Tooth migration correction post-treatment in a metabolic syndrome patient.
Journal name: Journal of Indian Society of Periodontology
Original article title: Self-correction of pathologic tooth migration after nonsurgical periodontal treatment in a metabolic syndrome patient with severe periodontitis and drug-influenced gingival enlargement
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:
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Hsin-Che Lee, Chao-Nan Wu, Kuo Yuan
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Self-correction of pathologic tooth migration after nonsurgical periodontal treatment in a metabolic syndrome patient with severe periodontitis and drug-influenced gingival enlargement
Year: 2021 | Doi: 10.4103/jisp.jisp_417
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Drug-influenced gingival enlargement (DIGE) and reduced bone support due to periodontitis are significant contributors to pathologic tooth migration (PTM). This case study highlights the management of an 85-year-old Taiwanese male with advanced periodontitis, DIGE, and uncontrolled diabetes mellitus, who presented with severe gingival enlargement and spontaneous bleeding. The comprehensive treatment strategy focused on nonsurgical periodontal therapy, lifestyle modification, and careful management of his diabetes and hypertension with an emphasis on improving oral hygiene. Remarkably, both DIGE and PTM resolved spontaneously after one year without surgical intervention.
The Role of Nonsurgical Treatment in Resolving DIGE and PTM
The effective management of DIGE and PTM can often be achieved through meticulous initial-phase periodontal therapy and reinforcement of oral hygiene, particularly in patients with extended conditions like diabetes. In this case, the patient underwent thorough scaling and root planing combined with the prescription of adjunctive antibiotics due to his poorly controlled diabetes. The results showed significant improvement in his oral hygiene, marked reduction in gingival swelling, and a decrease in the gingival overgrowth index from 90% to 22%. Notably, spontaneous realignment of the anterior teeth occurred, indicating that periodontal therapy can potentially alleviate the conditions contributing to PTM, possibly through mechanisms such as wound contraction and restoration of force balance in the periodontium.
Conclusion
This case reinforces the potential benefits of a nonsurgical approach to managing advanced periodontal diseases, particularly in patients with systemic health challenges. By focusing on comprehensive periodontal care and patient education on oral hygiene practices, the necessity for invasive surgical procedures can often be minimized or eliminated. Sustainable management strategies are crucial to improving patient outcomes, particularly for those who are at increased risk for complications due to systemic conditions like uncontrolled diabetes and cardiovascular diseases. As such, dentists should prioritize effective nonsurgical treatment options to enhance patient care in similar clinical scenarios.
FAQ section (important questions/answers):
What causes drug-influenced gingival enlargement (DIGE)?
DIGE is primarily caused by the use of certain medications, particularly calcium channel blockers. Poor oral hygiene and conditions like diabetes mellitus can exacerbate the enlargement, leading to severe gingival issues.
How is pathologic tooth migration (PTM) related to periodontitis?
PTM often occurs in patients with severe periodontitis due to reduced bone support and tissue inflammation. It is characterized by movement of teeth from their normal positions.
What treatment options are available for severe DIGE and PTM?
Management typically includes surgical, orthodontic, and prosthodontic treatments. However, nonsurgical approaches such as improved oral hygiene and systematic periodontal therapy can also lead to significant improvements.
Can DIGE and PTM resolve without surgical intervention?
Yes, as shown in a case study, both DIGE and PTM can resolve spontaneously with nonsurgical treatment, emphasizing the importance of early diagnosis and improved oral care for favorable outcomes.
What role does diabetes play in gingival enlargement?
Diabetes mellitus can negatively affect periodontal health, increasing the likelihood of gingival enlargement. Poorly controlled diabetes can exacerbate inflammation and tissue overgrowth, complicating gingival issues.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Tooth migration correction post-treatment in a metabolic syndrome patient.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Table:
In clinical research, tables are often used to present data, findings, and results in an organized manner, making them easily interpretable. In this context, a 'table' may refer to the summary data highlighting the effectiveness of treatments for conditions like drug-induced gingival enlargement (DIGE) and pathologic tooth migration (PTM).
2) Hygiene (Hygienic):
Hygiene refers to practices that promote health and prevent disease, particularly oral hygiene in dentistry. Good oral hygiene is crucial in managing conditions like DIGE and PTM, as poor hygiene can exacerbate gingival enlargement and periodontal disease, leading to more severe dental issues requiring complex treatments.
3) Relative:
This term may refer to the comparison between different treatment outcomes or conditions in the context of disease management. Studies often evaluate the relative efficacy of nonsurgical versus surgical interventions in treating DIGE and PTM in patients, assessing which approaches yields better patient outcomes.
4) Inflammation:
Inflammation is a biological response involving immune cells, blood vessels, and proteins to harmful stimuli. In this case, gingival inflammation due to periodontitis and DIGE can lead to increased tooth mobility and pathologic migration. Effective periodontal treatment aims to reduce this inflammation, improving patient's oral health.
