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Questions and Answers
What is NOT a precise description of gingival enlargement?
What is NOT a precise description of gingival enlargement?
What condition involves an accumulation of collagenous connective tissue?
What condition involves an accumulation of collagenous connective tissue?
What is characterized by an abnormally large amount of fluid in the intercellular spaces?
What is characterized by an abnormally large amount of fluid in the intercellular spaces?
What does NOT contribute to gingival enlargement, but can appear as an increase in size because of underlying osseous or dental tissues?
What does NOT contribute to gingival enlargement, but can appear as an increase in size because of underlying osseous or dental tissues?
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What type of enlargement is associated with systemic diseases, like diabetes?
What type of enlargement is associated with systemic diseases, like diabetes?
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What describes the location of gingival enlargement that involves the gingiva throughout the mouth?
What describes the location of gingival enlargement that involves the gingiva throughout the mouth?
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What is the classification of gingival enlargement when it is confined to the gingival margins?
What is the classification of gingival enlargement when it is confined to the gingival margins?
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What is the classification of gingival enlargement that is limited to the gingiva adjacent to a single tooth or group of teeth?
What is the classification of gingival enlargement that is limited to the gingiva adjacent to a single tooth or group of teeth?
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What is the clinical term for an isolated enlargement of the gingiva, like an abscess?
What is the clinical term for an isolated enlargement of the gingiva, like an abscess?
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Which of the following is NOT a characteristic of Drug Induced Gingival Overgrowth (DIGO)?
Which of the following is NOT a characteristic of Drug Induced Gingival Overgrowth (DIGO)?
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According to the content, what can exacerbate Drug Induced Gingival Overgrowth (DIGO)?
According to the content, what can exacerbate Drug Induced Gingival Overgrowth (DIGO)?
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What does the term 'Diffuse' refer to in the context of gingival enlargement?
What does the term 'Diffuse' refer to in the context of gingival enlargement?
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What is the scoring guide for gingival enlargement used for?
What is the scoring guide for gingival enlargement used for?
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What is the main focus of the discussion in the content?
What is the main focus of the discussion in the content?
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Gingival enlargement that is confined to the interdental papilla is classified as:
Gingival enlargement that is confined to the interdental papilla is classified as:
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Which of the following is considered a FALSE enlargement, according to the content?
Which of the following is considered a FALSE enlargement, according to the content?
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What is the primary symptom of gingival overgrowth?
What is the primary symptom of gingival overgrowth?
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When does gingival overgrowth typically occur?
When does gingival overgrowth typically occur?
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What is a common characteristic of gingival overgrowth?
What is a common characteristic of gingival overgrowth?
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What distinguishes gingival overgrowth from gingival hyperplasia?
What distinguishes gingival overgrowth from gingival hyperplasia?
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What is the primary aim of the lecture on gingival overgrowth?
What is the primary aim of the lecture on gingival overgrowth?
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Why is it important for clinicians to be aware of gingival overgrowth?
Why is it important for clinicians to be aware of gingival overgrowth?
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What is a potential management strategy for patients presenting with gingival overgrowth?
What is a potential management strategy for patients presenting with gingival overgrowth?
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Why is it important to understand the causative factors of gingival overgrowth?
Why is it important to understand the causative factors of gingival overgrowth?
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Which group of drugs is primarily associated with Drug Induced Gingival Overgrowth (DIGO)?
Which group of drugs is primarily associated with Drug Induced Gingival Overgrowth (DIGO)?
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What is the most common immunosuppressant associated with DIGO?
What is the most common immunosuppressant associated with DIGO?
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How long after the initiation of Anti Convulsant medication does DIGO become clinically noticeable?
How long after the initiation of Anti Convulsant medication does DIGO become clinically noticeable?
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Which of the following conditions is the least likely to be treated with Anti Convulsants?
Which of the following conditions is the least likely to be treated with Anti Convulsants?
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What percentage of patients taking Anti Convulsant medication may present with DIGO?
What percentage of patients taking Anti Convulsant medication may present with DIGO?
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What characteristic change is noted in the gingiva when treated with immunosuppressants?
What characteristic change is noted in the gingiva when treated with immunosuppressants?
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What is the maximum severity timeline for DIGO after starting Anti Convulsant treatment?
What is the maximum severity timeline for DIGO after starting Anti Convulsant treatment?
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Which Anti Convulsant medication is NOT listed as causing DIGO?
Which Anti Convulsant medication is NOT listed as causing DIGO?
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Which surface is gingival overgrowth more prominent when induced by Ciclosporin?
Which surface is gingival overgrowth more prominent when induced by Ciclosporin?
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What is a potential effect when Ciclosporin is combined with Amlodipine or Nifedipine?
