Gingival hyperplasia treatment using diode laser gingivectomy in a child with cerebral palsy: case report

Gingival hyperplasia is associated with several factors, such as chronic inflammation due to the large accumulation of biofilm and medications including anticonvulsants. The aim of this study is to report a clinical case of a 4-year-old spastic quadriplegic cerebral palsy patient with gingival hyperplasia in the palatal region of the upper teeth induced by the use of high doses of anticonvulsant medications. The patient attended the Dental Assistance Center for People with Disabilities, with fibrotic gingival hyperplasia in the upper posterior region, covering the dental crowns on the palatal and occlusal surfaces. Oral hygiene instructions were previously carried out using chlorhexidine gluconate solution (0.12%) on the teeth with the aid of a cotton swab, twice a day for seven days, to reduce bacterial plaque levels and control periodontal inflammation. Gingivectomy was performed using a gallium aluminum arsenide diode laser (GaAlAs; 808±10 nm, 2.5 W output power, continuous mode). Following the surgical procedures, photobiomodulation therapy was performed with a low-level aluminum gallium indium phosphide diode laser (InGaAlP; 660±10 nm, 100 mW, 3 J) at three points (anterior, middle and posterior region of surgical wound). The patient returned at 7 and 30 days after surgery presenting accelerated wound healing. It was concluded that the high-level diode laser associated with photobiomodulation therapy were effective for performing a conservative and safe procedure in a patient with severe neurological disorder.

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Treatment Methods Conditioned by the Gravity of Drug-Induced Gingival Hyperplasias

Revista de Chimie ◽

10.37358/rc.17.11.5941 ◽

2017 ◽

Vol 68 (11) ◽

pp. 2618-2622

Author(s):

Alina Mihaela Calin ◽

Mihaela Debita ◽

Raluca Dragomir ◽

Ovidiu Mihail Stefanescu ◽

Cristian Budacu ◽

...

Keyword(s):

Dental Treatment ◽

Histopathological Examination ◽

Transplant Rejection ◽

Surgical Excision ◽

Channel Blockers ◽

Gingival Hyperplasia ◽

Drug Induced ◽

Treatment Methods ◽

Systemic Medication ◽

Bacterial Plaque

The first drug discovered to be involved in the development of gingival hyperplasia is phenytoin, which is indicated in the treatment of epileptic patients. The other drugs are calcium channel blockers with vasodilating effect. The most important one is Nifedipine, while Ciclosporin A, which is used as an immunosuppressant in the prevention of transplant rejection, causes gingival hyperplasia as a secondary effect. Gingival hyperplasia can reach an impressive volume, completely covering the dental crown and affecting the masticatory and physiognomic functions. The elucidation of the mechanism, by which drug-induced gingival hyperplasia occurs, favoring factors and the choice of conservative or surgical treatment methods, emphasizing the prophylactic treatment. The study batch was subject to intraoral and extraoral clinical examinations and the data were included in the dental treatment sheet of each patient, 11 patients aged over 60 years, who came to the Clinic ... in the period 2014-2016. The diagnosis was based on the anamnesis, the clinical aspect of the lesions and the histopathological examination. After the surgical excision of the hyperplasia affected area, recurrence was prevented by dispensarizing the patients and controlling the bacterial plaque through rigorous oral hygiene. Treatment depends on the severity of the lesions, as well as on the physionomic and masticatory functions. Conservative etiological therapy is attempted, by removing the bacterial plaque and local irritant factors, by reducing the dose of drugs, or by changing the systemic medication.

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An evidence-based review of hyperbaric oxygen for children with cerebral palsy

South African Journal of Physiotherapy ◽

10.4102/sajp.v57i4.519 ◽

2001 ◽

Vol 57 (4) ◽

pp. 21-22

Author(s):

F. M. Bischof

Keyword(s):

Cerebral Palsy ◽

Pilot Study ◽

Motor Function ◽

Controlled Trial ◽

Evidence Based ◽

Level Of Evidence ◽

Double Blind ◽

Double Blind Placebo ◽

Children With Cerebral Palsy ◽

High Level

This paper reviews the evidence in the literature for the use of hypebaric oxygen (HBO) in the treatment of cerebral palsy (CP). To date there are only two published studies on the outcome of HBO administration in CP. A pilot study showed significant improvement in gross motor function but provided a low level of evidence. A recent multicentre, double blind, placebo controlled trial reported similar improvements in both HBO and placebo groups, but no difference between the groups. This study had a high level of evidence. The results suggest that participation in the trial produced clinically important gains in function. The outcome of the study implies that HBO may have a placebo effect in CP.

