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Results for “GINGIVAL HYPERPLASIA”

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PubMed1975

Parosteal osteogenic sarcoma of the mandible, Existence masked by diffuse periodontal inflammation.

A 38-year-old man was in a state of poor oral hygiene, with multiple broken carious teeth and diffuse inflammatory hyperplasia of the gingival tissues. A mandibular, alveolar soft tissue mass in the premolar-molar region was noted on the right side, in continuity with the gingival hyperplasia. Biopsy of the lesion ruled out a diagnosis of squamous cell carcinoma. The patient underwent extraction of his teeth, and all hyperplastic tissues including the tumefaction were excised. Five months later, the patient had a recurrent mass in the same location that was removed via hemimandibulectomy. The mass was diagnosed as a parosteal osteogenic sarcoma.

Adult↗
PubMed2001

[Dentistry and epilepsy].

Epileptic seizures are the third most common medical incident in dental surgeries. Dentists should ask patients about a history of epilepsy and should know how to manage an epileptic seizure. Falls caused by seizures increase the risk of dental injuries, and fixed dental replacements (e.g., tooth implants) are recommended to reduce the risk of aspiration. Phenytoin induces gingival hyperplasia in 50% to 60% of patients, treatment options include a switch to alternative anticonvulsant drugs and improved dental hygiene. In addition to conventional dental care, the use of electric toothbrushes and the application of chlorhexidine and regular professional dental cleaning may prevent the development of gingival hyperplasia. Local anaesthetic agents without added adrenalin should be chosen (e.g., Mepivacain and Articain). There are case reports of reflex epileptic seizures caused by (prolonged) brushing of teeth.

Anesthesia, Dental↗
PubMed1978

Specific 5 alpha-dihydrotestosterone receptors in human gingiva.

The cytoplasm of normal human male and female gingiva contains a receptor capable of specifically binding 5 alpha-dihydrotestosterone (DHT). This binding has a high affinity for DHT (Kd, approximately 2.2 x 10-9 M) and a low capacity (approximately 190 fmol/mg protein). The binding is extremely heat sensitive and exhibits a pattern of competition similar to that obtained with DHT receptors from other target tissues. The demonstration of a specific DHT receptor in human gingiva provides the first direct biochemical evidence that this tissue may function as a target organ for androgens. There was no correlation between the Kd in normal tissue and gingival hyperplasia or between the Kd or number of binding sites and the age or sex of the patient. However, there sites and the age or sex of the patient. However, there was a significant difference (P less than 0.0005) between the amount of DHT-binding sites per mg protein in normal tissue as compared to gingival hyperplasia (drugs or pregnancy).

Adolescent↗
PubMed1995

Zimmermann-Laband syndrome in a patient with severe mental retardation.

Zimmermann-Laband syndrome in a patient with severe mental retardation: The Zimmermann-Laband syndrome (ZLS) is a rare autosomal dominant disorder characterized by gingival hyperplasia or fibromatosis, various skeletal anomalies including dysplasia of the distal phalanges of thumbs and halluces, vertebral defects, and hepatosplenomegaly. Thus far, 23 cases, including 11 patients from 2 families, have been reported. Most cases of ZLS have a normal intelligence although some cases are mildly retarded. Differential diagnosis includes other causes of gingival hyperplasia. We report on a patient with ZLS and severe mental retardation and review the literature. We conclude that severe mental retardation is a feature of the syndrome.

Abnormalities, Multiple↗
PubMedDate not supplied

Clinical and microbiological analysis of periodontally diseased sites after renal transplant.

