Treatment of Localized Gingival Enlargement with Diodelaser- A Case Report

M. Vijayalakshmi*, Gayathri S.**, V. Nandhini ***, M. G. Krishna Baba****
Periodicity:April - June'2019

Abstract

The role of lasers in dentistry is well established for the conservative management of oral diseases. The diode laser system has a wide range of applications in the ablation of lesions, incisional and excisional biopsies, gingivectomies, gingivoplasties, soft tissue reductions (tuberosity region), and certain crown lengthening procedures. The oral mucosa is constantly subjected to external and internal stimuli, and therefore manifests a spectrum of diseases ranging from developmental, reactive, and inflammatory to neoplastic. These lesions present as either generalized or localized gingival enlargements. Gingival enlargements in the anterior region of the mouth have obvious effects on aesthetics and function and can affect the psychology of the patient. The terms hyperplasia and hypertrophy are not precise descriptions of gingival enlargement as they are strictly histological diagnoses and require microscopic analysis of a tissue sample. Hyperplasia refers to an increased number of cells, and hypertrophy refers to an increase in the size of individual cells. Because these identifications obviously cannot be performed with a clinical examination and evaluation of the tissue, the term gingival enlargement is appropriate. Therefore, based on history and clinical examination, the lesion was provisionally diagnosed as idiopathic gingival enlargement because the patient did not have any significant associated factors that could cause gingival enlargement. Reactive lesions are clinically and histologically non-neoplastic nodular swellings that develop in response to chronic and recurrent tissue injury, which stimulates an exuberant or excessive tissue response. They may present as pyogenic granuloma, fibrous epulis, peripheral giant cell granuloma, fibro epithelial polyp, peripheral ossifying fibroma, giant cell fibroma, and pregnancy epulis, commonly manifesting in the gingiva. Clinically, these reactive lesions often present diagnostic challenges because they mimic various groups of pathologic processes. They are clinically similar but possess distinct histopathological features. Detailed case history, clinical, and histological investigations are required to successfully manage gingival growths of the gingiva. The treatment of gingival growths by laser surgery has proven to be more advantageous compared to conventional surgical techniques, such as avoidance of needle infiltrated anesthesia, complete absence of post-surgical pain, and minimal bleeding. Diode lasers, specifically, operate at a wavelength that is easily absorbed by the gingival tissues while posing little risk of damaging the tooth structure. This case report presents the management of localized gingival overgrowth with a laser.

Keywords

Gingival, Diodelaser, Case Report, Granuloma, Tuberosity Region.

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