5) Disease:
Disease encompasses pathological conditions affecting function or structure within the body. In dentistry, diseases like periodontitis and DIGE significantly impact oral health, highlighting the need for effective preventive and therapeutic strategies to manage such conditions, particularly in older patients with comorbidities like diabetes.
6) Bleeding:
Bleeding, particularly during dental examinations, can indicate underlying issues, such as periodontal disease. In the context of DIGE and PTM, spontaneous bleeding from gingival tissue can signify inflammation and poor health, necessitating a comprehensive management strategy that includes improving hygiene and periodic dental assessments.
7) Antibiotic (Antibacterial):
Antibiotics are medications used to treat bacterial infections and are often adjuncts in periodontal therapies. In this case, adjunctive antibiotics like amoxicillin and metronidazole were used to enhance the effects of scaling and root planing in managing periodontitis, particularly in patients with uncontrolled diabetes.
8) Channel:
In this context, 'channel' may refer to calcium channel blockers, a class of medications linked to drug-induced gingival enlargement. Understanding the effects of these medications on gingival tissue is crucial for managing DIGE, as alternative medications might help mitigate associated gingival overgrowth.
9) Drug:
Drugs, particularly those causing side effects like DIGE, play a significant role in managing certain health conditions. Awareness of drug-induced side effects prompts providers to consider alternative treatments or additional therapies to mitigate adverse outcomes while managing the underlying conditions effectively.
10) Blood:
Blood glucose levels are critical in managing diabetes and its related conditions. In the case report, the patient's high blood glucose levels were instrumental in diagnosing uncontrolled diabetes, which was a significant factor influencing his periodontal health and treatment responses for DIGE and PTM.
11) Pur:
Poor conditions typically reflect suboptimal practices or health states, such as poor oral hygiene in this case. Poor oral care has been shown to exacerbate conditions like DIGE and periodontitis, highlighting the importance of education and preventive measures to enhance patient self-care and treatment success.
12) Male:
The term male in this context describes the gender of the patient involved in the case report. Research often takes into account gender as a variable in disease prevalence and treatment responses, but both genders can be affected by conditions such as DIGE and PTM.
13) Alleviation:
Alleviation refers to the reduction or easing of symptoms or conditions. In the context of this report, alleviation is significant as nonsurgical procedures aimed at comprehensive periodontal management resulted in significant reductions in symptoms of DIGE and PTM, highlighting effective treatment modalities.
14) Observation:
Observation in clinical practice refers to carefully monitoring a patient’s condition or response to treatment. In this case, the patient's observation of dental conditions prompted clinical evaluation, leading to diagnoses of DIGE and PTM, underscoring the value of patient feedback in healthcare delivery.
15) Discussion:
Discussion refers to reviewing and analyzing findings to draw conclusions about treatment efficacy or disease management. In this context, the discussion highlights how certain interventions successfully resolved DIGE and PTM in the patient, emphasizing the importance of nonsurgical approaches in complex cases.
16) Medicine:
Medicine plays a central role in preventing, diagnosing, and treating diseases and their complications, including oral health issues such as diabetes and periodontal disease. The intersection of medicine and dentistry is crucial as systemic health significantly impacts oral health outcomes and treatment strategies.
17) Swelling:
Swelling, particularly gingival swelling, is a key indicator of inflammation and periodontal disease severity in patients. Addressing swelling through proper periodontal interventions is essential for managing conditions like DIGE and PTM effectively, contributing to improved oral health and quality of life.
18) Family:
Family support can significantly impact a patient's ability to maintain treatment regimens and adhere to oral health practices. In the context of this report, the patient's family involvement in decision-making about treatments for DIGE and PTM illustrates the importance of social support in healthcare.
19) Study (Studying):
Study refers to research or clinical evaluations conducted to gather data on specific medical conditions or treatments. The studies mentioned in this report provide insights into the management of DIGE and PTM, contributing valuable information on effective nonsurgical treatments in advanced periodontal cases.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Tooth migration correction post-treatment in a metabolic syndrome patient.’. Further sources in the context of Science might help you critically compare this page with similair documents:
Spontaneous bleeding, Periodontal disease, Type 2 Diabetes Mellitus, Scaling and root planing, Comprehensive management, Oral Consent, Spontaneous resolution, Advanced periodontitis, Pathologic tooth migration, Nonsurgical periodontal treatment, Reactive positioning, Abstract Drug-influenced gingival enlargement, Severe gingival enlargement, Calcium channel blocker treatment, Oral hygiene improvement, Gingival overgrowth index, Adjunctive antibiotics, Meticulous initial phase periodontal therapy, Pathogenic pressure, Maintenance every 3 months, Gums and spontaneous bleeding.