This study compared the clinical and microbiological status of periodontally diseased sites in 42 patients who had a renal transplant and were undergoing immunosuppressive therapy (21 taking azathioprin and corticosteroids [Az-C] and 21 taking cyclosporin-A [Cy-A] with those of 21 systemically healthy matched controls. Probing pocket depth (PPD), bleeding on probing (BOP) and gingival hyperplasia (GH) were measured at 339 sites. Subgingival plaque samples were analyzed for the presence of Porphyromonas gingivalis, Treponema denticola and/or Bacteroides forsythus using the BANA test. Our findings suggest that immunosuppressed patients showed significantly less inflammation and fewer putative anaerobic pathogens using the BANA test, and that patients undergoing therapy with cyclosporin-A have a higher frequency of sites with gingival hyperplasia when compared with patients medicated with azathioprin or corticosteroids.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Oral lesions in a group of kidney transplant patients.

AIM: To assess the prevalence of oral mucosa lesions (OL) in a group of kidney transplant (KT) patients, and analyze possible OL associations with one another and with drugs use and relevant clinical and laboratory variables. METHODOLOGY: Transversal study, in which consecutive KT patients from the nephrology outpatient service at a General Zonal Hospital were examined. The prevalence of several types of OL was assessed, and their possible statistical associations with one another and total leukocyte count, renal function, the simplified oral hygiene index (S-OHI), cyclosporin-A (CsA) dose and blood levels, and nifedipine use was analyzed. A logistic regression model was used to analyze the association between gingival hyperplasia (GH) and CsA dose and nifedipine use. RESULTS: Fifty (55.6%) men and forty (44.4%) women were studied. Sixty percent of the patients had at least one OL. Oral candidiasis (OC) was found in 18.7%; 13% had lesions clinically compatible with hairy leukoplakia (CHL). An association was found between OC and CHL (P<0.05). Saburral tongue (ST) was found in 22% of the patients and gingival hyperplasia (GH) in 49%, which was distributed as follows: Grade 1 in 11 (12.2%); Grade 2 in 26 (28.9%), and Grade 3 in 7 (7.8%). Logistic regression results showed an association between GH and poor oral hygiene (P< 0.001), but not to either CsA dose or blood levels, or nifedipine use (P=0.075). CONCLUSION: Sixty percent of the KT patients had at least one OL. The association between GH and poor oral hygiene corroborate the need for oral hygiene practices supervision in the transplant patient.

Adolescent↗
PubMed1986

Gingival enlargement. A comparison between cyclosporine and azathioprine treated renal allograft recipients.

The immunosuppressive drug cyclosporine (CsA) which is used to facilitate renal transplantations, has shown several side effects. Gingival hyperplasia has been demonstrated in animal experiments and also during treatment of humans. In the present study the prevalence of gingival enlargement was investigated in a group of patients treated with CsA. The results were compared with those obtained from a time matched control group of patients treated with azathioprine. The CsA treated patients showed a high prevalence of gingival enlargement, while the azathioprine treated patients showed none. Edentulous patients showed no gingival enlargement. The gingival enlargement was confined to the free gingiva and the interdental papilla, and had a rough surface, with small fissures. It was extremely fragile and bled on probing. Oral hygiene measures showed a slight reduction of the size of the gingival enlargement.

Adult↗
PubMed1989

[Osseointegrated implants in clinical dentistry. Follow up maintenance phase].

