Omar Rahim
Introduction: Puberty associated gingival enlargement is one of the gingival diseases categorized as dental plaque induced gingival diseases modified by endocrine system, in the currently accepted periodontal disease classification. Usually, a conventional periodontal therapy comprising oral prophylaxis, scaling and root planning is sufficient to treat the condition. However, in some cases where there is more amount of fibrotic tissue along with the inflammation, occurring to surgical means is a key to management success. Aim: The purpose of this study is to report a typical presentation of generalized gingival enlargement associated with puberty and highlight the importance of taking an accurate history in achieving a correct diagnosis and improving a best therapeutic approach to restore aesthetic and masticatory functions.
Methods: A seventeen-year-old female patient was referred to periodontology service at Mustapha Algiers University Hospital Center for assessment and treatment of generalized gingival enlargement. According to the medical history which revealed that gums had started swelling up in concomitance with the first menstruations, we associated the clinical features to the hormonal influences occurring in puberty. The swelling was not appeared to be associated with hereditary forms.
Results: On intraoral examination, a reddish pink bulging of the interproximal papillae with blunt and rounded marginal gingiva was seen on the facial surface extending from the mesial surface of #31 to mesial surface of #41. It was spineless, friable and edematous There was a presence of marginal plaque and false periodontal pockets with bleeding on probing. Motivation and professional plaque control associated to the classical non-surgical periodontal treatment was performed. Hence to accomplish an aesthetic and functional outcome, surgical reduction of the overgrowth was performed by conventional gingivectomy and wound area was covered with periodontal pack for 1 week. The patient was recalled periodically at 1 week, 2 weeks and 1 month, during maintenance phase to assess the healing. After one month, the patient had an aesthetically satisfactory gingival appearance and no sign of recurrence.
Conclusions: At the sexual maturation period the exaggerated response of the gingival tissues to plaque and hormonal influence in microbial flora leads to gingival growth. In the present case, gingivectomy was the treatment of choice after a nonsurgical periodontal management. Patient-reported outcomes were satisfaction and approved aesthetic smile.