What is a potential effect when Ciclosporin is combined with Amlodipine or Nifedipine?
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Which medical condition is associated with the use of Tacrolimus?
Which medical condition is associated with the use of Tacrolimus?
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What type of morphology does calcium channel blocker induced gingival overgrowth typically exhibit?
What type of morphology does calcium channel blocker induced gingival overgrowth typically exhibit?
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Which drug is NOT associated with the treatment of angina?
Which drug is NOT associated with the treatment of angina?
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Which of the following conditions is NOT treated by Sirolimus?
Which of the following conditions is NOT treated by Sirolimus?
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What is the primary clinical concern associated with drug-induced gingival overgrowth (DIGO)?
What is the primary clinical concern associated with drug-induced gingival overgrowth (DIGO)?
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In which region of the gingiva does gingival overgrowth induced by calcium channel blockers typically appear?
In which region of the gingiva does gingival overgrowth induced by calcium channel blockers typically appear?
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Flashcards
Gingival Overgrowth
Gingival Overgrowth
Proliferation and enlargement of the gingiva, often drug-induced.
Chronic Overgrowth
Chronic Overgrowth
A slowly progressing increase in the size of gingiva that is painless.
Causes of Overgrowth
Causes of Overgrowth
Potential factors leading to gingival overgrowth include medications and systemic diseases.
Hyperplasia vs Enlargement
Hyperplasia vs Enlargement
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Clinical Features
Clinical Features
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Assessment Measures
Assessment Measures
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Management Recommendations
Management Recommendations
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Spontaneous Disappearance
Spontaneous Disappearance
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Hyperplasia
Hyperplasia
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Hypertrophy
Hypertrophy
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Fibrosis
Fibrosis
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Oedema
Oedema
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Localized Gingival Enlargement
Localized Gingival Enlargement
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Generalized Gingival Enlargement
Generalized Gingival Enlargement
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Marginal Gingival Enlargement
Marginal Gingival Enlargement
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Inflammatory Enlargements
Inflammatory Enlargements
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Papillary
Papillary
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Discrete
Discrete
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Diffuse
Diffuse
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Gingival enlargement scoring guide
Gingival enlargement scoring guide
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Drug Induced Gingival Overgrowth (DIGO)
Drug Induced Gingival Overgrowth (DIGO)
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Genetic predisposition
Genetic predisposition
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Plaque presence
Plaque presence
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Gingival inflammation
Gingival inflammation
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Anti Convulsants
Anti Convulsants
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Phenytoin
Phenytoin
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Immunosuppressants
Immunosuppressants
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Ciclosporin
Ciclosporin
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DIGO severity timeline
DIGO severity timeline
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Tacrolimus
Tacrolimus
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Incidence rate of DIGO
Incidence rate of DIGO
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Gingival overgrowth with Ciclosporin
Gingival overgrowth with Ciclosporin
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Calcium Channel Blockers
Calcium Channel Blockers
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Gingival Overgrowth with Calcium Channel Blockers
Gingival Overgrowth with Calcium Channel Blockers
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Medical conditions for Amlodipine
Medical conditions for Amlodipine
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Common symptoms of DIGO
Common symptoms of DIGO
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Impact of combining medications
Impact of combining medications
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Study Notes
Gingival Overgrowth
- Gingival overgrowth is the proliferation and intensification of the gingiva.
- It's a common clinical problem, often linked to specific conditions.
- Typically found in areas with teeth, not in edentulous spaces.
- Overgrowth often disappears if a tooth requires extraction in the affected area.
- The overgrowth is chronic and gradually increases in size.
- It's typically painless.
- If surgically removed, it often recurs.
- Spontaneous disappearance usually happens within a few months after discontinuing the related drug.
GDC Learning Outcomes
- The document lists numerous GDC learning outcomes, categorized with numbers in the format '1.1.1' and '1.9.1'.
- Outcomes cover various aspects of the subject matter.
Formative Assessment
- Students are required to complete a mind map titled "The management of the patient presenting with drug-induced gingival overgrowth."
- A gingival overgrowth workbook also needs completion.
- Both assignments are to be submitted to Mrs. Watson.
Aim
- The aim of the lecture is to raise awareness of gingival overgrowth.
- To cover the causes and implications for clinicians.
- To provide ways to help patients with this condition.
Learning Outcomes (Detailed)
- Identify clinical features associated with gingival overgrowth.
- Categorize potential causative factors of gingival overgrowth.
- Select appropriate assessment measures for patients with gingival overgrowth.
- List the classification of gingival overgrowth and areas of the mouth where it may present.
- Evaluate the impact of gingival overgrowth on oral health and patient well-being.
