Online ISSN: 2515-8260

Author : Baliga, Dr. Vidya S.

Drug Induced Gingival Overgrowth : A review

Dr. Komal Bhombe; Dr. Vidya S. Baliga; Dr. Akanksha Nibudey

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 1744-1756

Pharmacological drug therapies are frequently associated with undesirable side effects. When considering the periodontal aspects, Drug Induced Gingival Overgrowth (DIGO) is a one such adverse effect. The first case of gingival overgrowth (previously known as hyperplasia) was reported by Kimball (1939) following chronic phenytoin therapy. Since then such proliferative lesions have been reported associated with several other groups of drugs namely Phenytoin (PHT) among the anti- epileptics, Cyclosporine (CsA) amongst immunosuppressants and various Calcium Channel Blockers (CCBs). The condition gradually leads to complications like pain, gingival disfigurement (aesthetic concerns) and difficulty in maintaining oral hygiene measures.
Management of this condition has been of a great challenge to the clinicians due to its relapse and persistence of risk factors (Age, periodontal factors, drug variables and genetic association). When considering the risk factors, their sensitivity and reliability are of utmost importance for determining the incidence of recurrence and formulation of patient specific therapy. Along with periodontal consultation, treatment should be multidisciplinary in approach discussed with the concerned physician. Initially non-surgical approach including elimination of local factors and drug substitution should be opted. The persistence of condition later necessitates the need for periodontal surgery in form of gingivectomy and flap surgery. Following surgery, maintenance by meticulous oral hygiene with chlorhexidine mouth rinses and periodic professional cleaning should be considered to prevent it from recurring and re-treatment.
Thus, for overall benefit of the patient it is fundamental to know the condition while considering its treatment. This review will briefly summarize the clinical aspects, pathogenesis, risk factors and management of DIGO.

Vertical Ridge Augmentation : A review

Dr. Akanksha Nibudey; Dr. Vidya S. Baliga; Dr. Prasad Dhadse; Dr Komal Bhombe

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 1757-1766

Dimensional variations in the alveolar ridge after extraction often negotiations on achieving adequate  implant stability and placement of implants in the right prosthodontic positions. These circumstances request augmentation of the residual ridge to accomplish successful implant placement and long-term survival. Vertical Ridge Augmentation  is accomplished using both hard and soft tissue grafting procedures that intend to augment the alveolar ridge volume beyond the existing skeletal envelope; they are usually performed at the edentulous site of a deficient alveolar ridge . Although there are a large variety of alveolar ridge augmentation techniques with various degrees of success,  this review concentrate on vertical ridge augmentation using guided bone regeneration, autogenous block and alveolar distraction osteogenesis . Vertical ridge augmentation  procedures before or during dental implant placement are technically challenging and often encounter procedure-related complications. To minimize complications and promote success, a literature search was conducted to validate procedures used for Vertical Ridge Augmentation. A decision tree based on the amount of additional ridge height needed (<4, 4 to 6, or > 6 mm) is developed to improve the procedure-selection process. A decision tree guides selection of the most appropriate treatment modality and sequence for safe, predictable management of the vertically deficient ridge in implant therapy. Though the available literature speaks of an excess of methods and agents for ridge augmentation, there is a comparative scarcity of quality evidence to guide the selection of suitable techniques and material. Henceforth, this paper is an endeavor to develop and describe an evidence-based decision pathway for the selection of suitable techniques for various clinical situations. Additionally, a descriptive overview of various techniques and materials is presented.