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常规牙龈切除术治疗正畸性牙龈增生:一例报告

Conventional Gingivectomy Procedure in the Management of Orthodontic-Induced Gingival Overgrowth: A Case Report.

作者信息

Dalal Aakanksha M, Oza Ranu R, Shirbhate Unnati, Gurav Tikeshwari

机构信息

Department of Periodontics and Implantology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND.

Department of Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, IND.

出版信息

Cureus. 2024 Jul 15;16(7):e64556. doi: 10.7759/cureus.64556. eCollection 2024 Jul.

DOI:10.7759/cureus.64556
PMID:39144890
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11323948/
Abstract

Gingival enlargement (GE) can result from gingival inflammation, fibrous overgrowth, or a combination of both factors. Various etiological factors contribute to GE, including low-grade trauma, iatrogenic causes, drug-induced effects, systemic diseases, plaque accumulation, hormonal influences, vitamin deficiencies, genetic predispositions, and idiopathic reasons. Effective treatment in clinical practice hinges on accurately diagnosing the underlying cause. Among these, plaque-induced inflammation is the most common, driven by the accumulation of plaque and calculus. One challenge in maintaining oral hygiene is orthodontic treatment, which can impact speech, chewing, aesthetics, and psychological well-being. In this case report, a 21-year-old female patient developed GE associated with orthodontic appliance use. To address this, excess gingival tissue was surgically removed under local anesthesia using gingivectomy and gingivoplasty procedures, and the excised tissue was sent for histopathological examination. Following the surgery, a periodontal dressing (GC Coe Pack™) was applied to protect the tissue and aid in healing. The case underscores that enlarged gingival tissue, covering nearly half of the dental crowns, led to plaque accumulation and aesthetic concerns. Post-procedure, achieving a proper gingival contour eliminated suprabony pockets and enhanced the aesthetic appearance. The patient showed positive outcomes with no remaining suprabony pockets, resulting in a natural gingival contour, improved aesthetics, and reduced plaque retention. Surgical gingivectomy and gingivoplasty proved to be successful interventions in this case.

摘要

牙龈增生(GE)可由牙龈炎症、纤维性过度生长或这两种因素共同引起。多种病因可导致牙龈增生,包括轻度创伤、医源性原因、药物性影响、全身性疾病、菌斑堆积、激素影响、维生素缺乏、遗传易感性和特发性原因。临床实践中的有效治疗取决于准确诊断潜在病因。其中,菌斑诱导的炎症最为常见,由菌斑和牙石堆积所致。保持口腔卫生的一个挑战是正畸治疗,它会影响言语、咀嚼、美观和心理健康。在本病例报告中,一名21岁女性患者出现了与正畸矫治器使用相关的牙龈增生。为解决这一问题,在局部麻醉下使用牙龈切除术和牙龈成形术手术切除多余的牙龈组织,并将切除的组织送去做组织病理学检查。手术后,应用牙周敷料(GC Coe Pack™)保护组织并促进愈合。该病例强调,增大的牙龈组织覆盖了近一半的牙冠,导致菌斑堆积和美观问题。术后,实现适当的牙龈外形消除了龈上袋并改善了美观。患者取得了良好的效果,没有残留龈上袋,形成了自然的牙龈外形,美观得到改善,菌斑滞留减少。在本病例中,手术牙龈切除术和牙龈成形术被证明是成功的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/c2d1429bcf24/cureus-0016-00000064556-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/e938527252ed/cureus-0016-00000064556-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/a445375a8fb9/cureus-0016-00000064556-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/276ccfb3b7ae/cureus-0016-00000064556-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/bf377d75adb7/cureus-0016-00000064556-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/682a1a8fb55b/cureus-0016-00000064556-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/c2d1429bcf24/cureus-0016-00000064556-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/e938527252ed/cureus-0016-00000064556-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/a445375a8fb9/cureus-0016-00000064556-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/276ccfb3b7ae/cureus-0016-00000064556-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/bf377d75adb7/cureus-0016-00000064556-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/682a1a8fb55b/cureus-0016-00000064556-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf8/11323948/c2d1429bcf24/cureus-0016-00000064556-i06.jpg

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本文引用的文献

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Pan Afr Med J. 2022 Aug 24;42:305. doi: 10.11604/pamj.2022.42.305.36600. eCollection 2022.
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Protein carbonylation associated with nickel liberation in orthodontic gingival overgrowth.正畸性牙龈增生中与镍释放相关的蛋白羰基化。
Arch Oral Biol. 2021 May;125:105103. doi: 10.1016/j.archoralbio.2021.105103. Epub 2021 Mar 4.
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Impact of Orthodontic Treatment on Periodontal Tissues: A Narrative Review of Multidisciplinary Literature.正畸治疗对牙周组织的影响:多学科文献的叙述性综述
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