- Recommend potential management for patients with this condition.
Gingival Overgrowth (Detailed)
- Gingival enlargement/overgrowth is the proliferation and intensification of the gingiva.
- It's a common problematic condition typically found in areas with teeth rather than edentulous spaces; overgrowth ceases where teeth are extracted in affected areas.
- The enlargement is chronic and gradually increases in size.
- It's generally painless.
- If surgically removed, it frequently recurs.
- Spontaneous disappearance typically happens a few months after the causative drug is discontinued.
Overgrowth/Enlargement V Hyperplasia
- The terms hyperplasia and hypertrophy have been historically used to describe the condition.
- These terms, however are less precise for gingival enlargement, as they require a histological analysis of a tissue sample.
Cellular Mechanisms
- Fibrosis: Accumulation of collagenous connective tissue.
- Cellular hypertrophy: Increased size of individual cells.
- Cellular hyperplasia: Increased number of individual cells.
- Edema: Abnormal collection of fluid in intercellular spaces.
Classification of Gingival Overgrowth
- The document shows a classification of gingival Overgrowth with a visual representation in a cicle, identifying inflammatory enlargements (chronic and acute), drug-induced enlargement, neoplastic enlargement (gingival tumors), and enlargements associated with systemic diseases and conditions as separate factors.
Gingival Enlargement Classification (Location/Distribution)
- Localized: Limited to gingiva adjacent to a single tooth or group of teeth.
- Generalized: Involves the gingiva throughout the mouth.
- Marginal: Confined to the gingival margins.
- Papillary: Confined to the interdental papilla.
- Discrete: An isolated enlargement, for example, an abscess.
- Diffuse: Involving gingival margins, attached gingivae, and interdental papillae.
Scoring Guide for Gingival Enlargement
- A scoring guide is available for gingival enlargement, which can be used in patient records.
- Enables documentation of progression or reduction of this condition.
- Scoring values range from 0 (no enlargement) to 3 (enlargement covering more than ⅓ of the tooth).
Drug-Induced Gingival Overgrowth (DIGO)
- DIGO refers to abnormal gingival growth due to an adverse drug reaction.
- It's a side effect of systemic drug administration.
- It can be exacerbated by patients with a genetic predisposition, presence of plaque, or gingival inflammation.
Drug Groups Associated with DIGO
- Anticonvulsants (e.g., Phenytoin, Sodium Valproate, Phenobarbitone).
- Immunosuppressants (e.g., Ciclosporin, Tacrolimus, Sirolimus).
- Calcium Channel Blockers (e.g., Amlodipine, Felodipine, Nicardipine Hydrochloride).
Anticonvulsants (Detailed)
- Anticonvulsant drugs, like Phenytoin, are used in epilepsy treatment.
- DIGO was identified within a year of the first anti-epileptic drug being use.
- Up to 50% of patients taking anti-convulsants may develop gingival overgrowth.
- Younger patients tend to show greater susceptibility.
- Symptoms are usually noticeable within 2–3 months and peak in 12–18 months.
Anticonvulsants - Drugs/Medical Conditions
- This section lists specific anticonvulsant drugs and associated medical conditions.
Immunosuppressants (Detailed)
- Immunosuppressants, commonly used in transplant patients and auto-immune conditions, can cause gingival overgrowth.
- Example drugs include Ciclosporin, Tacrolimus, and Sirolimus.
- Ciclosporin is most commonly associated with DIGO.
- 53% of patients on ciclosporin for renal transplants experienced gingival overgrowth.
- Gingiva may appear more vascularized relative to anticonvulsant use.
Calcium Channel Blockers (Detailed)
- Calcium channel blockers are used in the management of various conditions, including hypertension and angina.
- Gingival overgrowth often occurs related to the use of these medications
- The gingival overgrowth frequently appears in greater prominence on the labial surface.
- Overgrowth is usually hyperemic, soft, and with a higher bleeding tendency.
- Increased incidence of gingival overgrowth often occurs when this class of medication is taken in combination with other drugs such as Ciclosporin and Amlodipine/Nifedipine.
Calcium Channel Blockers - Drugs/Medical Conditions
- This section lists specific calcium channel blocker drugs and associated medical conditions.
Complications Due To DIGO
- Questions regarding complications are highlighted for further discussion.
Exacerbating Factors
- Factors that worsen the condition are discussed.
Further Reading
- Includes links to various online resources that provide additional information about the study topic.
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Description
Test your knowledge on gingival enlargement and its classifications. This quiz covers various aspects, such as causes, characteristics, and conditions associated with gingival enlargement. Perfect for dental students and professionals looking to reinforce their understanding of this topic.
