جستجوی مقالات مرتبط با کلیدواژه
gingival overgrowth
در نشریات گروه پزشکی-
Background
Gingival enlargement (GE) is a common clinical observation among orthodontic patients, yet its underlying causes remain unclear. This study aims to investigate the potential involvement of salivary matrix metalloproteinase (MMP)‑2 and MMP‑9 activity in orthodontic‑induced GE.
Materials and MethodsIn this case–control study, we enrolled 50 subjects, including 25 individuals with GE and 25 without. The participants, aged 10–35 years, were in the 4th or 5th month of their orthodontic treatment. Comprehensive clinical assessments, encompassing plaque index, gingival index, and GE score were performed, and saliva samples were subjected to gelatin zymography to assess enzyme activity. Statistical analysis, including the Chi‑square test for age distribution, independent samples t‑test for age comparison between study groups, Mann–Whitney U test for MMP activity comparison, and Wilcoxon signed–rank test for comparison of data from the 4th to 5th months of treatment,was performed using SPSS version 23.0,with a significance level set at 0.05.
ResultsMMP‑2 activity was undetectable in the zymograms. In the 4th month of treatment, MMP‑9 activity was more prominent in the case group, though this disparity did not reach statistical significance in the 5th month. Furthermore, MMP‑9 activity did not exhibit a correlation with the GE score.
ConclusionThe activity of MMP‑9 in the saliva of orthodontic patients with GE increases during the 4th month of treatment, but no correlation exists with the degree of GE.
Keywords: Fixed Orthodontic Appliances, Gingival Overgrowth, Matrix Metalloproteinase‑2, Matrix Metalloproteinase‑9 -
The aim of the present report was to discuss a unique case of gingival plasma cell granuloma (PCG) in a hypertensive patient on Amlodipine therapy. Also, we attempt to emphasize the importance of considering primary and advance investigations before making a definite diagnosis. PCG is an extremely rare, reactive, non-neoplastic lesion characterized by the predominance of polyclonal plasma cells. Drug-induced gingival overgrowth is a known side effect of Amlodipine. A hypertensive 60-year-old female patient reported with a chief complaint of swollen gums and discomfort in the upper front teeth region. A provisional diagnosis of Amlodipine-induced gingival overgrowth, combined gingival overgrowth, and fibroma was suggested. Surprisingly, histopathology revealed it to be a plasma cell lesion which was confirmed by advanced investigations, thereby establishing a confirmatory diagnosis of PCG.Keywords: Amlodipine, Diagnosis, Gingival Overgrowth, Plasma Cells, Plasma Cell Granuloma
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Journal of Dentistry, Shiraz University of Medical Sciences, Volume:19 Issue: 3, Sep 2018, PP 248 -252The pursuit of esthetic excellence has become a major goal in the dental treatment and orthodontic treatment. The beauty of the smile is not only constituted by the shape, position, and size of the teeth, but also based on the characteristics of the gingival tissue and conformation of the lips, which should be as harmonious as teeth. Gummy smile is one of the complaints of the patients, since such a situation can influence self-esteem and social relationships. The development of new more conservative techniques may provide a better therapeutic option than surgical procedures, such as the application of botulinum toxin, in the treatment of gummy smile. The purpose of this article is to present the case of a patient who presented dentogingival discrepancy and gummy smile, treated by resective gingival surgery and by application of botulinum toxin, optimizing smile harmony, and achieving improved self-esteem and quality of life. The application of botulinum toxin is an alternative less invasive, faster, safer, and more effective. Moreover, it produces harmonics and pleasing results when applied in target muscles, respecting the appropriate dose and type of smile. Therefore, the technique is a useful adjunct in the esthetic improvement of the smile and provides better results when combined with resective gingival surgery.Keywords: Gingival overgrowth, Botulinum toxins type A, Gummy smile, Gingivectomy, Dental esthetics
