With such a relatively rare disease as hypertrophic gingivitis, the pathological proliferation of gingival tissues is observed due to their chronic inflammation. The ongoing processes in this case are irreversible, therefore it is important to stop them as soon as possible - to conduct adequate treatment.
Hypertrophic gingivitis - causes
The considered form of gingivitis can arise as a separate disease or be a manifestation of periodontitis in a neglected stage. In the development of the defeat, key factors are played by local or common factors, often their combination is observed. It is possible to suspect what caused the disease, probably due to the prevalence of changes in the tissues. So, if hypertrophic gingivitis is localized (observed mainly in the zone of canines and incisors of both jaws), then probable provoking factors are:
- anomalies of occlusion (open, deep, cross);
- deviations from the norm of the placement of teeth in the dentition (crowding in the anterior part of the jaw, hyperdontia, twisting);
- anomalies in the development of the frenum of the lips;
- tartar;
- poor-quality seals and dentures;
- improper hygiene of the oral cavity when wearing orthodontic appliances, etc.
The generalized type of pathology, in which tissue change is observed on the entire jaw or on both jaws, experts attribute to the following reasons:
- changes in the hormonal background of the body;
- chronic endocrine diseases;
- diseases of the hematopoietic system;
- lack of vitamin C;
- treatment with Diphenin.
Hypertrophic gingivitis - symptoms
There are two forms of hypertrophic gingivitis, characterized by a different clinical picture:
1. Fibrous form:
- proliferation and consolidation of the interdental gingival papillae;
- the gingival papillae do not change color (remain pale pink);
- the change of tissues can occur both from the outside and from the inside of the teeth;
- formation of false dentogingival pockets is observed;
- bleeding is not observed.
2. Edema:
- an increase in the gingival papillae, and their swelling;
- gingival tissues acquire a purplish-cyanotic shade, glossy luster, become loose;
- formation of false dentogingival pockets is observed;
- When you touch the gums, there is a bleeding;
- soreness in brushing teeth, eating food.
Differential diagnosis of hypertrophic gingivitis
When conducting diagnosis of hypertrophic gingivitis, a specialist should exclude other pathologies with similar symptoms: fibromatosis, epulis, periodontitis . This disease differs from other types of periodontal damage that chronic hypertrophic gingivitis affects only gum tissue, and the alveolar process of the jaw bone remains intact. This can be confirmed by X-ray diagnostics. When microscopic examination of the gums, thickening of epithelial tissues without keratization is detected.
Than to treat a hypertrophic gingivitis?
After stating the exact diagnosis and finding out the factors that cause hypertrophic gingivitis, treatment begins with the elimination of these causes. It is not excluded that this will require consultation of doctors of other specialties. In cases where hypertrophic gingivitis is associated with taking medications, it is necessary to agree on a treatment regimen with a doctor who prescribed the medicine. The choice of methods is carried out taking into account the form of the disease and the level of damage. Conservative therapy and radical methods can be used.
Hypertrophic gingivitis, fibrous form - treatment
If hypertrophic gingivitis, a fibrous form, is diagnosed, then conservative techniques are not enough, and they often prove ineffective in this case. It is recommended to carry out an operative removal of pathological growths, which can be performed in one of the following ways:
- cryodestruction - exposure to affected tissues with low temperatures;
- diathermocoagulation - high frequency alternating current treatment;
- surgical excision with a scalpel.
In addition, removal of soft and hard dental deposits, caries treatment, local antiseptic and anti-inflammatory therapy, general immuno-strengthening therapy are prescribed. Patients are given advice on the prevention of recurrence of the disease, including proper oral care with the use of special pastes and rinses, dental floss.
Hypertrophic gingivitis, edematous form - treatment
Hypertrophic gingivitis, edematous form of which is considered less severe, in this case can be cured by means of medical and physiotherapy techniques, which include:
- elimination of dental deposits;
- treatment of gums with antiseptics and anti-inflammatory agents;
- gum massage;
- electrophoresis ;
- ultrasound therapy;
- laser therapy;
- darsonvalization.
In the absence of positive results of the treatment, sclerosing therapy is recommended - the injection of medicines into the gingival tissues under local anesthesia. In addition, local use of glucocorticosteroids is prescribed for the removal of severe inflammatory processes, vitamin-mineral complexes.