Hypertrophic gingivitis is a chronic inflammatory process of the gum tissue that proceeds without disorders of the gingival attachment and is accompanied by an increase in the volume of the gingival tissue( proliferation).For hypertrophic gingivitis is characterized by the growth of the gingival papillae and the gums themselves, which cover the crowns of teeth.
Patients suffering from this form of gingivitis complain of severe pain, persistent bleeding gums and a significant increase in the volume of the gums, which can partially cover the crowns of teeth outside( not from the side of the tongue).
At the same time, the patient's gum remains quite firm and underneath, on the teeth, tartar is formed, which creates favorable conditions for the reproduction of microorganisms. With hypertrophic gingivitis, teeth can slightly shift.
Reasons for
Why does hypertrophic gingivitis develop, and what is it? The causes of this form of gingivitis are as follows:
- Endocrine disorders ( hormonal shifts).Isolate the independent form of gingivitis in young men - "youthful" gingivitis and hypertrophic gingivitis in pregnant women.
- Disturbances in the development of the dento-maxillary system : bite pathology( especially deep incisal overlap), crowding of teeth in the frontal part of the lower jaw, or close arrangement of the teeth, abnormalities of the teeth position in the arc, etc.
- Hypertrophic gingivitis focal develops under the action of a mechanical traumaedge of the destroyed tooth, overhanging edges of the seal, clasp of the prosthesis, etc.).
Depending on the clinical picture, two forms of hypertrophic lesion of the gingival tissue are distinguished: fibrous and granulating. Each of the forms of the disease is characterized by its symptoms.
Classification of
Two forms of this pathology are considered:
- The fibrous form of of hypertrophic gingivitis is characterized by the growth of the gingival papillae, which have a pale pink hue. They have a dense structure and at the same time bleeding. As a rule, patients complain only of non-aesthetics.
- Hypertrophic gingivitis with edematous form is manifested by edema of the gingival papillae, swelling and cyanosis. The surface of the gums is loose, dents remain when touched, and bleeding may occur when probing. Patients are concerned about pain when chewing and brushing their teeth.
The choice of method for the treatment of hypertrophic gingivitis depends on the form of the course of the disease, the prevailing symptoms, the overall health of the patient.
Symptoms of hypertrophic gingivitis
In addition to the visual increase in the volume of the gum in hypertrophic gingivitis, especially in its edematic form, there are a number of other symptoms:
- Bleeding and soreness of the gums even with light touches, especially during brushing;
- Gums sore during eating, acute pain when eating cold, hot or sour food;
- Difficulty with chewing food due to overgrown gums.
Depending on the degree of irritation of the gums, three degrees of development of hypertrophic gingivitis are distinguished:
- 1 degree - light, the gingival papillae cover 1/3 of the tooth;
- 2 degree - medium, the gingival papillae cover up to 1/2 tooth height;
- 3 degree - heavy, the gingival papillae cover more than 1/2 of the tooth's height.
In case of edematous form, the gingival outgrowth in some cases either partially or completely disappears after elimination of etiological factors( after the end of orthodontic treatment, after replacement of poor-quality fillings, with normalization of hormonal background, after cancellation or replacement of drugs, after delivery).
In both forms, regular courses of professional hygienic treatment and anti-inflammatory therapy are combined with high-quality personal hygiene of the oral cavity.
Hypertrophic gingivitis: photo
How does this ailment look like, we offer detailed photos to view.
Diagnostics
Instrumental examination reveals bleeding gums, soft plaque and the presence of supragingival tartar. With the help of the periodontal probe, the dental sulcus is examined: as a rule, the integrity of the dentogingival joint is not broken, the dentogingival pocket is absent;symptom of bleeding is positive.
For qualitative diagnostics use indices:
- hygiene;
- periodontal;
- PMA;
- And also:
- Schiller-Pisarev test;
- biopsy of gingival tissue;
- complex examination of gingival tissue.
Clinical tests are also important to detect gingivitis symptoms before the patient presents complaints to prevent the clinical manifestation of gingivitis. First of all, bleeding when probing the dentogingival sulcus refers to such tests. It should be noted that the morphological signs of inflammation are determined even in the clinically intact gum.
Treatment of hypertrophic gingivitis
To determine the appropriate treatment option, it is necessary to find out the root cause of hypertrophic gingivitis. After determining the etiological factor, the doctor proceeds to the next stage of therapy: conducts professional hygiene of the oral cavity and teeth.
Antibacterial, anti-inflammatory and immunostimulating therapy is used to treat hypertrophic gingivitis. Gum bleeding helps to take vitamin complexes and applications with Vikasol. Apply drugs that have capillary-strengthening properties, as well as drugs that accelerate the regeneration of the gingival tissue.
The granulating form of the disease is treated with cauterizing agents - piozidotherapy and diathermocoagulation. The use of Piotsida is effective for the treatment of gingivitis of the first and second severity. Destructive methods of therapy are not used to treat gingivitis fibrous form. Observations show that wound healing after surface pyocidotherapy lasts 7-10 days, after deep 12-15 days, and ends with the formation of hardly noticeable tender scars.
Unfortunately, hypertrophic gingivitis does not always give in to conservative methods of treatment. In most cases, the third stage remains indifferent to the medicines, and the specialist has nothing else to do but to remove the pathologically enlarged gingival papillae surgically.
Operative intervention is performed under local anesthesia( in the absence of indications for general anesthesia) and is called "gingivectomy."The enlarged gingival papillae are excised, leaving only the part that should be in a healthy person.
Prevention
In hypertrophic gingivitis prevention is reduced to the elimination of chronic mechanical gum injuries, regular oral hygiene, proper hygienic care for teeth and gums, and solutions to the patient's dental problems. Very important is the therapy of endocrine diseases, rational selection of medicines.