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BackgroundTo evaluate the effect of Cyclosporin A (CsA) and angiotensin II (Ang II) on cytosolic calcium levels in cultured human gingival fibroblasts (HGFs).Materials And MethodsHealthy gingival samples from six volunteers were obtained, and primary HGFs were cultured. Cell viability and proliferation assay were performed to identify the ideal concentrations of CsA and Ang II. Cytosolic calcium levels in cultured gingival fibroblasts treated with CsA and Ang II were studied using colorimetric assay, confocal and fluorescence imaging. Statistical analyses were done using SPSS software and GraphPad Prism.ResultsHigher levels of cytosolic levels were evident in cells treated with CsA and Ang II when compared to control group and was statistically significant (PConclusionThus calcium being a key player in major cellular functions, plays a major role in the pathogenesis of drug‑induced gingival overgrowth.Keywords: Angiotensin II, calcium, Cyclosporin A, gingival overgrowth
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Background And AimSquamous cell carcinoma (SCC) is usually considered a disease of older people. Recently, there is a change in the occurrence of such lesions in young patients and lacking the established risk factors.CASE REPORT: A 21-year-old male reported with an innocuous gingival growth over lower incisors since a month. Within 15 days he noticed another gingival growth in same region lingually. The growths were mildly tender with no suppuration. The associated teeth were non-mobile and vital. The radiographic findings were insignificant. An excisional biopsy was performed under local anesthesia. The stained H and E section showed a hyper-parakeratinized stratified squamous surface epithelium with underlying connective tissue with collagen fibers, fibroblasts, blood vessels and areas of dense chronic inflammatory cell infiltrate. Epithelium exhibited features of dysplasia. There was a breach in the continuity of the basement membrane and the malignant epithelial cells were seen invading the connective tissue in form of thin cord.ConclusionThe histopathological study confirmed the diagnosis of well differentiated SCC. Oral SCC is not a disease of the elderly anymore. We also reviewed the literature of SCC in young patients. Thus biopsy is mandatory for any non-resolving gingival growth.Keywords: Gingival Overgrowth, Interdental Papilla, Squamous Cell Carcinoma, Gingival Neoplasm, Mandible
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Cyclosporine is a selective immunosuppressant that has a variety of applications in medical practice.Like phenytoin and the calcium channel blockers, the drug is associated with gingival overgrowth. This review considers the pharmacokinetics, pharmacodynamics, and unwanted effects of cyclosporine, in particular the action of the drug on the gingival tissues. In addition, elucidates the current concepts in mechanisms of cyclosporine-induced gingival overgrowth. Clinical and cell culture studies suggest that the mechanism of gingival overgrowth is a result of the interaction between the drug and its metabolites with susceptible gingival fibroblasts. Plaque-induced gingival inflammation appears to enhance this interaction. However, understanding of the pathogenesis of gingival overgrowth is incomplete at best. Hence, it would be pertinent to identify and explore possible risk factors relating to both prevalence and severity of drug-induced gingival overgrowth. Newer molecular approaches are needed to clearly establish the pathogenesis of gingival overgrowth and to provide novel information for the design of future preventive and therapeutic modalities.Keywords: Cyclosporine, fibroblast, gingival overgrowth, periodontitis, phenytoin, Renin, Angiotensin system
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Pregnancy tumor is a benign, hyperplastic lesion of the gingiva, considered to be reactive or traumatic rather than neoplastic in nature. The term pyogenic granuloma is a misnomer as it is not filled with pus or granulomatous tissue histologically. It is multi factorial in nature, which shows an exaggerated response to stimuli such as low grade or chronic irritation, trauma or hormonal variations. Higher levels of sex hormones during pregnancy produce effects on sub gingival microflora, the immune system, the vasculature and specific cells of periodontium which in turn in the presence of local irritants exaggerate the lesion. Since the lesion is clinically indistinguishable from other type of hyperplastic conditions, histological findings are required for proper diagnosis. We present a case report of recurrent pyogenic tumor which showed the evidence of pre‑existing localized periodontitis with extensive horizontal bone destruction. The lesion was excised by electrocautery combined with conventional flap procedure after parturition period. During 3 and 6 months follow‑up period post‑operative healing showed satisfactory results without recurrence.Keywords: Gingival overgrowth, pregnancy tumor, pyogenic granuloma
