PMC3357019_01
Extraoral appearance of an enlarged and fissured upper lip in the patient of the study
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F1
Trivandrum, with the chief complaint of a swollen upper lip and enlarged gums [Figures 1 and 2]. The patient first noticed a mild reddish discoloration involving her upper lip around 5 years back, which progressively increased in size without any apparent discomfort. The upper lip appeared edematous and dry with exaggerated fissures [Figure 1].
Characteristic appearance of the gingival enlargement in the patient of the study
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F2
Trivandrum, with the chief complaint of a swollen upper lip and enlarged gums [Figures 1 and 2]. The patient first noticed a mild reddish discoloration involving her upper lip around 5 years back, which progressively increased in size without any apparent discomfort. Intra oral examination showed generalized enlargement of marginal and attached gingivae [Figure 2].
Pre treatment panoramic radiographic view of the patient in the study
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F3
Panoramic radiograph couldn't detect any bony pathology, and there were no changes in the lamina dura, periodontal ligament space and alveolar bone crest [Figure 3].
Surgical views of maxillary and mandibular anterior sextants of the patient in the study. (a) Pre surgical view; (b) After gingivectomy; (c) Excised tissue; (d) Pre surgical view; (e) After gingivectomy; (f) Excised tissue
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F4
External bevel gingivectomy was done in all six sextants and the specimens were sent for histopathological examination [Figures 4a-4f].
Histopathological appearance (hematoxylin and eosin staining) showing infi ltrate of plasma cells in a dense collagenous stroma. (a) Low power view (x10); (b) High power view (x40)
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F5
There was increased vascularity with dilated and engorged blood vessels [Figure 5].
Pre treatment gingival appearance
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F6
After 2 weeks of excision, the surgical site was healing and the lesion showed remission; however, the gingiva appeared reddish and atrophic even after one month [Figures 6 and 7].
Post treatment changes in the gingival appearance
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F7
After 2 weeks of excision, the surgical site was healing and the lesion showed remission; however, the gingiva appeared reddish and atrophic even after one month [Figures 6 and 7].
Pre treatment appearance of the upper lip
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F8
Most interestingly, there was a dramatic reduction in the lip enlargement without any additional therapeutic procedures [Figures 8 and 9].
An evident reduction in the lip size post treatment compared to the appearance before the treatment in the patient of the study
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F9
Most interestingly, there was a dramatic reduction in the lip enlargement without any additional therapeutic procedures [Figures 8 and 9].
Recurrence of lesion after 8 months correlating with local irritants in the patient of the study
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F10
It remained in the same condition for the next 8 months, while the gingival lesions showed mild recurrence [Figures 10 and 11].
After oral prophylaxis
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F11
It remained in the same condition for the next 8 months, while the gingival lesions showed mild recurrence [Figures 10 and 11].