• Journal of Periodontal and Implant Science
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• 제39권1호
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• pp.103-108
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• 2009

Purpose: It is well recognized that gingival enlargement is induced by unwanted effect associated with three major drugs/drug groups - phenytoin, cyclosporine, and the calcium channel blockers. The present case report describes the effect and limitation of non-surgical treatment in gingival enlargement cases. Materials and methods: Three cases included 2 drug-influenced gingival enlargement patients and a idiopathic gingival fibromatosis patient. For the drug-influenced gingival enlargement patients, the medication was replaced with other medication. And then, all the patients were treated non-surgically. Results: Drug-influenced gingival enlargements had been reduced after non-surgical treatment and the results were well-maintained. In the idiopathic gingival fibromatosis case, non-surgical treatment resulted in only limited reduction of gingival enlargement, and surgical periodontal treatment was unavoidable. Conclusion: These case reports indicated that non-surgical periodontal treatment with change in medication was effective in the treatment of drug-influenced gingival enlargements. Non-surgical approach can be considered as the primary management to reduce the gingival enlargement. If non-surgical treatment encounters a limitation, surgical treatment should be considered.

• 대한치과의사협회지
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• 제52권12호
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• pp.712-719
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• 2014

Localized gingival enlargement is a common finding and tends to be reactive hyperplasia. Gingival reactive lesions are usually asymptomatic and respond to conservative treatment. However, a small entity of localized gingival enlargement is distinct from non-neoplastic growth, including developmental and neoplastic lesions. Since their clinical characteristics are similar with other lesions of gingiva, it can cause diagnostic dilemma, and is recommended to submit biopsy and confirm pathologic diagnosis. Their incidence of recurrence are different, therefore method of treatment should vary depending on the diagnosis. This review explains identification and treatment of localized gingival lesions.

• 대한치과의사협회지
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• 제52권12호
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• pp.720-725
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• 2014

Generalized gingival enlargement, also known as gingival hyperplasia or hypertrophy, is defined as an abnormal diffuse overgrowth of gingival tissues. There are several causes of generalized gingival enlargement and they can be grouped into four categories: hereditary gingival fibromatosis, medication-induced, inflammatory, and systemic or neoplastic causes of gingival enlargement. This paper reviews the clinical features, differential diagnosis and significance of generalized gingival enlargements.

• Journal of Oral Medicine and Pain
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• 제23권2호
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• pp.119-125
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• 1998

The authors treated a 58-year old female patient who had come to the Department of Oral Medicine, KNUH due to the chief complaints of gingival enlargement and bleeding on the upper and lower jaw. The lesions were diagnosed as cyclosporin-A induced gingival enlargement by patient's history and clinical examination. The patient was treated with gingivectomy using pulsed Nd:YAG laser. After gingivectomy the wound was compressed with 0.1% chlorhexidine-soaked gauze to prevent relapse of the lesion. Good healing process was observed and there were no recurrences until 3-month follow-up visit. From the results of this clinical trial it was suggested that a pulsed Nd:YAG laser gingivectomy would be helpful for the treatment of cyclosporin-A induced gingival enlargement in renal transplant patients.

• Journal of Periodontal and Implant Science
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• 제35권4호
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• pp.1109-1116
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• 2005

The purpose of this study was to observe the effects of periodontal therapy, including nonsurgical periodontal therapy with azithromycin, surgical therapy, and maintenace therapy on the drug-induced gingival enlargement, by means of measuring gingival thickness. The test group of 18 patients with drug-induced gingival enlargement received scaling, root planing with azithromycin for 5 days, with or without surgical periodontal treatment. The control group of 18 patients who had not taken any medication, received scaling and root planing, with or without surgical periodontal treatment. Both groups received supportive periodontal therapy every 3 months for 2 years. The mean period of total treatment is 32 months in the test group and 31 months in the control group. The thickness of the buccal gingiva was measured using an ultrasonic device of $SDM^{(R)}$(Krupp Corp., Essen, Germany). The results revealed that the test $group(1.21{\pm}0.51mm)$ showed statistically thicker buccal gingiva than the control $group(1.01{\pm}0.3mm)$. In the test group, the buccal gingiva was thickest on 2nd molars and was thinnest on canines of both dental arches. In the control group, the buccal gingiva was thickest on central incisors in the maxilla and 2nd molars in the mandible, while the thinnest areas were on canines in the maxilla and 1st premolars in the mandible. It would be concluded that the periodontal treatment with azithromycin aids in decreasing the degree of the gingival enlargement but cannot prevent the recurrence completely.

