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Elio Reyes - One of the best experts on this subject based on the ideXlab platform.
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Severe Postpartum Gingival Enlargement
Journal of periodontology, 2009Co-Authors: Dwight E. Mcleod, Daniel C. Stoeckel, Juan Contreras, Elio ReyesAbstract:Background: Gingival Enlargement is a clinical condition that has been widely studied and is directly associated with specific local or systemic conditions. It is very rare that Gingival Enlargement presents without a clear underlying etiology.Methods: A 24-year-old African American female presented with Gingival Enlargement that manifested postpartum and was most likely related to changes in estrogen/progesterone. The Gingival Enlargement was treated with non-surgical and surgical periodontal therapies.Results: There was no evidence of recurrence of the Gingival Enlargement at 9 years post-treatment.Conclusions: The etiology in this case remains unclear and could not be strongly supported by any reports in the literature. Future studies on Gingival Enlargement may explain such an unusual clinical occurrence.
Farrukh Faraz - One of the best experts on this subject based on the ideXlab platform.
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Unusual case of postpartum Gingival Enlargement: diagnosis and management
International Journal of Medicine, 2016Co-Authors: Shipra Arora, Abdul Ahad, Shruti Tandon, Arundeep Kaur Lamba, Farrukh FarazAbstract:Gingival Enlargement is a clinical condition that has been widely studied. Usually, it is related to specific local or systemic factors. However, it is difficult sometimes to find out a definite etiology, and treatment has to be done according to presenting clinical features. This article presents an unusual case of Gingival Enlargement that occurred after pregnancy without any clear underlying etiology. A female aged 31 years reported with Gingival Enlargement and mobility of teeth during lactation period. Gingival Enlargement had started 2 months after child birth. All female sex hormones were found to be within normal limits. Karyotyping was also found to be normal, without any genetic alteration. Radiographic analysis revealed generalized severe crestal bone loss. After phase I periodontal therapy, Enlargement was managed surgically under local anaesthesia. On histological examination of excised specimen, tissue was found to be hyperplastic. Although a definite etiology could not be ascertained, the treatment was successful and there has been no recurrence after one year post-treatment interval.
Robert E. Cohen - One of the best experts on this subject based on the ideXlab platform.
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Non-drug induced Gingival Enlargement.
General dentistry, 2013Co-Authors: Michelle L Moffitt, Robert E. CohenAbstract:Gingival Enlargement refers to an increase in the size of the Gingival tissue. The etiology varies, and often is multifactorial; however, local and systemic conditions, disease, and idiopathic factors may contribute to Gingival Enlargement. Tissue consistency can vary from soft and spongy to dense, typically appearing darker in shade compared to the drug-induced Gingival Enlargement. Treatment modalities usually involve surgical removal of excess tissue, non-surgical debridement, use of chemotherapeutic agents, and/or elimination or mitigation of contributing factors and conditions.
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Drug-induced Gingival Enlargement: an overview.
Compendium of continuing education in dentistry (Jamesburg N.J. : 1995), 2013Co-Authors: Michelle L Moffitt, D. Bencivenni, Robert E. CohenAbstract:The first documented case of drug-induced Gingival Enlargement was reported in 1939. Since that time, specific medications have been associated with this condition. Although the biologic mechanisms responsible for drug-mediated Gingival Enlargement remain unclear, a multifactorial etiology is considered to be responsible, with contributing factors including age, genetic predisposition, and local conditions. While the role of plaque remains to be completely elucidated, there is abundant clinical evidence demonstrating at least partial resolution of drug-induced Gingival Enlargement following improved plaque control. Variations in drug kinetics, Gingival crevicular fluid concentrations, protein synthesis, and the presence of growth factors also might contribute to the mechanism of Gingival overgrowth.
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Treatment Modalities for Drug–Induced Gingival Enlargement
Journal of dental hygiene : JDH, 2012Co-Authors: Michelle L Moffitt, D. Bencivenni, Robert E. CohenAbstract:Purpose: This paper identifies 3 specific classifications of commonly prescribed medications that are known to cause Gingival Enlargement and describes surgical and non-surgical treatment therapies. Primary risks associated with druginduced Gingival Enlargement, including increased dental decay and periodontal disease are also discussed. The precise bacterial etiology in Gingival Enlargement remains unclear, although sufficient evidence exists to support the role of good oral hygiene in decreasing the incidence and severity of Gingival Enlargement and improving overall Gingival health. Etiology, treatment planning and coordination of care between physician, dentist or dental hygienist when indicated are important factors determining whether a surgical or non-surgical course of treatment should be considered. This study supports the NDHRA priority area, Health Promotion/Disease Prevention: Validate and test assessment instruments/strategies/mechanisms that increase health promotion and disease prevention among diverse populations.
