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Int Poster J Dent Oral Med 9 (2007), No. 2     15. June 2007

Int Poster J Dent Oral Med 2007, Vol 9 No 02, Poster 363

Effect of full-mouth-disinfection in the treatment of drug-induced gingival overgrowth

Language: English

Authors:
Dr. Joerg K. Krieger, Dr. Diana M. Krigar
Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg
Prof. Dr. Peter Eickholz
Department of Periodontology, Center for Dental, Oral and Maxillofacial Medicine, University Hospital Frankfurt
Dr. Bettina Dannewitz
Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg
Department of Periodontology, Center for Dental, Oral and Maxillofacial Medicine, University Hospital Frankfurt

Date/Event/Venue:
29, 30 June and 1 July 2006
Europerio 5
Madrid

Introduction

Several drugs, such as cyclosporin A (CsA), calcium channel blockers and phenytoin can cause gingival overgrowth (GO). The traditional periodontal therapy of GO comprises professional tooth cleaning and surgical reduction of the overgrown gingival tissue.

Objectives

The clinical effects of non-surgical periodontal therapy according to the concept of full-mouth-disinfection (FMD) was evaluated retrospectively in patients with drug-induced GO.

Material and Methods

Fig.1: Patient (female) with drug-induced (CsA) gingival overgrowth; clinical situation at baseline Fig.2: Same patient as shown in fig.1: clinical situation 2 months after full-mouth-disinfection

Fig.3: Same patient as shown in fig.1: clinical situation 6 months after full-mouth-disinfection Fig.4: Same patient as shown in fig.1: clinical situation 22 months after full-mouth-disinfection

Patients

  • 10 patients (7 female), age between 32 and 73 years
  • medicated with CsA and/or calcium channel blockers

Treatment

  • all patients received antiinfective therapy (AT), including oral hygiene instructions, professional tooth cleaning followed by subgingival scaling and root planning (SRP) of all quadrants within 24 hours according to the concept of "full-mouth-disinfection" (FMD)
  • After AT patients rinsed with 0.12% CHX solution and brushed with 1% CHX gel for the following 2 weeks

Clinical examinations

  • plaque control record (PCR), gingival bleeding index (GBI), probing pocket depth (PD) were recorded at baseline, reevaluation and the last supportive periodontal therapy (SPT) visit
  • at 6 sites per tooth (mb, b, db, do, o, mo) PD, using a rigid periodontal probe (PCPUNC 15, Hu Friedy, Chicago IL, USA) at baseline and reevaluation and SPT
  • reevaluation of the clinical situation approximately 4 months after FMD

Reevaluation

  • after completion of FMD, 9 patients were assigned to SPT and monitored for a mean of 24 months
  • 1 patient received further periodontal surgery (flap surgery including gingivectomy)

Statistical analysis

  • PD sites were stratified as follows: ≤ 4mm, 5-6 mm and ≥ 7mm

 

Results

Results I

  • the number of sites with PD ≤ 4mm was increased significantly after FMD (56.5 to 97.4%)
  • concomitantly sites with 5-6 mm and ≥ 7mm decreased in the same interval (27.1 to 2.2%, 16.4 to 0.4% respectively)
  • PCR and GBI also declined significantly compared to baseline
  • all clinical variables remained stable over SPT
  • further surgical therapy was only necessary in one case

Results II

Tab.1: Clinical parameters (PD at baseline, reevaluation, last SPT)

Results III

Tab.2: Clinical parameters (GBI/PCR)

Conclusions

Conclusion FMD and regular SPT were effective in resolving inflammation and reducing the need for further surgical treatment in patients with drug-induced gingival overgrowth. The clinical situation remained stable over the average follow-up period of 24 months.

 

This Poster was submitted by Dr. Joerg K. Krieger.

Correspondence address:
Dr. Joerg K. Krieger
Section of Periodontology
Department of Conservative Dentistry
Clinic for Oral, Dental and Maxillofacial Diseases
University Hospital Heidelberg
INF 400
D-69120 Heidelberg