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BackgroundCyclosporin A (CsA) is a known immunosuppressive agent and can be considered as a lifesaving drug in the organ transplantation cases. However, it is associated with many side-effects on different tissues and body organs including the periodontal tissues. The present animal study was undertaken to evaluate the effects of CsA targeting the tissue triad of periodontal tissues, i.e., gingiva, alveolar bone and cementum in rats.Materials And MethodsTwelve 6-week-old male Wistar rats weighing 150-200 g were considered for the case-control study in rats. The rats were divided into 2 groups: (1) CsA (test) group (2) Saline (control) group and were administered the same subcutaneously daily once for 45 days. Impressions were taken and study casts were prepared on weekly basis for the morphometric analysis. At the end of 45 days, rats were sacrificed and specimens were analyzed for histomorphometric analysis. CsA and saline groups were analyzed to test of association using the Student t test at99% confidence interval.ResultsThe morphometric examination showed significant gingival overgrowth in the CsA group, whereas no such growth in the saline group. Similarly, on histomorphometric analysis, there was a significant loss of alveolar bone in CsA group as compared with control. Furthermore, there was large amount of cementum formation accompanied by insertion of new connective tissue fibers especially in the cervical region of the tooth in CsA group rats.ConclusionCsA targets the periodontal tissues (gingiva, alveolar bone and cementum) in different pattern. Its role in cementogenesis can be utilized for periodontal regeneration, if its local application is testified and verified in the future animal studies.Keywords: Alveolar bone loss, cyclosporin A, gingival overgrowth, new cementum formation
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BackgroundAlthough cyclosporine (CsA) and calcium channel blockers (CCBs) parallel to each other may provoke gingival enlargement (GE), there are few considerations about combined effects of CsA and CCBs on gingival tissues.ObjectivesThis study aimed to determine prevalence of GE among renal transplant recipients and to compare its occurrence in patients who received only CsA and those who were on CsA and amlodipine.Patients andMethodsWe conducted a prospective randomized case-control trial including 213 renal transplant recipients between February 2010 and August 2010. They were randomly divided into two groups including control group (on continuous treatment with CsA alone; n = 112) and trial group (treated with combined CsA and amlodipine; n = 101). Buccal, lingual, and inter-proximal membranes at last 12 anterior teeth were assessed for GE and packet depth (PD) using Gingival Index of McGaw and others, and Packet Index of Turesky–Gilmore–Glickman, respectively.ResultsMarked GE was observed in 26 patients (25.7%) in trial group and only in 4 individuals (3.6%) in control group (P = 0.000). In logistic regression analysis, obese (OR = 3, P = 0.04), older (OR = 2.8, P = 0.03), and female (OR = 1.3, P = 0.03) recipients as well as who received high dose amlodipine (OR = 4.4, P = 0.000) were at risk for marked GE.ConclusionsThere is a strong correlation between GE, in particular marked GE, and combination therapy with CsA and amlodipine in transplant patients compared to those treated by CsA alone. We suggest CsA dose reduction may restrain this adverse effect.Keywords: Amlodipine, Gingival overgrowth, kidney Transplantation
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هدفنیفیدیپین یک داروی کلسیم کانال بلوکر از گروه هیدروپیریدین است که بطور وسیع بعنوان وازودیلاتور در درمان هیپرتانسیون و بیماری ایسکمیک قلبی استفاده می شود. افزایش حجم لثه یکی از عوارض جانبی مصرف دارو می باشد. در این تحقیق، شیوع بیماری های لثه و افزایش حجم لثه را در بیماران قلبی تحت درمان با نیفیدیپین مورد بررسی قرار داده ایم.مواد و روش هادر این مطالعه مقطعی، 16 بیمار قلبی مصرف کننده نیفیدیپین 20 بیمار دارای اختلالات قلبی که نیفیدیپین مصرف نمی کردند، مقایسه گردید. تمام بیماران از نظر بیماری های پریودنتال و افزایش حجم لثه با اندکس های پریودنتال اندکس راسل؛ پلاک اندکس سیلنس و لو (PI) و اندکس افزایش حجم لثه میلر و دم یا GO مورد ارزیابی قرار گرفتند.نتایجبین دو گروه نیفیدیپین و شاهد از لحاظ سن، جنس، اندکس راسل و اندکس PI هیچ تفاوت معنی داری وجود نداشت، اما درصد شیوع هیپرپلازی در گروه نیفیدیپین در ناحیه دندان های قدامی فک پایین شدیدتر بود که از نظر آماری معنی دار نبود (P=0.05). شیوع افزایش حجم کلینیکی لثه مرتبط با دارو درمانی مزمن با نیفیدیپین پایین است.نتیجه گیریهیپرپلازی ناشی از نیفیدیپین بطور مستقیم با سطح تحصیلات و بهداشت دهان در ارتباط است.
