Clinical Image

Management of Gingival Overgrowth Associated with Orthodontic Therapy

Himabindu Dukka*
Department of Oral Health and Rehabilitation, University of Louisville School of Dentistry, USA


*Corresponding author: Himabindu Dukka, Department of Oral Health and Rehabilitation, University of Louisville School of Dentistry, 501 S Preston St, Louisville, KY 40202, USA


Published: 30 Apr, 2018
Cite this article as: Dukka H. Management of Gingival Overgrowth Associated with Orthodontic Therapy. J Dent Oral Biol. 2018; 3(3): 1132.

Clinical Image

A 15-year-old male presented with gingival overgrowth associated with the lower anterior teeth. The patient was undergoing orthodontic therapy and oral examination revealed hyperplastic gingiva on the buccal aspect of teeth #26 - #23 with plaque accumulation noted on the tooth surfaces (Figure 1). Most of the fixed orthodontic appliances can hinder oral hygiene measures causing increased plaque retention [1]. This can lead to gingival enlargement, which results in pseudo pocketing with no attachment loss [1]. A combination of non-surgical and surgical treatment may help patients undergoing orthodontic therapy resolve the gingival enlargement [2,3]. The current patient was treated with external bevel gingivectomy. Local anesthesia was achieved with 2% Lidocaine with 1:1,00,000 epinephrine following which a UNC periodontal probe was used to make bleeding points on the buccal surfaces of the lower anterior teeth marking the base of the pockets. A #15 Bard Parker scalpel blade was used to make the incisions on the buccal aspects of teeth #26 - #23and the excess tissue was removed (Figure 2). Oral hygiene instructions were given to the patient. One month post operative image showed dramatic improvement in the gingival appearance (Figure 3). The inflammation was resolved with healthy gingival contour and consistency. Although plaque removal can be a challenge with fixed orthodontic appliances, patient motivation and oral hygiene practices are imperative for maintaining periodontal health.


Figure 1

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Figure 1
Initial presentation.

Figure 2

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Figure 2
Intra operative image.

Figure 3

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Figure 3
One month post operative image.

References

  1. Eid H, Assiri HA, Kandyala R, Togoo RA, Turakhia VS. Gingival enlargement in different age groups during fixed orthodontic treatment. J Int Oral Health. 2014;6(1):1-4.
  2. Pinto AS, Alves LS, Zenkner JEDA, Zanatta FB, Maltz M. Gingival enlargement in orthodontic patients: Effect of treatment duration. Am J Orthod Dentofacial Orthop. 2017;152(4):477-82.
  3. Dongari-Bagtzoglou A, Research, Science and Therapy Committee, American Academy of Periodontology. Drug-associated gingival enlargement. J Periodontol. 2004;75(10):1424-31.