Sarah Ahmad Alfaqeeh1 , Sukumaran Anil2
1. Post-graduate student, Demonstrator, Division of Orthodontics, Department of Preventive Dental Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia.
2. Professor, Division of Periodontics, Department of Preventive Dental Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Corresponding author: “Dr. Sarah A. A1-Facieeh” firstname.lastname@example.org
Volume 18, Issue 1 (January - March 2009)
Adult patients have many preexisting conditions that are not seen in the adolescent population including tooth loss, severe skeletal dysplasias, periodontal disease and various forms of temporomandibular dysfunction (TMD). Frequently, the preexisting conditions that are present in the adult patient interfere with the achievement of orthodontisc’s general idealized goals. Problem-oriented synthesis of the dental needs of each case helps determine specific treatment objectives that one must establish before determining the treatment plan. A 51 years old patient approached the dental clinic to improve her smile esthetics. She was a skeletal class III high angled case with an increased lower facial height and a dentally class I with supraerupted upper right central incisor, mild spacing between right upper central and lateral incisors and moderate lower anterior crowding. Bolton discrepancy showed 4 mm of overall tooth material excess in the lower arch. Gingival overgrowth associated with nifedipine intake was also recorded. As a more realistic treatment plan with an interdisciplinary approach was considered to be appropriate in terms of treatment efficacy and duration, a team comprising of a periodontist, an orthodontist and a restorative dentist was formed to manage the case. The importance of multidisciplinary approach in managing the case was explained. After gingivectomy, the patient was kept in a maintenance program, including oral hygiene instructions and professional tooth cleaning during the complete orthodontic treatment. Follow-up of the case for a year did not reveal any recurrence of the drug induced gingival enlargement. This case not only emphasizes the role of meticulous oral hygiene maintenance in preventing the recurrence of gingival enragement but also the ease with which adult cases could be managed efficiently with minimal endeavors by a team approach.
Drug induced gingival enlargement, multidisciplinary approach, nifedipine, orthodontic treatment.