The aim of this study is to determine the method of maintenance care for support the functional condition during long period. The present paper reports on the result of osseointegrated titanium fixture in four complete denture patients. The marginal soft tissue reactions were investigated at the 1st, 3rd, 6th, 12th and 18th month after prothetic restrations by clinical examination and microbiological observations. All abutments were surrounded by clinically in healthy gingiva, however most individuals with the implant fixture had used as a complete denture for many years, without oral hygiene. For a favorable prognosis of the implant-recipients, self plaque control should be acquired for the patients shortly after prothetic restration. Before the healing phase, it is necessary to recall frequently for maintenance marginal soft tissue and prothetic restoration. After healing and remodeling phase, the interval of maintenance care was decided on each 3rd months. The interval seemed practically reasonable because the 18th month later the prognosis was satisfactory. This report presents two cases of complications during the maintenance phase of osseointegrated implants. Case I: A 72-year-old female patient presented gingival hyperplasia formation around the abutment after 19th months on abutment setting. We performed excision of the hyperplastic gingiva and apically positioned flap. Probing depth (PD) could not be determined because of gingival hyperplasia formation before operation, but there was marking reduction of probing depth after operation. The gingival bleeding index (GBI) was improved and the amount of gingival crevicular fluid (GCF) was reduced after operation. In pre-operative anaerobic culture, the proportions of Capnocytophaga species and Haemophilus actinomycetemcomitans were found. Post-operatively, Capnocytophaga sp. was not found, but H. actinomycetemcomitans was unchanged. Case II: A 47-year-old male patient presented gingivitis around the abutment after 13th months on abutment setting. We performed cleaning of the abutment surface with the flap procedure. Furthermore, a joint screw between the fixture and abutment was adapted due to loosening after operation, PD was unchanged, GBI was improved and GCF was slightly reduced. In pre-operative anaerobic culture, Bacteroides intermedius was rich. Post-operatively, B. intermedius was not found. In conclusion, we advocate that maintenance care of osseointegrated implants is the most important factor in the procedure.

Aged↗
PubMed1980

Immunoglobulins in periodontal tissues. III. Concentrations of immunoglobulins in dilantin-induced and idiopathic gingival hyperplastic tissues.

Immunoglobulin levels in both Dilantin-induced and idiopathic hyperplastic gingiva were determined and compared with the concentrations in normal gingival tissue. A statistically significant increase in IgG was found in Dilantin hyperplastic tissue, but no significant difference could be shown for idiopathic gingival hyperplasia. IgA levels did not differ significantly in the three types of tissue assayed. IgM was detected in 90% of the Dilantin hyperplastic gingival specimens assayed (mean GI = 1.2) and in 75% of the idiopathic hyperplastic tissue (mean GI = 0.7). This incidence of IgM detection was higher than that reported for normal and inflamed gingiva from periodontitis patients. The significance of these findings and possible correlation with the degree of tissue inflammation are discussed.

Adolescent↗
PubMedDate not supplied

Medication-induced gingival enlargement: a clinical review.

This review discusses the etiology and treatment of gingival hyperplasia. It cites evidence that medications such as phenytoin, an anticonvulsant; cyclosporine, an immunosuppressant; and numerous calcium channel blocking agents have been shown clinically and histologically to produce analogous gingival enlargements. A multiphasic approach to treating disfiguring gingival hyperplasia through mechanical and chemical plaque control, in conjunction with the surgical removal of the hyperplastic tissue, is discussed.

Anticonvulsants↗
PubMed1996

Oral presentation of posttransplantation lymphoproliferative disorders. An unusual manifestation.

Cyclosporine, an immunosuppressive agent widely used in organ transplantation, has several undesirable side effects, including gingival hyperplasia, which occurs in up to 70% of patients. Another complication associated with use of cyclosporine and other immunosuppressants is an increased incidence of malignancies. Long-term use of cyclosporine also is associated with a spectrum of hyperproliferative disorders ranging from reactive lymphoid hyperplasia to aggressive malignant lymphomas. While cyclosporine-related lymphoproliferative disorders have been widely reported, they have not been described in the oral cavity as the first manifestation of this disease. We report on two cardiac transplantation patients with a history of cyclosporine use who presented initially with oral symptoms of lymphoproliferative disorder. Both had erythematous to cyanotic and hyperplastic gingiva. On gingivectomy, the fixed tissue was soft, glistening, and tan colored, in contrast to the usual firm, white, cyclosporine-associated, benign gingival fibrous hyperplasia. Histologically, a dense, diffuse infiltrate of lymphoplasmacytoid cells with vesicular nuclei, prominent nucleoli, a moderate amount of cytoplasm, and high mitotic activity was observed. Immunocytochemical studies confirmed that the cells were monoclonal for lambda light chains in one patient and kappa light chains in the other. The cells from one patient were positive for CD45, while both patients were negative for CD20 and all nonhematopoietic antigens tested. Both tissues were strongly positive for Epstein-Barr virus. Morphology and immunocytochemistry findings are consistent with a posttransplant lymphoproliferative disorder. These are the first two reported cases of cyclosporine-associated posttransplant lymphoproliferative disorders presenting as gingival hyperplasia.

