Patient:
19-year-old patient presented with gingival overgrowth and want to enhance her appearance.
Diagnosis:
Iatrogenic gingival overgrowth due to orthodontic treatment.
( In our case we performed the diagnosis and analysis CLINICALLY “Gum display and symmetry, Teeth proportions, Bone amount and relation, Lip length and dynamics, Teeth display in rest and smiling position” , And RADIOGRAPHICALLY “CBCT” , All that to identify and classify the condition depending on JAMES COSLET classification ” 1A, 1B, 2A, 2B” , and based on this classification, we determine the treatment plan).
Treatment Plan:
After our diagnosis we determined COSLET classification of our case ( 1A ” Adequate amount of keratinized gingiva will be after gingival removal & Normal relationship between crest of alveolar bone and CEJ ” ), And depending on that our treatment plan was “Just Gingevictomy”.
Procedure:
– Anaesthesia injection ( labial infiltration ).
– Marking of bleeding point by periodontal probe at three point for each tooth ( mesial , distal and mid facial ).
– Surgical incision by surgical blade #15 , and our incision is external beveled incision ( beveled coronaly 45° ).
– Making gingivoplasty by surgical blade for reshaping of gingival architecture and decrease it’s horizontal thickness.
– Saline.
– Application of periodontal pack ( Zink oxid eegional ) for 5 : 7 days.
Materials:
– Zink oxid eegional for periodontal pack., in addition to our instruments that include ( periodontal probe, surgical blade and caliber ).
– Medical gauze.
– Saline.
Outcome:
Good healing path after removal of periodontal pack and restoring of normal proportions of teeth.
Conclusion:
Our surgical procedure is slightly difficult due to our performance while orthodontic braces is in it’s place , this will be easier if there is no braces.
Pre operative condition
Immediately after incision
Periodontal pack application and orthodontic braces helped in it's support.
After initial healing.
Pre and post
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