Gingivitis hyperplastica

By Dr. Vishaal Bhat on Saturday, December 22, 2007 with 0 comments

a) Gingivitis hyperplastica pubertalis - iuvenilis

Etiology - unknown.

Clinical picture - frequently occurs at girls of pubertal age. Its appearance is favored by bad oral hygiene, orthodontic anomalies, or previous gingivitis. A small, not painful swelling of palatal papillae appears first, that becomes hypertrophied at later stages. After the end of puberty, this disease may either disappear or it is transformed into a chronic form at some subjects.

Therapy - is the same as in case of a chronic gingivitis. Sclerotization of interdental papillae by calcium is sometimes advisable. If a hyperplasia is so large that it causes obstruction during eating, it is possible to perform a gingivectomy.

b) Gingivitis hyperplastica gravidarum

Etiology - occurs at about 50% of pregnant women during the second or third month of pregnancy. After the end of lactation, the disease often disappears. Its appearance is supported by bad hygienic conditions or earlier gingivitis.

Clinical picture - various forms ranging from light hyperplasia of the pale gingiva to heavy edematous soaking and interdental papillae hyperplasia can be found. Papillae may even cover the teeth crowns, they loose its shape, the gums are livid, bleeding and contain granulous tissue. Hyperplasia may sometimes be restricted to a narrow section of dentition. This form is called a gestation tumor - epulis gravidarum.

Therapy - if hyperplasia obstructs during eating, a gingivectomy is indicated.

c) Gingivitis hyperplastica during the vitamin C deficiency

This disease, associated with malnutrition, occurs very rarely in this country. Its signs are hyperplasia and exulceration of gingiva with bleeding.

d) Gingivitis hyperplastica diphenylhydantoinica

Etiology - hyperplasia of the epithelium of a non-inflammatory origin, that is induced by a medication used by epileptics.

Clinical picture - the gingiva is smooth and pale, inflammatory changes may come at later stages. Young individuals are more prone to hyperplasia, this susceptibility decreases after 30 years of age. The disease occurs at 50% of epileptics, often preceded by a chronic gingivitis or bad oral hygiene.

Therapy - oral hygiene improvement, removal of irritating factors, dental massages. If a hyperplasia obstructs mastication (during frequent recurrences), gingivectomy is indicated. A neurologist has to be consulted for a possible change of a medication.

e) Gingivitis hyperplastica during leukemia

Etiology - occurs most often at acute forms of leukemia.

Pathologic anatomy - diffusive infiltration of connective tissues with white blood elements that are characteristic for a particular type of the disease.

Clinical picture - gingival hyperplasias appear at the oral side at first, more often at the frontal section. They are not painful, and inflammatory signs are missing. The surface of a gingiva may exulcerate and bleeding may occur. Gingival bleeding may take place even without the presence of ulcers. Other oral mucous membranes are notably pale.

Therapy - is completely in the hands of a hematologist. A dentist takes care of a patient’s oral hygiene and removal of local harmful effects.

Caveat! Any oral surgical interventions are contraindicated. Necessary extractions may be performed after consulting a hematologist only.

Category: Periodontics Notes



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