A 28-year-old man reported to the Department of Periodontics, Mahatma Gandhi Missions Dental College and Hospital, Navi Mumbai, with a chief complaint of swollen gums involving the entire upper and lower jaws. History revealed appearance of gingival enlargement at 10 years of age. With slow progression, the condition became increasingly severe and generalized, causing unaesthetic appearance together with difficulties in speaking and mastication besides these, no other complaints were present, such as pain, bleeding or halitosis. The patient reported a history of prior surgical excision seven years ago which was followed by orthodontic intervention during which the gingival overgrowth recurred. Medical history was not contributory as the patient was not on any medication that could be associated with gingival hyperplasia, such as phenytoin, cyclosporine, or calcium channel blockers.Family history revealed, the sister (33-year-old) [Table/ Fig-1b], niece (7-year-old) , and mother (60-year-old) [Table/ Fig2a-c] all exhibited signs of gingival enlargement. The sister gave a similar history as the patient with appearance of enlargement at 10 years of age, with gradual increase in size and extent of severity. In the niece, gingival enlargement was noticed early at the age of four years, and by the age of seven had gradually increased in size to cover the crowns of all the teeth. The mother reported development of isolated areas of gingival enlargement at the age of 16 which gradually increased in severity involving all the teeth, resulting in aesthetic disfigurement and deranged occlusion. At the age of 24, she underwent full mouth extraction in an attempt to eliminate the enlargement, and has been wearing complete denture prosthesis since then.Extra oral examination revealed a dysmorphic face with evident protrusion of the lips. The patient was unable to close his lips completely because of the gingival overgrowth. Other features noticed were macrocephaly, hypertelorism, bushy eyebrows with synophrys (unibrow), hypoplastic nares and cupid`s bow mouth [Table/ Fig-1]. Intra-orally, the examination found generalized, severe gingival overgrowth involving both buccal and lingual regions in the maxillary and mandibular arches [Table /Fig-3,4]. The enlarged gingiva was pink, firm, and smooth. No acute inflammatory signs were present. The patient's dentition suffered from serious malocclusion, involving displacement, rotation, and diastemas. Other features noticed were a highly arched palate, and v-shaped maxillary and mandibular arches. The extra and intra-oral features were remarkably similar in the patient's mother, sister (underwent cosmetic correction of synophrys), and niece. Intra-oral examination of the mother revealed Oral manifestations may vary from minimal involvement of only tuberosity area and the buccal gingiva around the lower molars to a generalized gingival enlargement. It can occur as an isolated disorder but can be one feature of a syndrome. Although the clinical and histopathological characteristics of ...
ABSTRACT'Halitosis' or bad breath is an unpleasant problem that affects people socially and psychologically. Halitosis is caused by a mixture of breath with malodorous compounds emanating from different areas of the oral cavity, respiratory tract and upper digestive tracts.Breath odor research captured the scientific community's attention during the last few decades. This has led to advances in analytical instruments used for identification and measurement of these malodorous compounds. The dental profession's response to the problem of halitosis has been met with hurdles in regards therapy often due to perceptive differences of the patient. This review attempts to highlight the identification, classification, diagnosis and treatment of halitosis.
Stress or tension is an unavoidable part of human life. It has been proven to cause not only health-related problems but problems pertaining to periodontium too. These include periodontal pocket formation, apical migration of junctional epithelium and delated wound healing. This paper connects the link between stress, its effect on general health and consequently on oral health. How to cite this article Sharma N, Gujjari SK, Kanagotagi S. Stress and the Periodontium. J Contemp Dent 2012;2(2):28-30.
Objectives Neutrophils play a critical role as a part of the innate immune response. Although neutrophils are primarily protective, they release products partly responsible for the destruction seen in periodontal disease. The techniques presently available for counting neutrophils require special equipment and are only semi-quantitative. The aim of the present investigation was to check the efficacy of a single, rapid, non-invasive assay to enable the expedient quantification of oral neutrophils, and utilize the assay to quantify the number of neutrophils in periodontal disease. Materials and Methods Forty five subjects were recruited in the study. They were put into three groups based on the Gingival Index and Russell's Periodontal Index as clinically healthy (Group 1), gingivitis (Group 2) and periodontitis (Group 3). GCF samples were collected using a durapore filter and the number of neutrophils counted using an improved Neubaeur's Chamber. Results Neutrophils were present in GCF of all the samples. There was statistically significant difference between the neutrophil numbers in all the samples with respect to severity of periodontal disease. The strength of association was the strongest between probing pocket depth and neutrophil counts. Conclusion This study demonstrates that it is possible to collect and quantify oral neutrophils by a single, rapid, noninvasive assay using durapore strips.
Background and objective Pink gingival esthetics, especially in the anterior teeth, has been an important success criterion in implant-supported restoration. The factor vital to the esthetic success, in the anterior maxillary implants, is the soft tissue profile, which should replicate that of the natural healthy tooth. The absence of the interimplant papilla causes an interimplant black triangle thus leading to cosmetic deformities, phonetic difficulty and food impaction. True papilla regeneration is not possible because the peri-implant soft tissue does not have the same structure as that of the periodontium and, therefore, the term ‘papilla-like’ tissue formation or ‘implant papilla’ is used. This resultant ‘implant papilla’ is the product of soft tissue depth and volume and has to be skilfully surgically created. However, reconstructing a predictable peri-implant papilla is the most complex and challenging aspect of implant dentistry. This article presents a review of various innovative surgical techniques to reconstruct interimplant papilla. How to cite this article Rajguru SA, Pathak TS, Padhye AM, Kanagotagi S, Gupta HS, Rathod AA. Interimplant Papilla Reconstruction. J Contemp Dent 2014;4(1):30-40.
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