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treatment modalities for drug induced Gingival Enlargement
American Dental Hygienists Association, 2012Co-Authors: Michelle L Moffitt, D. Bencivenni, Robert E. CohenAbstract:Purpose: This paper identifies 3 specific classifications of commonly prescribed medications that are known to cause Gingival Enlargement and describes surgical and non-surgical treatment therapies. Primary risks associated with druginduced Gingival Enlargement, including increased dental decay and periodontal disease are also discussed. The precise bacterial etiology in Gingival Enlargement remains unclear, although sufficient evidence exists to support the role of good oral hygiene in decreasing the incidence and severity of Gingival Enlargement and improving overall Gingival health. Etiology, treatment planning and coordination of care between physician, dentist or dental hygienist when indicated are important factors determining whether a surgical or non-surgical course of treatment should be considered. This study supports the NDHRA priority area, Health Promotion/Disease Prevention: Validate and test assessment instruments/strategies/mechanisms that increase health promotion and disease prevention among diverse populations.
Jaume Miranda - One of the best experts on this subject based on the ideXlab platform.
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Reliability of two measurement indices for Gingival Enlargement.
Journal of periodontal research, 2012Co-Authors: Jaume Miranda, Magí Farré, Ll. Brunet, Pere N. Roset, Carlos MendietaAbstract:Miranda J, Brunet Ll, Roset P, Farre M, Mendieta C. Reliability of two measurement indices for Gingival Enlargement. J Periodont Res 2012; 47: 776–782. © 2012 John Wiley & Sons A/S Background and Objective: The objective of this study was to analyze the concordance of the vertical Gingival overgrowth index (GOi) and the horizontal Miranda & Brunet index (MBi) and to compare their reliability and reproducibility for an early diagnosis of Gingival Enlargement. A wide range of methods has been employed to determine the severity of drug-induced Gingival Enlargement (DIGE) that has resulted in uncertainty with regard to the prevalence of this side effect. In recent studies, different indices have been used to grade DIGE. The large variability observed between studies and the differences between vertical and horizontal Gingival-Enlargement measurements could be the result of the use of nonreliable indices during the measurement process. Some indices involve invasive procedures that require many measurements, or even a data-processing system, while others are less convenient and technically expensive and complex. In previous studies we used two complementary indices – the vertical GOi and the horizontal MBi. The results of these studies found some differences between both indices, with the MBi rendering higher estimates of DIGE prevalence that was attributed to its greater sensitivity for the detection of minimal changes in Gingival thickness. To our knowledge, there are no studies comparing different measurement indices for Gingival Enlargement that are supported by statistical concordance analysis. Material and Methods: Twelve plaster casts from patients who had worn orthodontic brackets, and who had different degrees of chronic inflammatory Gingival Enlargement, were analyzed. Three previously trained examiners registered twice the degree of buccal overgrowth, using the GOi and MBi, in all cast models with a minimum interval of 7 d between the first and the second evaluation. In total, from each cast, measurements from 16 Gingival sites were taken using the GOi, and from nine Gingival units (mesial and distal sites measurements) using the MBi. Concordance analysis of the registered measurements (intra-examiner and among examiners) for each index and between indices was assessed using the nonweighted Kappa index with a confidence interval of 95%. Results: We obtained 648 values for the GOi and the MBi. The overall score 0 (indicating absence of Enlargement) was 32.7% and 19.8% for GOi and MBi, respectively, score 1 (light/moderate) was 39.7% and 48.1%, and score 2 (severe) was 27.6% and 32.1%. Concordance analysis for each index showed intra-examiner Kappa values of 0.820 for the GOi and 0.830 for the MBi. Interexaminer Kappa values were 0.720 for the GOi and 0.770 for the MBi. Concordance between indices showed Kappa values for the same examiner of 0.600, whereas concordance among different examiners was 0.550. Discrepancies between indices indicated a systematic skew, with 79–82.1% of discrepancy associated with a higher value for the MBi compared with the GOi. Conclusion: Both Gingival Enlargement indices analyzed are reliable, complementary and applicable for measuring Gingival overgrowth. However, the MBi shows, with fewer measurements, a greater sensitivity than the GOi for the detection of the early stages of Gingival Enlargement, being adequate for the screening of large populations at risk.
