i-manager's Journal of the Indian Dental Association Tamil Nadu (JIDAT)


Volume 9 Issue 3 April - June 2019

Treatment of Localized Gingival Enlargement with Diodelaser- A Case Report

M. Vijayalakshmi* , Gayathri S.**, V. Nandhini ***, M. G. Krishna Baba****

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.

A Critical Review of Bisphosphonates in Periodontics

S. Senthilnathan * , B. Meenapriya **, J. Johnson Raja ***, J. P. Mohan Raj ****

Abstract

Bisphosphonates are a class of drugs that are widely used to inhibit bone resorption in various bone diseases. Due to their increased affinity to bone and ability to increase osteoblastic differentiation while inhibiting osteoclastic activity, bisphosphonates are also used as host modulation agents in periodontal diseases. Bisphosphonates have been shown to prevent bone destruction in osteoporosis by altering the host response. The purpose of this paper is to discuss the implications of bisphosphonates in periodontics and their potential complications.

Photodynamic Therapy – A Review

V. K. Vijay* , S. Srinivasan**, M. Navarasu***, M. Thirumavalavan****

Abstract

Periodontitis is defined as "an inflammatory disease of the supporting tissues of the teeth caused by specific microorganisms or groups of microorganisms." Mechanical removal of the biofilm and adjunctive use of antibacterial disinfectants or various antibiotics have been conventional methods of periodontitis therapy. Photodynamic therapy (PDT) involves the use of low-power lasers with an appropriate wavelength to kill microorganisms treated with a photosensitizer drug. Hence, PDT could be an alternative to conventional periodontal therapeutic methods. This review aims to discuss the evolution and uses of photodynamic therapy.

Grinspan’s Syndrome - A Case Report and Review of Literature

N. Kannan* , R. S. Gayatri**, Dheepthi R.***, Deepti J.****

Abstract

Oral Lichen Planus is a common muco-cutaneous disorder characterized by an inflammatory skin condition that causes an itchy, non-infectious rash of small, polygonal, flat-topped pink or purple lesions, predominantly on the oral and skin (arms and legs) areas. It is often linked to diabetes mellitus and vascular hypertension, and this triad is referred to as Grinspan’s Syndrome. We present a case of a 50-year-old female patient with characteristic lesions of oral erosive lichen planus on the buccal mucosa and gingiva, who has a history of vascular hypertension and has been diagnosed with type II diabetes mellitus.

Unicystic Ameloblastoma mimicking Radicular cyst – A Case Report

S. Thiruneelakandan* **

Abstract

Ameloblastoma is a slow-growing, persistent, and locally aggressive neoplasm of epithelial origin. Ameloblastomas are classified into conventional, unicystic, and peripheral types. Unicystic ameloblastoma refers to those lesions which clinically and radiographically resemble a cyst, but on histologic examination show a typical ameloblastomatous epithelium lining part of the cystic cavity, with or without luminal and/or mural tumor growth. This paper presents a case of unicystic ameloblastoma in a young female patient, which was clinically diagnosed as a radicular cyst. The paper highlights the significance of histopathologic examination in the diagnosis and prognosis of such cases.