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Parent-Infant Interaction during the First Year of Life in Infants at High Risk for Cerebral Palsy: A Systematic Review of the Literature

Neural Plasticity ◽

10.1155/2019/5759694 ◽

2019 ◽

Vol 2019 ◽

pp. 1-19 ◽

Cited By ~ 5

Author(s):

F. Festante ◽

C. Antonelli ◽

O. Chorna ◽

G. Corsi ◽

A. Guzzetta

Keyword(s):

Cerebral Palsy ◽

High Risk ◽

Family Involvement ◽

Developmental Trajectories ◽

Cochrane Library ◽

High Risk Infant ◽

Neurological Risk ◽

Interactive Behaviors ◽

Early Parent ◽

High Level

Introduction. Perinatal adverse events put neonates at high risk for short and long-term disabilities, including cerebral palsy (CP). The most recent guidelines about early intervention in infants with brain damage have emphasized the importance of family involvement from the very first phases of development. Early parent-infant interactions are pivotal in promoting infant cognitive and social developmental trajectories. However, little is known about the extent to which severe adverse perinatal events can affect the quality of early parent-infant interactions. Patients and Methods. We systematically searched five databases (PubMed, PsycINFO, EMBASE, CINAHL, and Cochrane Library) for the publications assessing parent-infant interactions in infants at high neurological risk within 1 year of age. Articles were selected if they involved direct comparison between high-risk populations and healthy controls or low-risk populations, and if quantitative or semiquantitative tools were used to assess the parent-infant interaction. Measures of parent-infant interaction included infant interactive behaviors, parental interactive behaviors, and dyadic interactive patterns. Results. The search yielded 18 publications that met the inclusion criteria. The articles represent a high level of heterogeneity in terms of infant neurological risk, infant age, and tools assessing interactive behaviors. Both infant and maternal behaviors within the investigated interactive exchanges were reported to be compromised, leading to subsequent overall impairment of the dyadic patterns. Conclusion. While the studies reviewed here provide general and important information, the review did not yield a clear picture of early dyadic interactions in high-risk infant populations. Further observational studies are warranted in order to provide a more accurate knowledge of the early dyadic exchanges between infants at high neurological risk and their parents, as they might provide a critical opportunity for early family centered habilitative interventions.

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Diode laser assisted excision of a gingival pyogenic granuloma: A case report

Clinics and Practice ◽

10.4081/cp.2019.1179 ◽

2019 ◽

Vol 9 (3) ◽

Cited By ~ 2

Author(s):

Dimitrios Andreadis ◽

Ioanna Lazaridi ◽

Eleftherios Anagnostou ◽

Athanasios Poulopoulos ◽

Prashanth Panta ◽

...

Keyword(s):

Diode Laser ◽

Surgical Excision ◽

Pyogenic Granuloma ◽

Complete Healing ◽

Dental Restoration ◽

Maxillary Molar ◽

Oral Site ◽

Bacterial Plaque ◽

A Minor

exuberant, reactive lesion seen in response to local irritation or trauma caused by dental calculus, bacterial plaque, caries and restorations, with a strong predilection for the gingiva. It is among the frequently encountered oral lesions, occurring at a challenging oral site, the gingiva. Herein, we report a 71-year-old medically compromised Caucasian female who presented with a relatively large lobulated pyogenic granuloma on the buccal gingiva of the maxillary molar-premolar region. Total surgical excision was performed with an 840nm diode laser followed by the placement of hyaluronate gel and relevant periodontal dressing. Two weeks after surgical excision, complete healing was observed, but patient denied replacement of dental restoration. After 4 months of follow-up, an overall reduction of associated teeth mobility was also observed, with a minor recurrence in gingival inflammation. The objective of this report is to briefly review clinical, radiographic and histological findings of pyogenic granuloma along with a detailed discussion on its management through a diode laser.

