Orofacial granulomatosis is a condition that manifests clinically as painless labial enlargement, perioral and mucosal edema, oral ulcers, and gingivitis. It is characterized by non-necrotizing granulomatous inflammation of the oral and maxillofacial region. When the swelling only affects the lips, the pathology is called Miescher’s granulomatous cheilitis; however, when it also causes facial paresis and lingua plicata, it is known as Melkersson-Rosenthal syndrome. We report a case that was successfully treated with a combination of a local (intralesional) steroid, a systemic antibiotic, and a systemic steroid. After 6 months of therapy, we observed improvement in gingival hyperplasia and buccal mucosa and lip edema.
Patient: Female, 39-year-old Final Diagnosis: Peripheral giant cell granuloma (PGCG) Symptoms: Gingival overgrowth and difficulty chewing Clinical Procedure: Treated by surgical intervention Specialty: Dentistry Objective: Unknown etiology Background: Peripheral giant cell granuloma, or epulis, is a common and benign oral lesion that can grow rapidly. Diode lasers are increasingly used to excise soft-tissue lesions because the technique preserves tissue for histopathology while controlling bleeding. Here, we report the excision of a 2-cm benign peripheral giant cell granuloma of the oral mucosa by 975-nm infrared diode laser, with rapid wound healing and good tissue preservation for histological analysis. Case Report: A 39-year-old woman presented with a large red-purple lesion in the oral mucosa of the lower jaw, near teeth 41 and 32. According to the patient, despite the absence of pain, the lesion caused difficulty while eating, speaking, and maintaining oral hygiene. The periodontal assessment included the following parameters: clinical attachment level, gingival recession, pocket probing depth, Loe-Silness gingival index, and tooth mobility index. The lesion was excised under local anesthesia using a 975-nm diode laser, and histopathology reports confirmed the diagnosis of peripheral giant cell granuloma. Six weeks after removal of the peripheral giant cell granuloma, all periodontal parameters were improved except for clinical attachment level and gingival recession. Conclusions: Excision by 975-nm infrared diode laser can maintain tissue integrity for histopathology while allowing complete excision and control of bleeding. Soft lasers can provide advantages such as reduced bleeding, less operative and postoperative pain, decreased mechanical trauma, increased patient acceptability, and rapid wound healing without sutures, and they can be used to successfully remove peripheral giant cell granulomas.
The primary goal of periodontal therapy is to prevent in- flammation and maintain a healthy and functional peri- odontium. The degree of pathological changes in the periodontium mainly affects the choice of the therapeutic method and the success achieved. Non-surgical removal of plaque and calculus is part of the initial phase of man- agement of patients with gingivitis and periodontitis. The therapy consists in the mechanical removal of supra and subgingival plaque deposits, motivation of the patient and instructions for oral hygiene. In this paper, four clinical cases of treatment of periodontal inflammation with cu- rettage of periodontal pockets are presented. Non-surgi- cal treatment is effective in treating periodontal disease. It should always be the first therapy undertaken. Currently, the literature suggests that the use of laser and modern methods for modulating the host response are effective in preventing periodontal inflammation, but however, noth- ing will replace instrumentation during closed curettage. This has not changed over thousands of years and is un- likely to change.
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