43year old female patient comes with a complain of swelling in her upper anterior region..gave her medication..today she came..sweling reduce slightly..iopa shows no.periapical pathology. Today did scaling with hex wash on top of it. Gave maledication review in 15days.amy other suggestion is well come and by the way she is not diabetic.

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traumatic occlusion is primary etiology i believe for periodontal lesion. even if symptomatic relief will be given with scaling and antibiotics, the lesion may tend to recur. Thus under antibiotics coverage gingival curettage should be done followed by endodontic treatment with mandibular anteriors. canine to canine intentional rcts for both upper n lower teeth and correction of the bite with FPD. once the overjet and overbite will be corrected posterior bite will also settle. thus giving a long term better prognosis.

yaa doc traumatic occlusion matters hw much we do Rx,frst shud sort out primary etiology
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poor oral hygiene with acute loc.marginal gingivitis.Post IOPA radiographs i m sure there may be severe bone loss wrt.21,11region also 31 looks badly decayed with severe recession gums and anterior crowding also seen.41 is having just root piece i think due to extensive carious crown loss plus 42 is also carious.Remove 31 n 41 first then do a sub gingival scaling n gingival curettage plus if mobile extract 21 also.If no then do gingivectomy and then treat caries accordingly.Start tab.nimarozole 500 mg.plus tab.oflaxacin 500mg. tab.aceclo+serra+para combination,betadine mouth wash also ornidazole oral gel massage plus a good vit.c folic acid and vit.B12 combi tab.FPD from 32 to 42.

Doc i did scaling throughly today and gav her med lets review after 15 Day..she is responding to med's..post op pic vl be presnt after 15 Days
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Gingivitis Periodontal abscess qad 21,11 Traumatic injury Root planning Flap surgery Antibiotics Analgesics Mouthwash Multivitamins

Poor oral hygiene, epulis, advised surgery.

periodontal abcess will be there irt 21 n 11, proper drainage of that is required..IOPA shld be taken at stage..prescribe metronidazole 400 mg n Mox 500mg over a course f 5 days..poor oral hygiene associated with traumatic occlusion..generalised perio pockets will be there seen by a picture..subgingival scaling followed by curettage or flap is required..as bone loss must be there..take opg fr further confirmation.. simultaneously Endo treatment can be started in lower anterior...followed by bite correction n prosthesis..

Nice.point.of view doc
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I totally agree with Dr.Avanti.It is chronic periodontitis due to traumatic occlusion. Ther will be severe bone loss and gingival attachment.Drugs like Ofloxacine and Ornidazole with anti inflammatory drug can be given for a week.Metronidazole gel massage thrice daily after food will help a lot.

its a case of inflammatory gingival hyperplasia due to poor oral hygiene.do thorough supra n subgingival scaling along with gingivectomy with 11 n keep patient on doxycycline drug with 200 mg loading dose n 100 mg bd dose for atleast 14 days

pt s have a pathologic migration and have a false type of gingival enlargement ,I think after deep scaling while giving med metronidazole is very useful and for bone loss perio splinting require ....

traumatic occlusion can be a reason..moreover,hormonal imbalance due to menopause can also be the reason which is all superimposed by poor oral hygiene..try regular mouth wash and topical metrogyl gel application or antibiotic gum paint with vitamin supplements

go for an opg followed by gross scaling followed by perio surgery

why gross scaling. why not complete scaling??
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