Fogorvosi szemle, 2006 (99. évfolyam, 1-6. szám)
2006-04-01 / 2. szám
68 FOGORVOSI SZEMLE «99. évf. 2. sz. 2006. DR. I. GERA, DR. D. TIHANYI, DR. P. ROSTA Semmelweis University, Faculty of Dentistry, Dept. Periodontology, Budapest SURGICAL CORRECTION OF HEREDITARY GINGIVAL FIBROMATOSIS - CASE SERIES Introduction: The heredity gingival fibromatosis is a very rare disorder inherited by an autosamal dominant or recessive trait. The exact locus on the chromosome being responsible for the disorder is still unknown. Its occurrence is below 0.001 percent according to the epidemiological data. It mostly develops during the period of primary dentition and might cause problems in the course of tooth eruption and can lead to occlusal anomalies. Their treatment is definitively surgical but too early operations can lead to rapid recurrence. Conventional gingivectomy was preferred in the past, but today mostly reversed beveled gingivectomy techniques are used with better predictability and primary healing intentions. Cases: Three cases of young individuals with severe gingival overgrowth are presented. The first case was corrected with conventional gingivectomy techniques more than two decades before. It ended up with relatively delayed healing but rather acceptable gingival marginal contour and aesthetics. The second case was first detected at the age of 7 and followed up for over another 7 years. During this time period the exfoliation of the primary teeth were assisted, and some oral hygienic control was provided. Because of patient’s young age the surgery was postponed till the rapid phase of the skeletal development should finish. At the age of 13.5 the excessive mass of fibrotic tissue in the maxilla was removed by internal beveled incision and the palatal and buccal gingival flaps were united with sutures resulting in uneventful healing in ten days. The less severe mandibular hyperplasia and orthodontic problems are still to be corrected in the not so far future. The third case is a 18 years old adult who had been orthodontically treated for more than 1.5 years to extrude his teeth without any success before he came to our clinic. The radiographic examination proved that the teeth were fully erupted in the alveolar bone, but submerged in the hyperplastic mass of gingival tissue. The gingival correction in both arches was performed by internal beveled reverse excisions. Results and discussion: The treatment of gingival fibromatosis is definitely surgery. Today the more conservative internal beveled incision is preferred over the conventional gingivectomy providing more predictable healing and better aesthetics. The timing of the surgery is critical to avoid recurrences. It is not recommended to perform operation before the age of 13-14 due to the greater risk for recurrences. Postoperatively all patients need perfect plaque control and comprehensive orthodontic rehabilitation. , DR. I. GORZÓ University of Arts and Sciences, School of Dentistry and Oral Surgery, Szeged FROM SIMPLE GINGIVITIS TO SYSTEMIC DISEASES The inflammatory process defends the body in general, but at certain circumtances it can cause more damage to the host than benefit (for example: rheumatoid arthritis, glomerulonephritis, vasculitis, atherosclerosis, periodontitis, ect.). During the last 15 years it has become clear that periodontal inflammation can play a role in the initiation and worsening of the systemic diseases. The localized inflammation (acute and chronic as well) can cause diseases in distant organs in 3 ways: 1. metastasis infection by the bacteremia; 2. metastatic injury by the bacterial toxins; and 3. metastatic inflammation by different immuno-inflammatorical pathomechanisms. Several studies published supporting a modest association between periodontal disease and certain internal diseases such as myocardial infarction, stroke, adverse pregnancy outcomes, diabetes mellitus and chronic obstructive pulmonary diseases. Every day increases the number of evidences of laboratory and epidemiologic examinations which support the association between poor oral health and systemic diseases. What can prove this above mentioned association? 1. Consistency of association 2. Strength of association 3. Specificity of association 4. Right time sequence 5. Frequency of exposure 6. Biological plausibility 7. Supporting experimental evidences A number of data support a cause and effect association between periodontitis and some systemic conditions. DR. SZ. GYULAI GAÁL, DR. B. KÁDÁR, DR. B. NÉMETH Semmelweis University, Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Budapest TRAUMATISED UPPER FRONT TEETH. TREATMENT POSSIBILITIES The treatment of traumatisized front teeth are one of the recurrent problems of dental surgery. There are methods of treatment which were used in the past and are still used. These are tooth extraction, replantation, transdental fixation and implant placement.
