Enlargement of the gingival caused by phenytoin. An anticonvulsant used in the treatment of epilepsy, occurs in some of the patients receiving the drug. Its incidence varies from 3 to 62 percent, with the greater frequencies in younger patients. The hyperplasia is usually generalized throughout the mouth, but is more severe tendency in the maxillary and mandibular anterior regions. 18 year old male patient was admitted to our Department of Dentistry with the complaint of generalized painless gingival swelling. After the consult of the N.M. and laboratory study, the gingivectomy and gingivoplasty was performed. The periodontal pack and tin foil was applied on the attached gingival to protect a surgical site and bleeding control. We obtained a good result of improved esthetics and function.
Dentistry ; Epilepsy ; Esthetics ; Gingival Hyperplasia* ; Gingivectomy ; Gingivoplasty ; Hemorrhage ; Humans ; Hyperplasia ; Incidence ; Male ; Mouth ; Phenytoin* ; Tin

OBJECTIVE: To evaluate the clinical outcomes of vestibular incision subperiosteal tunnel access (VISTA) with connective tissue graft (CTG) in the treatment of Miller classes I and II localized gingival recession. METHODS: Ten patients with 10 Miller classes I and II localized gingival recessions were enrolled in the study. All defects were equal to or above 2 mm in recession depth. All the patients received treatment with VISTA+CTG. Their clinical parameters, including recession depth (Rec), recession width (RW), keratinized tissue width (KT), clinical attachment loss (CAL), probing depth (PD) were recorded and compared before surgery and 6 months later. The mean root coverage (MRC) and complete root coverage (CRC) were calculated at the end of 6 months. A visual analogue scale (VAS) was used to estimate the patients' discomfort during the operation and during the 2 weeks post-operation. Patient-based aesthetic satisfaction 6 months after surgery was evaluated by a VAS. RESULTS: The mean Rec was (2.65±0.82) mm at baseline, and (0.35±0.58) mm after 6 months. The VISTA+CTG treatment resulted in an improvement of (2.30±0.98) mm in recession depth (P<0.001). MRC was 86.67%±21.94% and CRC reached 70% at the end of 6 months. KT increased (0.90±1.22) mm (P<0.05). Aesthetic satisfaction on the patients' level was 8.30 based on VAS (0=unsatisfied, 10=extremely satisfied). The patients' discomfort during the operation and 2 weeks post operation were 2.40 and 4.30 (0=no pain, 10=extreme pain). Furthermore, clinical outcomes showed no statistically significant difference between the gingival biotypes, and between the teeth positioned in maxillary and in mandibular. CONCLUSION VISTA+CTG could be an effective treatment for Miller classes I and II localized gingival recession. Clinical outcomes indicated decrease in recession depth and width, and increase in width of keratinized tissue. Patients suffered little pain during the operation and 2 weeks post-operation of healing and accessed good aesthetic satisfaction. VISTA+CTG could be an option for the treatment of Miller classes I and II localized gingival recession.
Connective Tissue ; Gingiva ; Gingival Recession ; Gingivoplasty ; Humans ; Tooth Root ; Treatment Outcome

Humans ; Gingival Recession/surgery* ; Gingivoplasty/methods* ; Connective Tissue/transplantation* ; Treatment Outcome ; Gingiva/transplantation* ; Tooth Root