![]() ![]() With this type of CO 2 laser, sutures and/or surgical dressing are often not needed. Conventional instrumentation-such as blades, knives, and high-speed burs-can often lead to bleeding after surgical removal when the tissue is inflamed. Unlike other lasers, the Solea laser has the capabilities of removing both soft and hard tissue, precise cutting accuracy due to control of both laser beam power and size, and the ability to cauterize inflamed tissue (figures 4c and 4d). 3Īnother laser that has been used to treat gingival enlargement and gummy smiles is a 9.3 micron CO 2 laser (Solea from Convergent Dental figure 2a). Dental lasers such as diodes, 10.6 micron CO 2, erbium YAG, erbium chromium YAG, and Nd:YAG lasers have also been implemented to remove excess soft tissue. Conventional surgical treatment includes the use of surgical blades, knives, and high-speed burs to remove the excess gingival tissue. If these methods are ineffective, surgical treatment is warranted. Azithromycin has been used in some cases of drug-induced gingival overgrowth, as this antibiotic can slow down fibroblast division and lead to a reduction in excess gum tissue. The first line of treatment is most often noninvasive and includes the discontinuation of any offending medication, controlling the systemic disease with medical care, institution of good home oral care, and nonsurgical mechanical debridement (dental cleaning). Other more serious causes of gingival enlargement include leukemias, malignant neoplasms/carcinomas, as well as many forms of granulomatous diseases.Benign neoplasms such as giant cell granuloma, papillomas, and fibromas.Vitamin deficiencies (mostly vitamin C and vitamin Bs).Diseases requiring hormone replacement therapy.Hormonal changes associated with pregnancy or puberty.Systemic causes of gingival enlargement may result in localized gum tissue overgrowth or a generalized response in which all the teeth are affected. What are the systemic causes of gingival enlargement? If these methods do not result in the resolution of gingival enlargement, surgical treatment may be necessary (figures 4c and 4d). Bacteria caused by poor oral hygiene can exacerbate the drug’s effect, therefore nonsurgical mechanical debridement and good home care should be emphasized. Treatment may not be needed, and spontaneous resolution may occur if the drug causing the problem is discontinued or another drug is substituted. ![]() 10% or fewer of the cases are typically attributed to amphetamines.10% to 20% of the cases are typically attributed to calcium channel blockers, with nifedipine being the most notable problem (figures 4a and 4b). ![]() 30% of the cases are typically attributed to cyclosporine.50% of the cases are typically attributed to phenytoin (figure 3).Amphetamines (cocaine, Ritalin, methamphetamine)Ĭonsider this when evaluating the incidence of drug-induced gingival enlargement:. ![]()
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