16year female pt.with complaint of pain&itching in gingiva

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Gingival enlargement can be induced by three main causes (1) inflammation, (2) medication, and (3) systemic disease. 1.....gingival enlargement is typically caused by biofilm (bacteria) and the host response, resulting in familiar forms of periodontal disease such as gingivitis and periodontitis. Swelling, erythema, and bleeding are signs of these diseases  2....Medication-induced (drug-induced) gingival enlargement can be caused by certain classes of drugs... Anticonvulsants (phenytoin, phenobarbital, lamotrigine, vigabatrin, ethosuximide, topiramate, and primidone) Antihypertensives (calcium channel blockers such as nifedipine, amlodipine, and verapamil) Immunosuppressant (cyclosporine) 3...Hormonal changes associated with pregnancy or puberty and vitamin deficiencies (mostly vitamin C) are some of the more common causes TREATMENT The first line of treatment is most often noninvasive and includes the discontinuation of any offending medication, treatment of the systemic disease, institution of good home care, and nonsurgical mechanical debridement. If these methods are ineffective, surgical treatment is warranted.  1. Laser excision to remove inflamed gum tissue 2.. Electrosurgery 3.. Periodontal flap surgery 4.. Gingivectomy
Scaling and root planing A scaling and root planing procedure is to be considered effective if the patient is subsequently able to maintain their periodontal health without further bone or attachment loss and if it prevents recurrent infection with periodontal pathogens. The long term effectiveness of scaling and root planing depends upon a number of factors. These factors include patient compliance, disease progress at the time of intervention, probing depth, and anatomical factors like grooves in the roots of teeth, concavities, and furcation involvement which may limit visibility of underlying deep calculus and debris
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GINGIVECTOMY is the First Line of Treatment .... Followed by .....Tab Metrogyl , Tab Amoxiclav 625 , Tab Ibu+ Paracetamol ....and Tab Serratiopeptidase 10 , Cap Zevit ......for 5 days. After healing of the operated gingiva ..... Proper Periodontal and Orthodontic Treatment
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First and foremost rule out any h/o medication which causes gingival enlargement, provide oral prophylaxis and OHI, recall and observe the healing. In case traumatic bite or malocclusion is the prime cause provide treatment accordingly. If still no improvement then check for any systemic cause of inflammation and enlargement.
Typical case of puberty gingivitis......(if possible ask for gynae history and haemoglobin check ) go for scaling and polishing..... precribe tab. metronidazole 400mg TDs and tab.lyser-d 1 tds for 5days .....warm saline rinses and vit.c rich diet.....
My diagnosis is ANUG due to TFO And treatment plan is Supra as well as sub gingival scaling Rx Doxicycline i.e DOXT SL B.D for 7 days. Multivitamin with antioxidant i.e Zenron -L Gum paint Gumex/Stolin Follow up after 7 days.
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Scaling, root planing, oral hygiene instructions, mouth wash, gum paint, follow up, if still doesn't resolve than gingivectomy would be the only option...
It is anterior traumatic bite case causing swelled lower anterior teeth gingiva.for permanent ramedy traumatic bite should be cured
Does she have systemic diseas ? Dx : plaque induced gingivitis Tx : scaling and root planing OHI
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plaque induced gingivitis scaling and root planing or antibiotic or mouthwash
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