Management of Gingival Overgrowth Using CO_2 Laser and Gingivectomy Surgery - A Case Report

摘要

Drug induced gingival overgrowth is a troublesome side effect seen with the use of several medications in the susceptible patient. Medications mainly implicated are the anti convulsant drug dilantin sodium phenytoin, calcium channel blockers especially nifidipine, the immune suppressant drug cyclosporine and any combinations of these drugs. A renal transplant patient on nifedipine/cyclosporine was referred to the Periodontology Department, Faculty of Dentistry, University of Malaya, for management of gingival overgrowth. Patient's oral hygiene was poor and radiographic interpretation revealed moderate to advanced generalized alveolar bone loss. In this patient, a combination of gingivectomy and CO., laser surgery was used to remove drug induced gingival overgrowth. Although post surgical healing was slow, CO_2 laser surgery produced good hemostasis and less pain during the procedure and postoperatively when compared to conventional gingival debulking surgery like gingivectomy. It was established from this case report that CO_2 laser surgery has an adjunctive role in periodontal surgery especially in the removal of excess tissue which bleeds profusely when manipulated, has tendency to recur and with lesions needing repeated interventions.