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Prevalence and risk of Gingival Enlargement in patients treated with anticonvulsant drugs.
European journal of clinical investigation, 2001Co-Authors: Lluís Brunet, Jaume Miranda, Magí Farré, Leonardo Berini, Pere N. Roset, Carlos MendietaAbstract:Background Predictors of Gingival Enlargement in patients treated with anti-epileptics have not been previously assessed. This study was conducted to determine, with the aid of two indices that score vertical and horizontal overgrowth, the prevalence and risk factors for Gingival Enlargement in patients treated with phenytoin and other anticonvulsant drugs. Materials and Methods A cross-sectional study was conducted and data from 59 patients taking antiepileptics were compared with 98 controls. Gingival Enlargement was evaluated with two indices to score vertical overgrowth [Gingival overgrowth index (GO] and horizontal overgrowth [Miranda-Brunet index (MB)] . Gingival index, plaque index, and probing depth were also evaluated. Results The prevalence of Gingival Enlargement was significantly higher (P
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prevalence and risk of Gingival Enlargement in patients treated with anticonvulsant drugs
European Journal of Clinical Investigation, 2001Co-Authors: Lluís Brunet, Jaume Miranda, Magí Farré, Leonardo Berini, Pere N. Roset, Carlos MendietaAbstract:Background Predictors of Gingival Enlargement in patients treated with anti-epileptics have not been previously assessed. This study was conducted to determine, with the aid of two indices that score vertical and horizontal overgrowth, the prevalence and risk factors for Gingival Enlargement in patients treated with phenytoin and other anticonvulsant drugs. Materials and Methods A cross-sectional study was conducted and data from 59 patients taking antiepileptics were compared with 98 controls. Gingival Enlargement was evaluated with two indices to score vertical overgrowth [Gingival overgrowth index (GO] and horizontal overgrowth [Miranda-Brunet index (MB)] . Gingival index, plaque index, and probing depth were also evaluated. Results The prevalence of Gingival Enlargement was significantly higher (P < 0·0001) for both indices in the anticonvulsants treated groups than in the control group. Gingival overgrowth was significantly higher for both indices in the phenytoin group than in the non phenytoin group. Among the possible risk factors, only the Gingival index showed a significant association with Gingival Enlargement. For the MB index the risk of Gingival Enlargement (odds ratio) associated to phenytoin therapy and other anticonvulsants therapy were 52·6 (13·5–205) and 6·6 (1·5–28·2). Gingival index-adjusted odds ratios for the same drugs were 5·7 (1·3–24·7) and 18·1 (2–158), respectively. The concordance between GO and MB indices in the control group and in the phenytoin-group and non phenytoin-group showed a Kappa value of 0·773 and 0·697, respectively. Conclusion This study reports significant differences in the prevalence and severity of Gingival overgrowth in two groups of patients, one treated with phenytoin, and another treated with other anticonvulsants. Gingival inflammation is a significant risk factor for Gingival Enlargement in these patients.
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Prevalence and risk of Gingival Enlargement in patients treated with nifedipine.
Journal of periodontology, 2001Co-Authors: Jaume Miranda, Lluís Brunet, Magí Farré, Leonardo Berini, Pere N. Roset, Carlos MendietaAbstract:Background: Gingival Enlargement is a known side effect of nifedipine use. This study was conducted to determine the prevalence and risk factors for Gingival Enlargement in nifedipinetreated patients. Methods: A cross-sectional study was conducted in a primary care center. Data from 65 patients taking nifedipine were compared with 147 controls who had never received the drug. All patients were examined for the presence of Gingival Enlargement using 2 different indices: vertical Gingival overgrowth index (GO) in 6 points around each tooth, and horizontal MB index in the interdental area. Gingival index, plaque index, and probing depth were also evaluated. Results: The prevalence of Gingival Enlargement was significantly higher in nifedipine-treated cases than in controls (GO index, 33.8% versus 4.1%; MB index, 50.8% versus 7.5%, respectively). Higher Gingival and plaque indices were observed in patients taking nifedipine. Among the possible risk factors, only the Gingival index showed a significant associa...
