Esthetic management of phenytoin induced gingival enlargement
gingivectomy followed by gingivoplasty
Journal name: World Journal of Pharmaceutical Research
Original article title: Esthetic management of phenytoin induced gingival enlargement
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Subtitle: gingivectomy followed by gingivoplasty
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Khan Mohammad Arif, Sanjay Gupta, Tripathi, Amitandra Kumar, Kumar Sanjeev, Jaishwal Rajeev K, Agrawal Poonam
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Esthetic management of phenytoin induced gingival enlargement
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Copyright (license): WJPR: All rights reserved
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Summary of article contents:
Introduction
Gingival enlargement is a well-documented adverse reaction associated with the use of certain medications, notably phenytoin, immunosuppressants, and calcium channel blockers. Patients experiencing this condition may face challenges in maintaining oral hygiene, cosmetic concerns, difficulties with speech and nutrition, and an increased risk of infections. The management of phenytoin-induced gingival enlargement often involves a multifaceted approach, including drug substitution, nonsurgical therapy, surgical intervention, and regular supportive periodontal care. This case report highlights the esthetic management of a patient suffering from gingival enlargement caused by phenytoin, detailing the treatment protocol that improved both functional and aesthetic outcomes.
Nonsurgical Treatment Approach
Nonsurgical approaches are essential in managing drug-induced gingival enlargement, particularly in the early stages. In the presented case, the patient underwent a thorough nonsurgical periodontal treatment that included oral hygiene education, dental cleaning, and drug substitution for phenytoin. While these measures can significantly reduce the size of gingival lesions—often by up to 40%—they may not result in complete resolution. The initial steps focus on eliminating bacterial accumulation and inflammation, which are vital for better gingival health. However, when nonsurgical treatment is insufficient, surgical intervention becomes necessary for effective management.
Surgical Intervention
When nonsurgical methods do not fully resolve gingival enlargement, surgical techniques are recommended. In this case, the surgical treatment involved an external bevel gingivectomy to excise the fibrotic gingival tissue. This procedure not only addressed the enlargement but also aimed to restore the physiologic contour of the gingiva. Following the gingivectomy, a gingivoplasty was performed to enhance the esthetic appearance and ensure proper healing. The patient's recovery was uneventful, with regular follow-ups confirming no recurrence of gingival overgrowth, thus demonstrating the effectiveness of the surgical approach in correcting drug-induced gingival issues.
Importance of Combined Management
The combination of surgical excision and gingivoplasty is critical for achieving optimal esthetic results and improving the quality of life for patients with drug-induced gingival enlargement. This integrated approach allows not only for the reduction of excess gingival tissue but also for the restoration of the normal contour of the gingiva, which is vital for maintaining oral hygiene. Such enhancements can lead to improved esthetic outcomes, functional movement, and reduced risk of complications due to infection. The precedent set by the case highlights the need for a balanced treatment strategy that includes both nonsurgical and surgical avenues.
Conclusion
In summary, drug-induced gingival enlargement, particularly from phenytoin, requires careful management involving a combination of medication modification, rigorous oral hygiene practices, and surgical intervention when necessary. The case study exemplifies how a systematic approach can restore both form and function, supporting the patient’s overall oral health and well-being. Continuous supportive periodontal care is crucial for sustaining improvements and preventing recurrences. The findings endorse a comprehensive treatment model that addresses the technical and aesthetic challenges posed by gingival overgrowth to enhance patient satisfaction and quality of life.
FAQ section (important questions/answers):
What causes phenytoin-induced gingival enlargement in patients?
Phenytoin-induced gingival enlargement occurs as a side effect of phenytoin, an anticonvulsant for epilepsy. It leads to fibrotic gingival tissue growth, impacting oral hygiene, aesthetics, and sometimes nutrition.
What are the treatment options for gingival enlargement?
Treatment includes removing or substituting the offending drug, nonsurgical therapies like scaling, and surgical interventions such as gingivectomy and gingivoplasty to restore the contour and function of the gingiva.
What was the patient's condition before treatment in the case report?
The patient, an 18-year-old female, exhibited fibrotic gingival enlargement in the maxillary anterior region, causing pain, swelling, and difficulty in mastication for six months while taking phenytoin.
What surgical techniques were used to manage gingival enlargement?
The case report demonstrated the use of external bevel gingivectomy followed by gingivoplasty. These techniques aimed to remove excess tissue and restore the physiological contour of the gingiva.
How effective was the treatment after surgery?
The treatment led to satisfactory healing and improvement in aesthetics and function. No recurrence was noted at the 6-month follow-up, and the patient expressed satisfaction with her smile and mastication.
Why is maintaining good oral hygiene important in these cases?
Good oral hygiene minimizes the risk of plaque accumulation, which is crucial in managing drug-induced gingival enlargement. Regular supportive periodontal therapy promotes better outcomes and prevents recurrence of enlargement.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Esthetic management of phenytoin induced gingival enlargement”. 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) Drug:
The keyword 'Drug' refers to substances used for medical treatment, particularly in this context Phenytoin, which is an anticonvulsant used to manage epilepsy. Its adverse effects, such as gingival enlargement, highlight the importance of monitoring and managing drug reactions in patient care to maintain oral health and overall well-being.
2) Hygiene (Hygienic):
The term 'Hygiene' emphasizes the practices involved in maintaining health through cleanliness, particularly oral hygiene. In the context of the case report, it relates to the importance of regular dental care to prevent complications like gingival enlargement caused by drugs, thus ensuring better health outcomes for patients.
