Title |
A Comparison of 3 Surgical Techniques [Laser Excision, Scalpel Gingivectomy and Periodontal Flap] to Treat Calcium Channel Blocker Induced Gingival Overgrowth Favoring Laser Excision |
Clinical Question |
In an elderly hypertensive patient with calcium channel blocker induced gingival enlargement requiring surgical resection; does laser excision or surgery with a periodontal flap technique lead to a lower recurrence rate than does a classic gingivectomy? |
Clinical Bottom Line |
Recurrence of gingival overgrowth over a 6 month period is significantly reduced when surgery employs laser excision rather than a periodontal flap technique. |
Best Evidence |
|
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
16856895 | Mavrogiannis/2006 | 50 organ transplant patients with gingival enlargement caused by cyclosporin or a calcium channel blocker | Randomized Control Trial | Key results | This study compared each surgical technique with a conventional gingivectomy (2 cohorts) by separating the anterior maxilla into 2 surgical sites (canine to central incisor on either side). The periodontal flap technique, when compared to a scalpel gingivectomy, had a CI value of -2.6 ± 11.4(-7.2, 1.8) and p value 0.225. Laser excision compared to scalpel gingivectomy, on the other hand, had a statistically significant difference [p value of 0.05 and CI -7.1 ± 16.78 (-14.86, -0.02)]. | |
Evidence Search |
Gingivectomy[Mesh]; Surgical Procedures, Operative[Mesh]; Calcium Channel Blockers[Mesh]; Gingival Overgrowth[Mesh] |
Comments on
The Evidence |
Patients in this study were carefully selected based on gingival presentation and medical history. Post-surgery, gingival healing and overgrowth were measured on plaster study models at specific time intervals by a collaborator blinded to which surgical technique had been employed. Systems of variable analysis were listed. |
Applicability |
Although laser excision proves to be an effective form of treatment with reported postoperative pain comparable to that for a scalpel gingivectomy, the notable cost of the procedure may limit its use. The periodontal flap technique provided less assurance of long term stability and significantly increased postoperative pain compared to a conventional gingivectomy. |
Specialty |
(Oral Medicine/Pathology/Radiology) (General Dentistry) (Periodontics) |
Keywords |
Gingivectomy, calcium channel blocker, gingival overgrowth, hypertension, surgical therapy
|
ID# |
2201 |
Date of submission |
04/19/2012 |
E-mail |
smithve@livemail.uthscsa.edu |
Author |
Veronique Smith |
Co-author(s) |
|
Co-author(s) e-mail |
|
Faculty mentor |
Geza Terezhalmy, DDS |
Faculty mentor e-mail |
terezhalmy@uthscsa.edu |
|
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Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
None available | |