Chronic hypertrophic gingivitis
Chronic hypertrophic (hyperplastic) gingivitis - a chronic inflammation of gum tissue, accompanied by her razrostaniem. The basis of chronic hypertrophic gingivitis are changes in hormonal status with endocrine disorders, puberty, pregnancy and menopause).
Chronic hypertrophic gingivitis promote common diseases (leukemic reticuloendotheliosis), chronic intoxication, taking certain drugs (nifedipine, carbamazepine, cyclosporin).
Chronic hypertrophic gingivitis: an increase in the volume of gingival papillae, formation of false periodontal pockets.
Chronic hypertrophic gingivitis seen an increase in the volume of gingival papillae with the formation of false periodontal pockets. Gingival epithelial attachment in chronic hypertrophic gingivitis is not broken. Pathological changes in bone alveoli in chronic hypertrophic gingivitis because it is not.
According to clinical and morphological changes in isolated edematous and fibrous form of chronic gingivitis. Morphologically edematous form of hypertrophic gingivitis manifests edema of the connective elements papilla, vasodilatation, swelling of collagen fibers, lymphoplasmacytic infiltration of tissues.
The clinical picture of edematous forms of hypertrophic gingivitis proyalvetsya complaints patient's aesthetic defect because of the unusual form of gum, on pain of brushing teeth, and during the meal. When viewed from the mouth papilla enlarged, edematous, hyperemic or cyanotic, bleed when probed. Papillae have a glossy finish, after pressure on the surface of the papilla blunt instrument is part of the groove. Can be detected of tooth deposits.
Morphologically fibrous form of hypertrophic gingivitaproyavlyaetsya proliferation of connective tissue elements papilla, coarsening of collagen fibers, parakeratosis phenomena. Edema and inflammatory infiltration of fibrous tissue in the case of hypertrophic form of gingivitis is not expressed.
The clinical picture is the fibrous form of hypertrophic gingivitis manifests patients' complaints to the unusual form of gum disease and the associated aesthetic defect. When viewed from a patient with a fibrous form of hypertrophic gingivitis determine the increase papilla, they are pale pink, dense to the touch, pain and bleeding are absent. Can detect the hard and soft of tooth subgingival deposits.
Diagnosis of hypertrophic gingivitis difficulties, usually does not cause. To assess the dental status of the patient rather questioning, inspection, palpation gums, clinical probing of pockets, Schiller-Pisarev (in the form of edema). In doubtful cases showed radiological investigation.
To exclude blood disease, all patients should be an overall analysis of the blood. Patients with hypertrophic gingivitis should consult medical specialists appropriate profile (gynecologist, endocrinologist, hematologist, etc.), in some cases require in-depth study of the hormonal status of the patient.
Treatment of chronic hypertrophic gingivitis conducted taking into account the etiologic factors, the morphological patterns and clinical forms of the disease.
When the edematous form of hypertrophic gingivitis treatment begins with anti-inflammatory therapy:
- removal of tooth deposits
- applications of anti-inflammatory and antimicrobial agents
- appointment of an anti-inflammatory physiotherapy (galvanization, electrophoresis, darsonvalization)
With the ineffectiveness of the activities listed in the edematous form of hypertrophic gingivitapokazana sclerotherapy. It is performed by placing the edge of the gums and an introduction to clinical pockets turundas moistened with various sclerosing compounds: 20-30% solution of resorcinol, 10-25% solution of zinc chloride, 5-10% alcohol solution of propolis. At home in the edematous form of hypertrophic gingivitis and mouth rinses appointed bath with a decoction of herbs.
With the ineffectiveness of applicative sclerotherapy in the edematous form of hypertrophic gingivitis resorted to injecting the introduction of papilla of hypertonic solutions such drugs as 10% solution of calcium chloride, 40-60% glucose, 10% solution of calcium gluconate 90% solution of ethanol (deep sclerosing therapy). The introduction of sclerosing funds in the edematous form of hypertrophic gingivitis is performed under anesthesia.
As decongestants in the edematous form of hypertrophic gingivitis are also used steroids, for example, injections in papillae of 0,1-0,2 ml emulsion of hydrocortisone. Effectively as a daily rubbing in the papilla of ointments, which contain glucocorticoid hormones ("Ftorokort", "Lorinden", "Deperzolon", "Gioksizon"). Glucocorticoids can also be used as part of periodontal dressings.
With the ineffectiveness of conservative treatment of the edematous form of hypertrophic gingivitis spend excision of hypertrophied gingival margin - Gingivectomy operation.
Gingivectomy with edematous form of hypertrophic gingivitis is done under anesthesia in 6-8 teeth simultaneously. Excision of hypertrophic gums perform a cut that starts closer to the transition to the crease and obliquely to the sea bottom "false" pocket. In this case, only the outer part of the resected hypertrophied gingival margin.
When the fibrous form of hypertrophic gingivitis demonstrates the use of cytotoxic drugs, such as novembihina: 10 mg dissolved in 10 ml of isotonic sodium chloride solution and injected into the hypertrophic papillae of 0,1-0,2 ml weekly, 3-5 injections per course.
When the fibrous form of hypertrophic gingivitis effective point diathermocoagulation hypertrophied papilla. Surgery for a fibrous form of hypertrophic gingivitis is done under anesthesia. Electrode (the root of the needle) is introduced into the fabric of the papilla at a depth of 3-5 mm. In one session produce coagulation 5-4 papillae.
However, most often with a fibrous form of chronic hypertrophic gingivitis resort to surgical excision of enlarged gums - gingivectomy operations.
In pregnant patients with fibrous form of hypertrophic gingivitis of tooth removed deposits, conduct anti-inflammatory therapy. If postpartum condition of your gums is not normal, use sclerotherapy and surgical methods.
In juvenile (youth), hypertrophic gingivitis sit on the fence, all efforts are focusing on maintaining good hygiene and oral health. Treatment of chronic hypertrophic gingivitis conducted if the pathological changes in the gums do not disappear after puberty.
In leukemia dentists spend only symptomatic treatment of chronic hypertrophic gingivitis. Sclerosing means, physiotherapy and surgical methods of treatment in this situation protivopakazany.
If you have any questions about the diagnosis or treatment of chronic hypertrophic gingivitis, you can specify them with our dentist or dentist on the phone: (903) 167–99–20
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