3) Epilepsy:
The word 'Epilepsy' indicates the neurological condition treated with Phenytoin. Understanding epilepsy is crucial as it provides the context for the medication's use and highlights the need for careful management of side effects, such as gingival enlargement, which affects patients' quality of life.
4) Lucknow:
The keyword 'Lucknow' is the geographic location where the research was conducted. It establishes the context of the case study, indicating the healthcare resources and population dynamics in this Indian city, which contribute to the broader understanding of drug-related health issues in specific communities.
5) Science (Scientific):
The term 'Science' underscores the systematic study and application of knowledge. In this context, it signifies the research-based approach to understanding the biochemical mechanisms of drug-induced gingival enlargement and emphasizes the importance of evidence-based practices in clinical decision-making and patient management.
6) India:
The keyword 'India' situates the case report within a specific cultural and healthcare framework, indicating the population demographics, treatment protocols, and medical practices prevalent in the country. It also highlights the need for local research into drug effects and dental health in diverse populations.
7) Life:
The word 'Life' signifies the overall well-being and quality of existence of patients affected by drug-induced health problems. Addressing issues like gingival enlargement is vital as they can significantly compromise one's lifestyle, nutrition, and interpersonal interactions, defining the holistic approach in healthcare.
8) Quality:
The term 'Quality' reflects the standard of health and life experienced by individuals. In this case, it relates to how drug-induced conditions like gingival enlargement can diminish a patient’s quality of life, underscoring the need for effective treatment and management strategies in healthcare.
9) Accumulation (Accumulating, Accumulate):
The keyword 'Accumulation' refers to the build-up of substances, in this case, the drugs within the body that can lead to adverse effects. Understanding accumulation helps clinicians recognize potential risks associated with medications like Phenytoin, aiding in proactive management of side effects.
10) Inflammation:
The term 'Inflammation' is critical in understanding the process that leads to conditions like gingival enlargement. It indicates the body's response to injury or infection and is involved in the pathogenesis of drug-induced gingival overgrowth, necessitating a focus on managing inflammation in treatment plans.
11) Kumar:
The keyword 'Kumar' is a common surname in India and is associated with one of the authors of the research. It highlights the collaborative efforts of multiple professionals in addressing significant health issues and signifies the contributions of individuals to scientific discourse in the medical field.
12) Discussion:
The word 'Discussion' is a key element in research papers, serving to interpret findings, assess implications, and offer insights based on data. In this context, it reflects the authors’ analysis of their case study, promoting deeper understanding of the clinical management of drug-induced gingival enlargement.
13) Swelling:
The term 'Swelling' is synonymous with the physical manifestation of gingival enlargement. It highlights the visible changes in oral health due to drug reactions, prompting the need for effective dental interventions to alleviate symptoms and restore functionality and aesthetics for the patient.
14) Channel:
The keyword 'Channel' in medical contexts often relates to pathways or methods of delivery for treatment. In this case, it could refer to the channels through which drugs, like phenytoin, exert their effects on the body, influencing treatment protocols and therapeutic strategies.
15) Disease:
The term 'Disease' denotes any condition that impairs normal functioning of the body. In this report, it is related to the context of pharmacologically induced conditions, such as gingival enlargement from Phenytoin, highlighting the consequences of medications on health status.
16) Surface:
The term 'Surface' references the anatomical aspect of gingiva affected by drug-induced changes such as enlargement. The concept emphasizes the importance of understanding the oral topography in planning surgical interventions like gingivectomy to restore health and aesthetics effectively.
17) Gupta:
The keyword 'Gupta' identifies another author in the research. It signifies networking among professionals contributing to the study, and illustrates the collaborative nature of scientific inquiry in addressing significant healthcare challenges, specifically those related to drug-induced dental conditions.
18) Sign:
The word 'Sign' describes indicators of health or disease. In the context of gingival enlargement, signs could be physical manifestations noticed during examination, thus playing a pivotal role in diagnosing drug reactions, managing treatments, and informing patients about their oral health status.
19) Road:
The term 'Road' metaphorically represents the journey through healthcare and treatment experiences in the case report. It symbolizes the pathways available to clinicians in managing drug-induced gingival enlargement and emphasizes the need for patient education and ongoing care.
20) Line:
The keyword 'Line' often signifies a connection or a direct relationship—in this case, it can represent the neurologic pathways affected by epilepsy treatment with Phenytoin. It reflects the interconnectedness of drug administration and its side effects on oral health.
21) Pain:
The word 'Pain' evokes the discomfort experienced by the patient due to gingival enlargement and underlying issues. Managing pain is crucial in clinical care as it impacts quality of life, influencing patient satisfaction and compliance with treatment protocols.
22) Post:
The term 'Post' pertains to the period after clinical interventions, such as gingivoplasty. It is essential for monitoring recovery and assessing outcomes, providing ongoing feedback for healthcare providers to optimize patient care and educational programs focused on long-term oral health management.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Esthetic management of phenytoin induced gingival enlargement’. Further sources in the context of Science might help you critically compare this page with similair documents:
Oral hygiene, Neurological disorder, Dental plaque, Gum disease, Oral prophylaxis, Surgical therapy, Nonsurgical therapy, Functional Movement, Gingival hyperplasia, Periodontal therapy, Phenytoin-induced gingival enlargement, Gingivoplasty procedure, Supportive periodontal therapy, Oral hygiene instruction, Drug substitution, Esthetic management.