• 대한치과의사협회지
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• 제17권4호통권119호
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• pp.291-296
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• 1979

This patient, 30 year-old korean male, was admitted with complaints of the gingival enlargement and spontaneous bleeding of the gingival tissue with acute leukemia. In reviewing this case, the following points should have been understood; 1. This is a case of the gingivitis, gingival enlargement, gingival bleeding, so the patient showed the masticatory disturbances. 2. The generalized weakness, petechia in skin, anemia, and hepatomegaly on palpation were seen. 3. With the histopathological examination by means of microscopic views, numerous myelocytic cells, of which their shapes were in irregular, were appeared. 4. The prognosis was poor in spite of any other internal treatments.

• Journal of Periodontal and Implant Science
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• 제44권6호
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• pp.293-299
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• 2014

Purpose: Systemic disease can manifest oral signs at an early phase, which may be crucial for the diagnosis and timing of treatment. This report describes two patients who presented with gingival enlargement as an early sign of acute leukemia. Methods: Two patients presented with oral symptoms including severe gingival enlargement. The progress of their symptoms was associated with underlying systemic disease. Results: The patients were transferred to the Department of Hematology and diagnosed with acute myelomonocytic leukemia. They received appropriate treatment and survived. Conclusions: Gingival enlargement can be caused by underlying systemic diseases. Accurate diagnosis and timely referral are important for preventing a fatal situation. It must be emphasized that some oral signs and symptoms may be closely correlated with systemic diseases.

• Journal of Korean Dental Science
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• 제11권2호
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• pp.82-85
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• 2018

Leukemia is a hematological malignant disease with various clinical symptoms. Due to the fatal nature of the disease, early detection is important. Oral manifestations include ulcers and gingival enlargement with bleeding. Moreover, myeloid sarcoma or opportunistic infections may also occur. This report introduces a 31-year-old male presenting with generalized gingival enlargement with bleeding and another 81-year-old female with neoplasm on the left retromolar area. Both were diagnosed as acute monocytic leukemia. These cases implicate that gingival enlargement or mucosal lesion in the oral cavity may represent underlying systemic diseases. Related to this, it has to be reminded that making timely diagnosis and referral according to the clinical findings is crucial.

• 대한소아치과학회지
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• 제31권4호
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• pp.696-700
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• 2004

치은 섬유종증은 유리 치은과 부착 치은이 점진적으로 증식되는 비염증성 질환이다. 대부분 가족력이 있으며 영구치 맹출과 함께 발병하지만 유치 맹출시기에 드물게 출생 시부터 나타나기도 한다. 본 6세 여아의 경우 태어날 때부터 치은의 일부가 증식되어 있었고 가족력 및 치은 증식을 유발하는 약물을 복용한 병력은 없었다. 구강내 검진 시 섬유성 치은 증식 이 관찰되어 절제 생검을 시행하였고 그 결과 치은 섬유종증으로 진단하였다. 치은 섬유종증의 치료는 치은 절제술과 철저한 구강 위생의 관리이다. 그러나 치료 후 재발성 때문에 치료시기에 대해서는 논란 중이다. 일반적으로 영구치가 모두 맹출 한 이후에 치료할 것을 추천하지만 조기 치료는 구강의 기능 및 환아의 심미적, 심리적인 문제점을 개선시켜 주는 장점이 있다.

• 대한소아치과학회지
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• 제35권4호
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• pp.766-770
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• 2008

치은섬유종증(Gingival fibromaotsis)은 치은조직의 섬유성 증식을 나타내는 드문 구강질환이다. 원인은 명확히 규명되지 않았으나 상염색체 우성 또는 열성의 유전성이거나 특발성일 수 있다. 주로 영구치 맹출 시기에 나타나기 시작하나, 드물게 유치열기나 출생시부터 이환되는 경우도 있다. 치은은 서서히 증식하여 치아의 해부학적 치관부위를 덮거나 구개 변이를 일으켜 혀 운동장애를 야기하거나 입술 폐쇄를 방해하기도 한다. 이 증례의 환아는 14개월 된 여아로 출생 시부터 계속된 치은증식을 주소로 내원하였다. 특별한 가족력이나 의학적 병력은 없었고, 임상 유전검사 결과 알려진 어떤 증후군으로 진단되지 않았으나, 신체발달이 지연되어 있었다. 펀치 생검을 하였으며, 조직검사명은 치은섬유종증이었다. 가족력이 없어 특발성 치은섬유종증으로 진단하였다. 환아의 연령 및 전신 상태를 고려해 치은 절제술 등의 외과적 치료는 연기하기로 하였다.