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Finite Element Analysis of Provisional Structures of Implant-Supported Complete Prostheses

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-11-00188 ◽

2014 ◽

Vol 40 (2) ◽

pp. 161-168 ◽

Cited By ~ 2

Author(s):

Bruno Albuquerque Carneiro ◽

Rui Barbosa de Brito ◽

Fabiana Mantovani Gomes França

Keyword(s):

Finite Element ◽

Stress Distribution ◽

Three Dimensional ◽

Axial Loading ◽

Acrylic Resin ◽

Safe Procedure ◽

Element Analysis ◽

Posterior Teeth ◽

Occlusal Surfaces ◽

Three Dimensional Finite Element

The use of provisional resin implant-supported complete dentures is a fast and safe procedure to restore mastication and esthetics of patients soon after surgery and during the adaptation phase to the new denture. This study assessed stress distribution of provisional implant-supported fixed dentures and the all-on-4 concept using self-curing acrylic resin (Tempron) and bis-acrylic resin (Luxatemp) to simulate functional loads through the three-dimensional finite element method. Solidworks software was used to build three-dimensional models using acrylic resin (Tempron, model A) and bis-acrylic resin (Luxatemp, model B) for denture captions. Two loading patterns were applied on each model: (1) right unilateral axial loading of 150 N on the occlusal surfaces of posterior teeth and (2) oblique loading vector of 150 N at 45°. The results showed that higher stress was found on the bone crest below oblique load application with a maximum value of 187.57 MPa on model A and 167.45 MPa on model B. It was concluded that model B improved stress distribution on the denture compared with model A.

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Perawatan Kuretase Gingiva Gigi Anterior pada Periodontitis: Laporan Kasus

e-GIGI ◽

10.35790/eg.9.1.2021.32932 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Johanna A. Khoman ◽

Miranti A. Minanga

Keyword(s):

Oral Hygiene ◽

Chronic Periodontitis ◽

Systemic Disease ◽

Tooth Surface ◽

Periodontal Inflammation ◽

Root Planing ◽

Probing Depth ◽

Index Measurement ◽

Region I ◽

Bacterial Plaque

Abstract: In general, periodontal disease is caused by bacterial plaque on the tooth surface. Bacterial elimination by curettage will reduce periodontal inflammation. This case report was aimed to review the immune response to chronic periodontitis as well as case management with curettage. We reported a 22-year-old female patient came to the Dental and Oral Hospital of University of Sam Ratulangi (Unsrat) with complaints of swollen front gum, frequent gum bleeding, and gum bleeding during tooth brushing. The gum bleeding had occurred since 6 months ago. Tartar cleaning was performed on her three weeks ago. Based on anamnesis, the patient did not suffer from any systemic disease. Intraoral examination revealed that there were reddish gingiva, swelling in region I, II, III, and IV, and probing depth of teeth 21-25 with a mean of 4 mm. Oral Hygiene Index measurement obtained a value of 1.7 (medium category). This case was diagnosed as chronic periodontitis. The treatment consisted of scaling, irrigation with NaCl solution and aquadest, root planing, gingival curettage, and periodontal pack application. At the first control (one week after gingival curettage), the patient did not complain of any pain on the curettage area, periodontal pack was loose. The objective examination still revealed redness, debris, and calculus, OHI-S: 0,8+0,3=1,1 (good category). The prognosis was good since the patient was cooperative, did not have any systemic disease, and had high motivation to maintain oral hygiene.Keywords: curettage, chronic peridontitis Abstrak: Secara umum penyakit periodontal disebabkan oleh bakteri plak pada permukaan gigi. Eliminasi bakteri dengan kuretase akan menurunkan peradangan periodontal. Laporan kasus ini bertujuan untuk menjelaskan respon imun terhadap penyakit periodontitis kronis serta penatalaksanaan kasus dengan kuretase. Kami melaporkan kasus seorang pasien perempuan berusia 22 tahun datang ke Rumah Sakit Gigi dan Mulut Pendidikan Universitas Sam Ratulangi (Unsrat) dengan keluhan gusi bagian depan bengkak, gusi sering berdarah, dan perdarahan gusi saat menyikat gigi. Gusi berdarah sejak sekitar 6 bulan lalu dan pasien melakukan pembersihan karang gigi sekitar 3 minggu lalu. Dari hasil anamnesis didapatkan bahwa pasien tidak mempunyai riwayat penyakit sistemik. Pada pemeriksaan intraoral terdapat gingiva berwarna kemerahan dan pembengkakan di region I, II, III, IV, probing depthgigi 21-25 dengan rerata sebesar 4 mm. Hasil pengukuran Oral Hygiene Index(OHI) ialah 1,7 (kategori sedang). Diagnosis klinis kasus ini ialah periodontitis kronis. Tindakan yang dilakukan ialah scaling, irigasi dengan NaCl dan akuades, root planing, kuretase gingiva, dan pemasangan periodontal pek. Kontrol pertama dilakukan satu minggu pasca kuretase gingiva, dan pada pemeriksaan subjektif pasien tidak mengeluhkan rasa nyeri di daerah yang telah dilakukan kuretase gingiva, pek periodontal sudah terbuka malam hari pasca kuretase gingiva. Pemeriksaan objektif gingiva masih kemerahan, terdapat debris dan kalkulus, OHI-S: 0,8+0,3=1,1 (kategori baik). Prognosis baik karena pasien kooperatif, tidak memiliki riwayat penyakit sistemik, dan memiliki motivasi yang tinggi untuk menjaga kebersihan rongga mulut.Kata kunci: kuretase; peridontitis kronis