Adult↗
PubMed1999

Cyclosporin A regulates interleukin-1beta and interleukin-6 expression in gingiva: implications for gingival overgrowth.

BACKGROUND: Gingival overgrowth is a common side effect following the administration of cyclosporin A (CsA); however, the cellular mechanisms remain poorly understood. CsA's immunosuppressant properties involve the regulation of synthesis and cellular response to cytokines. A CsA-induced alteration in the cytokine profile within gingival tissue could provide a mechanism for gingival hyperplasia. The aim of this study was to investigate the effects of CsA on the production of 2 cytokines - interleukin-1beta (IL-1beta) and interleukin-6 (IL-6) - by both gingival fibroblasts and peripheral blood mononuclear cells (PBMC). METHODS: Cells were stimulated for 24 hours in the presence of CsA over a concentration range of 100 to 2,000 ng/ml and the resultant cytokine production determined by ELISA. In addition, levels of both cytokines within normal, inflamed, and overgrown gingival tissue were determined. RESULTS: CsA inhibited IL-6 production by gingival fibroblasts in a dose-dependent manner. In contrast, at a concentration of 2,000 ng/ml, CsA stimulated IL-6 production by PBMC (P <0.05). Fibroblasts derived from overgrown gingiva produced significantly higher levels of IL-6 than their normal counterparts (P <0.05). CsA inhibited IL-1beta production by PBMC over the whole concentration range (P <0.05). IL-1beta was not found in measurable quantities in any of the fibroblast cultures. Levels of IL-6 extracted from overgrown gingival tissue were significantly higher than in inflamed or normal tissue. In contrast IL-1beta levels in overgrown tissue were not statistically significantly greater than those in inflamed tissue. CONCLUSIONS: These results show that CsA does regulate cytokine expression in gingival tissue. This effect may play an important role in the pathogenesis of CsA-induced gingival overgrowth.

Adult↗
PubMed1978

Diphenylhydantoinate-induced hyperplasia of the masticatory mucosa in an edentulous epileptic patient.

Gingival hyperplasia caused by phenytoin sodium is rarely encountered in edentulous persons. A case of generalized palatal hyperplasia is reported in which retained roots and teeth were suspected of having perpetuated a preextraction lesion, whereas a subsequently placed complete denture initiated a midpalatal hyperplasia. The lesion remained in spite of nonuse of the denture for several years.

Adult↗
PubMed1978

Therapeutic leukopheresis of acute myelo-monocytic leukemia in pregnancy.

Cytopheresis techniques have proven useful in the provision of platelets and granulocytes for transfusion to the pancytopenic patient. Mechanical cell removal has been applied to the treatment of chronic myelocytic and lymphocytic leukemias and the Sezary syndrome. We have treated a 16-year-old pregnant acute myelomonocytic leukemia (AMML) patient for 12 weeks solely with the use of intensive leukopheresis utilizing batch processing centrifugation and packed red cell transfusions. The patient presented with a white blood cell count of 54,000/mm3 with 64% myelomonoblasts, a platelet count of 45,000/mm3, marked gingival hyperplasia, and splenomegaly. Patient had a normal spontaneous delivery of a 2.5-kg male infant without complications. At the time of delivery, 12 weeks later, the white blood count had fallen to 4,9000/mm3 with 8% blasts and the platelet count had risen to over 100,000/mm3. Gingival hyperplasia decreased and the patient felt well. We have treated an additional small group of patients with acute myelogenous leukemia (AML) with high white counts with short term intensive leukopheresis followed by chemotherapy with promising results.

Adolescent↗