Hypertrophic gingivitis during orthodontic treatment. Clinical case

Abstract

Background. In the process of human evolution, the stomatognathic system has undergone significant changes, which led to the development of various pathological types of occlusion and tooth position abnormalities. As a treatment, different types of orthodontic appliances are used, and one consequence is hypertrophic gingivitis. Hypertrophic gingivitis is a chronic pathological process of proliferative type, with the involvement of the connective tissue and the gingival fibromucosa, not involving the bone tissue, but with the loss of the anatomical-morphological configuration of the gum presenting an aesthetic defect that has a negative impact on health oral cavity and the patient's quality of life. The purpose of the work. Diagnosis and treatment of hypertrophic gingivitis induced by fixed appliance orthodontic treatment. Materials and methods. Case presentation. Patient A.V., B./16 years, addressed the SRIMC, presenting aesthetic and functional complaints. Following the clinical examination, the diagnosis of chronic hypertrophic gingivitis was established. Results. There are several causes to develop hypertrophic gingivitis, one of which is determined by the pressure of the orthodontic structure on the soft tissues of the periodontium, causing inflammation that becomes chronic. Another variant is also possible in which the main reason for the inflammatory reaction is enzymes and toxins produced by microorganisms from bacterial plaque accumulations. The treatment started with: 1. improvement of the main symptoms; 2. professional oral hygiene; 3. oral baths with chlorhexidine 0.06%, for one week; 4. administration of anti-inflammatory drugs and agents that normalize vascular tissue permeability: 5% butadiene ointment, 3% acetylsalicylic acid ointment, indomethacin in the form of gum applications; 5. electrophoresis. Conclusions. Hypertrophic gingivitis during orthodontic treatment is induced by the response reaction of the gingival tissues to the fixed orthodontic appliance and poor oral hygiene. By timely prevention and treatment using drugs and physiotherapy, further complications can be avoided, as well as the structure and functionality of the periodontal tissues can be completely normalized.