کلید واژگان: نیفیدیپین، اندکس، پلاک، افزایش حجم لثه، بیماری پریودنتال (پریودنتایتیس)PurposeNifedipine is a calcium blocking agent of the dihydropyridine group widely used as a vasodilating agent for the treatment of hypertension and ischemic heart disease. Gingival enlargement is a known side effect of nifedipine use. This study was conducted to determine the prevalence of periodontal disease and gingival enlargement in nifedipine treatment patients. Methods and Material: In a cross sectional study data from 16 patients taking nifedipine were compared with those of 20 patients with cardiac disorder who had not been treated with nifedipine. All patients were examined for the presence of periodontal disease and gingival enlargement using 3 different indices: Periodontal index (Russel), Plaque index (Silness and Loe) and gingival overgrowth index (GO) (Miller and Damm).ResultsBetween the nifedipine and control groups, there was no significant difference for age, sex, PI (Russel), and PI (Silness & Loe). But prevalence of gingival overgrowth and its severity were greater in the anterior and inferior teeth in the nifedipine group (P=0.05). Prevalence of clinically significant overgrowth related to chronic medication with nifedipine is low.ConclusionSeverity of hyperplasia induced by nifedipine directly depended on the level of education and oral hygiene.Keywords: NIFEDIPINE, INDICES, PLAQUE, GINGIVAL OVERGROWTH, PERIODONTAL DISEASE (PERIODONTITIS) -
بیان مساله: افزایش حجم لثه (GOI) یکی از عوارض جانبی و شایع درمان دارویی سیکلوسپورین می باشد. آزیترومایسین آنتی بیوتیک ماکرولیدی است که تاثیر آن در کاهش افزایش حجم لثه ناشی از مصرف سیکلوسپورین در مقالات متعدد مورد بحث قرار گرفته است.هدفمطالعه حاضر با هدف بررسی تاثیر آزیترومایسین سیستمیک بر روی افزایش حجم لثه ناشی از مصرف سیکلوسپورین در بیماران دریافت کننده کلیه پیوندی انجام شد.روش بررسیدر این مطالعه مورد- شاهدی و کارآزمایی بالینی 18 بیمار (6 زن و 12 مرد) پیوند کلیه که افزایش حجم لثه در آنها مشاهده شد، مورد مطالعه قرار گرفتند. بیماران به طور تصادفی در دو گروه درمانی قرار گرفتند: گروه مورد با مصرف آزیترومایسین سیستمیک و گروه شاهد با مصرف پلاسبوی سیستمیک. شاخصهای خونریزی در حین پروب کردن (BOP)، طول تاج کلینیکی (CL)، عمق پاکت (PPD)، شاخص افزایش حجم لثه (GOI) و Stent-IDP (فاصله عمودی یک Stent یا Plate در تماس با سطح اکلوزال دندانها در حداقل سه نقطه از قدامی ترین نقاط تماس تا نوک پاپی مزیال) قبل از درمان و دو و شش هفته پس از درمان اندازه گیری شدند. به منظور تحلیل داده های به دست آمده، از آزمونهای Wilcoxon و Mann-Whitney استفاده شد.یافته هابیشتر شاخصهای اندازه گیری شده در دو گروه مورد و شاهد پس از دو هفته به میزان معنی داری بهبود یافتند (05/0 P<). تفاوت میان دو گروه از نظر تغییر در متغیرهای مورد بررسی در زمانهای مختلف معنی دار نبود و بین دو گروه تنها از نظر شاخص BOP تفاوت معنی داری وجود داشت (05/0 P<)؛ به عبارت دیگر این شاخص پس از شش هفته در گروه مورد بهبود بیشتری را نسبت به گروه شاهد نشان داد.نتیجه گیریدر مجموع از یافته های این مطالعه، چنین استنباط می شود که تاثیر آزیترومایسین بر افزایش حجم لثه ناشی از مصرف سیکلوسپورین که در مطالعات قبلی گزارش شده تا حدودی اغراق آمیز است و احتمالا تاثیر این دارو فقط کاهش التهاب بوده است.
کلید واژگان: افزایش حجم لثه، سیکلوسپورین، آزیترومایسینStatement of Problem: Gingival overgrowth is a side effect commonly induced by Cyclosporin treatment. The effects of Azithromycin, a macrolidic antibiotic, has been focused on gingival enlargement treatment induced by cyclosporine in numerous articles.PurposeThe goal of the present study was to survey the effects of systemic Azithromycin in the treatment of gingival overgrowth induced by cyclosporine among renal transplant patients.Materials And MethodsIn this clinical trial study, 18 renal transplant patients (6 females and 12 males) with gingival overgrowth were studied. Samples were randomly divided into two groups: case group were treated by systemic Azithromycin and controls were treated by systemic placebo. Periodontal parameters including bleeding on probing (BOP), clinical crown length (CL), periodontal pocket depth (PPD), gingival overgrowth (GOI) and stent-IDP (vertical distant between a stent or plate with teeth occlusal planes at least from three of the most anterior contact points to mesial papillae) before treatment, two and six weeks after treatment were measured. To analyze the data, Wilcoxon and Mann-Whitney tests were used.ResultsMost of the measured indices, among case and control groups, were significantly improved, after two weeks (P<0.05). No statistically significant differences were found between two groups except for BOP index (P<0.05). In other words, more BOP improvement was observed in the case group after six weeks comparing to the control group.ConclusionConsidering the findings of this study, one can assume that the reported effects of Azithromycine on gingival overgrowth, induced by cyclosporine is somehow exaggerated and the effects attributed this medicine is probably inflammation reduction.Keywords: Gingival overgrowth, Cyclosporine, Azithromycine
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