , Gingivectomía/veterinaria , Periodontitis/veterinaria
15.
Artículo en Inglés | MEDLINE | ID: mdl-33171749

RESUMEN

INTRODUCTION: The administration of several classes of drugs can lead to the onset of gingival overgrowth: anticonvulsants, immunosuppressants, and calcium channel blockers. Among the anticonvulsants, the main drug associated with gingival overgrowth is diphenylhydantoin. MATERIALS AND METHODS: In this study, we compared the effects of diphenylhydantoin and gabapentin on 57 genes belonging to the "Extracellular Matrix and Adhesion Molecule" pathway, present in human fibroblasts of healthy volunteers. RESULTS: Both molecules induce the same gene expression profile in fibroblasts as well as a significant upregulation of genes involved in extracellular matrix deposition like COL4A1, ITGA7, and LAMB3. The two treatments also induced a significant downregulation of genes involved in the expression of extracellular matrix metalloproteases like MMP11, MMP15, MMP16, MMP24, and transmembrane receptor ITGB4. CONCLUSIONS: Data recorded in our study confirmed the hypothesis of a direct action of these drugs at the periodontium level, inducing an increase in matrix production, a reduction in its degradation, and consequently resulting in gingival hyperplasia.


Asunto(s)
Anticonvulsivantes/efectos adversos , Fibroblastos/efectos de los fármacos , Gabapentina/efectos adversos , Encía/efectos de los fármacos , Hiperplasia Gingival/inducido químicamente , Sobrecrecimiento Gingival/inducido químicamente , Fenitoína/efectos adversos , Anciano , Niño , Femenino , Fibroblastos/metabolismo , Expresión Génica/efectos de los fármacos , Encía/metabolismo , Encía/patología , Sobrecrecimiento Gingival/metabolismo , Voluntarios Sanos , Humanos , Masculino , Proyectos Piloto , Regulación hacia Arriba/efectos de los fármacos , Adulto Joven
16.
Oral Health Prev Dent ; 18(1): 929-943, 2020 10 27.
Artículo en Inglés | MEDLINE | ID: mdl-33215484

RESUMEN

PURPOSE: To present an update the orofacial manifestations of granulomatosis with polyangiitis (GPA) and present a clinical case with the initial signs in the oral cavity. MATERIALS AND METHODS: A bibliographic search was performed on Pubmed with the keywords 'Wegener's granulomatosis', 'etiology', 'oral manifestations', 'oral cavity', 'gingiva'. The inclusion criteria were papers published in English in the last 10 years that made reference to clinical cases with in which the oral cavity was affected. The quality of the results was assessed with 'The 2013 Care Checklist'. RESULTS: Nineteen clinical cases were analysed. The average quality was 7.68/13 (range 5-10/13). 73.7% of patients were women, the most frequent area for the lesions was the gingiva and the most prevalent lesion was gingival hyperplasia. 68.4% of the patients had this lesion as a first sign, 21.1% as a progression and 10.5% as a recurrence. 68.4% of the lesions resolved once medical treatment was established. CONCLUSION: GPA is a multisystem disorder associated with considerable morbidity and mortality if not treated. Early diagnosis improves the prognosis. The first manifestation of the disease can be seen in the oral cavity. It is important that dentists recognise the oral manifestation in order to improve the prognosis. Key words: granulomatosis, polyangiiitis, Wegener's granulomatosis.


Asunto(s)
Hiperplasia Gingival , Granulomatosis con Poliangitis , Femenino , Encía , Granulomatosis con Poliangitis/diagnóstico , Granulomatosis con Poliangitis/tratamiento farmacológico , Humanos , Pronóstico
17.
Oral Health Prev Dent ; 18(1): 953-958, 2020 10 27.
Artículo en Inglés | MEDLINE | ID: mdl-33215486

RESUMEN

BACKGROUND: Juvenile spongiotic gingival hyperplasia (JSGH) is a benign proliferation of non-keratinised stratified squamous epithelium with evident spongiosis, exocytosis leukocytes and dilated vessels with varying numbers of inflammatory cells. Although uncertain, it has been suggested that the epithelial proliferation is probably related to trauma and local irritants. It emerges as a painless erythematous patch or papule with an irregular surface. CASE REPORTS: We present a series of eight cases and a literature review of the clinical presentation and treatment approaches for JSGH. This series includes four females and four males with a mean age of 11.6 years, all complaining of injury to the gums. All lesions were painless and not bleeding. One patient associated the lesion with the onset of trauma and another with a previous history of an eruption cyst. Periapical radiographs of the adjacent area did not show any alteration of bone or teeth. Based on these findings, the diagnostic hypotheses were a non-neoplastic proliferative process or a factitious injury. Incisional biopsy was performed and histopathologic diagnosis was conclusive for JSGH. Surgical excision was conducted in three cases, and the other five cases were supported by clinical observation and plaque control in order to prevent gingival recession defects. After a follow-up period of 11 months (mean), no recurrence was observed for surgically treated cases and mild improvement was achieved with periodontal treatment. CONCLUSION: This case series illustrates the importance of diagnosis and follow-up of patients with JSGH. A conservative approach consisting of basic periodontal support instead of surgical excision may be indicated because of the risk of aesthetic defects at the involved areas.


Asunto(s)
Placa Dental , Hiperplasia Gingival , Recesión Gingival , Adolescente , Niño , Femenino , Hiperplasia Gingival/cirugía , Humanos , Masculino
18.
BMJ Case Rep ; 13(7)2020 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-32675130

RESUMEN

An 18-year-old woman presented with enlarged gingivae of 1-year duration with no history of drug consumption or systemic conditions that might explain the enlargement. Biopsy revealed hyperplastic gingival epithelium and a plasma cell-rich inflammatory infiltrate in the subepithelial connective tissue with the presence of scattered multinucleated giant cells. Immunostaining revealed the plasma cells to be positive for IgG4. Serum IgG4 levels were elevated at 3.6 g/L (reference range: 0.049-1.985). These findings led towards the diagnosis of an IgG4-related disease (RD). Other granulomatous conditions were also ruled out via series of investigations. The enlarged tissue was surgically excised. No corticosteroids were administered owing to the localised nature of the manifestations. After 3 months, the gingival size remained unchanged. This case has been reported with a relatively shorter follow-up period because of the rarity of the presentation. IgG4-RD should be considered while diagnosing a patient with gingival enlargement.


Asunto(s)
Encía , Hiperplasia Gingival , Enfermedad Relacionada con Inmunoglobulina G4 , Adolescente , Femenino , Encía/patología , Encía/cirugía , Hiperplasia Gingival/diagnóstico , Hiperplasia Gingival/etiología , Hiperplasia Gingival/patología , Hiperplasia Gingival/cirugía , Humanos , Enfermedad Relacionada con Inmunoglobulina G4/complicaciones , Enfermedad Relacionada con Inmunoglobulina G4/diagnóstico
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