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Gingival Enlargement Induced by Drugs
Drug Safety, 1996Co-Authors: Lluís Brunet, Jaume Miranda, Magí Farré, Leonardo Berini, Carles MendietaAbstract:Gingival Enlargement, an abnormal growth of the periodontal tissue, is mainly associated with dental plaque-related inflammation and drug therapy. Its true incidence in the general population is unknown. Gingival Enlargement produces aesthetic changes, pain, Gingival bleeding and periodontal disorders. Although Gingival overgrowth has been traditionally recognised as an adverse effect of phenytoin therapy, it has recently been reported in association with the use of cyclosporin and calcium antagonists. These 3 classes of drugs produce important changes in fibroblast function, which induce an increase in the extracellular matrix of the Gingival connective tissue. In the majority of those patients for whom dosage reduction, or drug discontinuation or substitution is not possible, and for whom prophylactic measures have failed, surgical excision of Gingival tissue remains the only treatment of choice.
Carlos Mendieta - One of the best experts on this subject based on the ideXlab platform.
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Reliability of two measurement indices for Gingival Enlargement.
Journal of periodontal research, 2012Co-Authors: Jaume Miranda, Magí Farré, Ll. Brunet, Pere N. Roset, Carlos MendietaAbstract:Miranda J, Brunet Ll, Roset P, Farre M, Mendieta C. Reliability of two measurement indices for Gingival Enlargement. J Periodont Res 2012; 47: 776–782. © 2012 John Wiley & Sons A/S Background and Objective: The objective of this study was to analyze the concordance of the vertical Gingival overgrowth index (GOi) and the horizontal Miranda & Brunet index (MBi) and to compare their reliability and reproducibility for an early diagnosis of Gingival Enlargement. A wide range of methods has been employed to determine the severity of drug-induced Gingival Enlargement (DIGE) that has resulted in uncertainty with regard to the prevalence of this side effect. In recent studies, different indices have been used to grade DIGE. The large variability observed between studies and the differences between vertical and horizontal Gingival-Enlargement measurements could be the result of the use of nonreliable indices during the measurement process. Some indices involve invasive procedures that require many measurements, or even a data-processing system, while others are less convenient and technically expensive and complex. In previous studies we used two complementary indices – the vertical GOi and the horizontal MBi. The results of these studies found some differences between both indices, with the MBi rendering higher estimates of DIGE prevalence that was attributed to its greater sensitivity for the detection of minimal changes in Gingival thickness. To our knowledge, there are no studies comparing different measurement indices for Gingival Enlargement that are supported by statistical concordance analysis. Material and Methods: Twelve plaster casts from patients who had worn orthodontic brackets, and who had different degrees of chronic inflammatory Gingival Enlargement, were analyzed. Three previously trained examiners registered twice the degree of buccal overgrowth, using the GOi and MBi, in all cast models with a minimum interval of 7 d between the first and the second evaluation. In total, from each cast, measurements from 16 Gingival sites were taken using the GOi, and from nine Gingival units (mesial and distal sites measurements) using the MBi. Concordance analysis of the registered measurements (intra-examiner and among examiners) for each index and between indices was assessed using the nonweighted Kappa index with a confidence interval of 95%. Results: We obtained 648 values for the GOi and the MBi. The overall score 0 (indicating absence of Enlargement) was 32.7% and 19.8% for GOi and MBi, respectively, score 1 (light/moderate) was 39.7% and 48.1%, and score 2 (severe) was 27.6% and 32.1%. Concordance analysis for each index showed intra-examiner Kappa values of 0.820 for the GOi and 0.830 for the MBi. Interexaminer Kappa values were 0.720 for the GOi and 0.770 for the MBi. Concordance between indices showed Kappa values for the same examiner of 0.600, whereas concordance among different examiners was 0.550. Discrepancies between indices indicated a systematic skew, with 79–82.1% of discrepancy associated with a higher value for the MBi compared with the GOi. Conclusion: Both Gingival Enlargement indices analyzed are reliable, complementary and applicable for measuring Gingival overgrowth. However, the MBi shows, with fewer measurements, a greater sensitivity than the GOi for the detection of the early stages of Gingival Enlargement, being adequate for the screening of large populations at risk.