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Assessment of adaptation of children of younger school age with cerebral palsy to occupations at correctional school

Pediatrician (St Petersburg) ◽

10.17816/ped9255-66 ◽

2018 ◽

Vol 9 (2) ◽

pp. 55-66

Author(s):

Olga P. Ponomareva ◽

Galina A. Suslova

Keyword(s):

Quality Of Life ◽

Elementary School ◽

Cerebral Palsy ◽

Educational Institution ◽

Psychomotor Development ◽

Medical Psychology ◽

School Age ◽

Low Level ◽

High Level

Formation of a school maturity at children of younger school age is the main objective of modern education. Special attention in the last decades is paid to children with disturbances of a musculoskeletal system, in particular, to children with the cerebral palsy (CP). Such children study at special correctional schools which prepare the pupils for independent life and work in society. Research objective: to estimate adaptation of children of younger school age with cerebral palsy to occupations at correctional school. Materials and methods. 75 children with the diagnosis are examined: Cerebral palsy, spastic diplegia mild or moderate severity, delay of psychomotor development, pseudobulbar dysarthtia. All children studied in state-funded educational institution for children with limited opportunities of health special (correctional) comprehensive school (the IV look) No. 584 "Ozerki" of Vyborgsky district of St. Petersburg (school No. 584 "Ozerki"). The age of children was from 7 to 11 years. The following indicators were estimated: quality of life of children by means of the questionnaire of PedsQL for category of children of 8-12 years, electroencephalogram indicators, the neurologic status, extent of disturbance of the speech. Children were examined by the neurologist, the psychologist and the logopedist. Results. 72% of children had the average and low level of adaptation. According to classification by L.A. Wagner (1989), “the low level” of adaptation prevailed at boys (42.2%) (the negative relation to school, suppressed mood, frequent complaints to an illness). “High level” also dominated at boys (33.4%) while at girls “the high level” of adaptation was observed only at 6 people (20%). Clinical inspection taped that at children the hyper excitability syndrome prevailed (at boys – 51.2%, girls – 63.3%). Also it was noticed that extent of disturbance of the speech depends on degree of a lesion of the central nervous system and also on age and sex features. The quality of life of children of elementary school is reduced. In scales of the questionnaire of PedsQL “physical functioning”, “emotional functioning”, “life at school” points don’t exceed 50. Only in a scale “social functioning” an indicator more than 70 points. Conclusions. The complex rehabilitation including the medical, psychology and pedagogical and logopedic care is necessary for children of elementary school of school No. 584 “Ozerki”.

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Prophylactic photobiomodulation therapy using 660 nm diode laser for oral mucositis in paediatric patients under chemotherapy: 5-year experience from a Brazilian referral service

Lasers in Medical Science ◽

10.1007/s10103-020-03060-9 ◽

2020 ◽

Vol 35 (8) ◽

pp. 1857-1866

Author(s):

Laiz Fernandes Mendes Nunes ◽

José Alcides Almeida de Arruda ◽

Alessandra Figueiredo Souza ◽

Raíssa Cristina Costa Silva ◽

Célia Regina Moreira Lanza ◽

...

Keyword(s):

Diode Laser ◽

Oral Mucositis ◽

Photobiomodulation Therapy ◽

Referral Service ◽

Paediatric Patients

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Evaluation of gingival hyperplasia caused by medications (Preprint)

10.2196/preprints.12283 ◽

2018 ◽

Author(s):

Ilma Robo

Keyword(s):

Oral Cavity ◽

Growth Index ◽

Gingival Hyperplasia ◽

Inclusion Criteria ◽

Clinical Appearance ◽

Routine Work ◽

Horizontal Growth ◽

Bacterial Plaque ◽

Patient’S History ◽

Bacterial Index

BACKGROUND Drug gingival hyperplasia is an uncommon pathology encountered during routine work in dental units. OBJECTIVE The purpose of this topic is to present the clinical appearance of gingival hyperplasia caused by medications. There are already three classes of medications that cause hyperplasia and based on data from the literature, the clinical cases encountered and included in this study have been compared. METHODS The study was conducted in a total of 311 patients, out of which 182 patients were included in our study, meeting the inclusion criteria. After each patient's history was recorded and it was found that patients were in their knowledge of chronic illness, undergoing treatment of gingivitis hypertrophic drugs was performed with a clinical examination of oral cavity and assessment by the Vertical Growth Index (GOI) and horizontal for hypertrophy and the index of bacterial plaque. RESULTS Of the data collected during the study, it was observed that 97% of patients with gingival hyperplasia are treated with nifedipine. 84% of patients treated with selected medicines and gingival hyperplasia in the oral cavity have been exposed at period of time for more than 1 year and 1 month. According to the GOI index, in the first rank of this index are about 21% of patients, in the second rank are 52%, in the third rank are 24% and in the fourth grade are 3%. According to the horizontal growth index of gingival hyperplasia, grade 1 included about 61% of patients and grade 2 included about 39% of patients with gingival hyperplasia. Bacterial index divides patients by degrees: grading 0 - 8.2%, grading 1 - 32.4%, grading 2 - 14% and grading 3 - 45.1%. CONCLUSIONS The highest percentage of gingival hyperplasia caused by drugs is due to dosing of nifedipine for a duration of dosing and application for systemic healing for more than 1 year. CLINICALTRIAL -

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339 Outcome of Tibial Selective Motor Fasiculotomy in the Management of Equinovarus Deformity Due to Cerebral Palsy (A Prospective Cohort Study in 14 Children)

Neurosurgery ◽

10.1093/neuros/nyx417.339 ◽

2017 ◽

Vol 64 (CN_suppl_1) ◽

pp. 276-276

Author(s):

Pavankumar Pelluru ◽

Aneelkumar Pulugopu ◽

Aniruddhkumar Purohit ◽

Naveenkumar Balane

Keyword(s):

Cerebral Palsy ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Lower Limbs ◽

Safe Procedure ◽

Plantar Flexors ◽

Motor Abilities ◽

Modified Ashworth Scale

Abstract INTRODUCTION Tibial Selective Motor fasiculotomy involves ablation of hyperexcitable tibial nerve fasicles, which help in reduction of spasticity in ankle plantr flexors METHODS This prospective cohort study included 14 children with cerebral palsy, age ranging from 5–18 (mean 10.21) years and M: F ratio is 5:1 having spasticity in the lower limbs. All the children were assessed pre and post operatively by Modified Ashworth Scale (MAS), Selective Voluntary Control (SVC) grade and locomotor Abilities (kneel walking, squat to stand, standing and walking). Tibial SMF was performed (n = 23) for relief of spasticity in ankle plantar flexors in 14 children and were followed for a mean of 30 (6-60) months. All the children were given physical therapy pre and post operatively. RESULTS >During a mean follow up (30 months) there was statistically significant reduction in spasticity (MAS, P < 0.005) from1.92 to 0.31 in ankle plantar flexors. Pre and post operative SVC grade also improved from 2.65 to 3.35 in ankle plantar flexors (p > 0.005). There were no complications and spasticity did not recur during follow up. 9 children required Z plasty simultaneously to relieve the contracture. CONCLUSION The Tibial SMF of tibial nerves significantly relieves spasticity in the ankle plantar flexors and thereby improves SVC equinous deformity and motor abilities in children having cerebral palsy. It is quite a safe procedure and the spasticity does not recur during a mean follow up of 30 months.

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