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Prevalence and risk of Gingival Enlargement in patients treated with anticonvulsant drugs.
European journal of clinical investigation, 2001Co-Authors: Lluís Brunet, Jaume Miranda, Magí Farré, Leonardo Berini, Pere N. Roset, Carlos MendietaAbstract:Background Predictors of Gingival Enlargement in patients treated with anti-epileptics have not been previously assessed. This study was conducted to determine, with the aid of two indices that score vertical and horizontal overgrowth, the prevalence and risk factors for Gingival Enlargement in patients treated with phenytoin and other anticonvulsant drugs. Materials and Methods A cross-sectional study was conducted and data from 59 patients taking antiepileptics were compared with 98 controls. Gingival Enlargement was evaluated with two indices to score vertical overgrowth [Gingival overgrowth index (GO] and horizontal overgrowth [Miranda-Brunet index (MB)] . Gingival index, plaque index, and probing depth were also evaluated. Results The prevalence of Gingival Enlargement was significantly higher (P
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prevalence and risk of Gingival Enlargement in patients treated with anticonvulsant drugs
European Journal of Clinical Investigation, 2001Co-Authors: Lluís Brunet, Jaume Miranda, Magí Farré, Leonardo Berini, Pere N. Roset, Carlos MendietaAbstract:Background Predictors of Gingival Enlargement in patients treated with anti-epileptics have not been previously assessed. This study was conducted to determine, with the aid of two indices that score vertical and horizontal overgrowth, the prevalence and risk factors for Gingival Enlargement in patients treated with phenytoin and other anticonvulsant drugs. Materials and Methods A cross-sectional study was conducted and data from 59 patients taking antiepileptics were compared with 98 controls. Gingival Enlargement was evaluated with two indices to score vertical overgrowth [Gingival overgrowth index (GO] and horizontal overgrowth [Miranda-Brunet index (MB)] . Gingival index, plaque index, and probing depth were also evaluated. Results The prevalence of Gingival Enlargement was significantly higher (P < 0·0001) for both indices in the anticonvulsants treated groups than in the control group. Gingival overgrowth was significantly higher for both indices in the phenytoin group than in the non phenytoin group. Among the possible risk factors, only the Gingival index showed a significant association with Gingival Enlargement. For the MB index the risk of Gingival Enlargement (odds ratio) associated to phenytoin therapy and other anticonvulsants therapy were 52·6 (13·5–205) and 6·6 (1·5–28·2). Gingival index-adjusted odds ratios for the same drugs were 5·7 (1·3–24·7) and 18·1 (2–158), respectively. The concordance between GO and MB indices in the control group and in the phenytoin-group and non phenytoin-group showed a Kappa value of 0·773 and 0·697, respectively. Conclusion This study reports significant differences in the prevalence and severity of Gingival overgrowth in two groups of patients, one treated with phenytoin, and another treated with other anticonvulsants. Gingival inflammation is a significant risk factor for Gingival Enlargement in these patients.
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Prevalence and risk of Gingival Enlargement in patients treated with nifedipine.
Journal of periodontology, 2001Co-Authors: Jaume Miranda, Lluís Brunet, Magí Farré, Leonardo Berini, Pere N. Roset, Carlos MendietaAbstract:Background: Gingival Enlargement is a known side effect of nifedipine use. This study was conducted to determine the prevalence and risk factors for Gingival Enlargement in nifedipinetreated patients. Methods: A cross-sectional study was conducted in a primary care center. Data from 65 patients taking nifedipine were compared with 147 controls who had never received the drug. All patients were examined for the presence of Gingival Enlargement using 2 different indices: vertical Gingival overgrowth index (GO) in 6 points around each tooth, and horizontal MB index in the interdental area. Gingival index, plaque index, and probing depth were also evaluated. Results: The prevalence of Gingival Enlargement was significantly higher in nifedipine-treated cases than in controls (GO index, 33.8% versus 4.1%; MB index, 50.8% versus 7.5%, respectively). Higher Gingival and plaque indices were observed in patients taking nifedipine. Among the possible risk factors, only the Gingival index showed a significant associa...