PMC8481045_01
Fibrous, nodular, hard gingival overgrowths extending to most of the clinical crown in the anterior and posterior parts of the mandibular arch.
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The patient presented with a dental history that includes thick deposits of calculus and plaque on all remaining teeth with fibrous, nodular, hard gingival overgrowths extending to most of the clinical crown in the anterior and posterior parts of the maxillary and mandibular arches (Figure 1).
Yellowish-white pseudomembranous slough was found covering the interdental papilla in the mandibular left area.
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Additionally, a yellowish-white pseudomembranous slough was found covering the interdental papilla in the mandibular left area (Figure 2). The gingiva in the mandibular left quadrant was edematous, fibrous, hemorrhagic, and painful swellings which had purulent exudate (Figure 2).
Panoramic radiograph presenting bone loss around teeth and lower 4-unit implant-retained bridge.
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Radiographically, bone loss can be observed around the teeth and implants; however, clinically, the implants are not mobile as submerged (Figure 3).
External bevel incision gingivectomy of the lower left quadrant and exodontia of #33, #34, and #35.
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An external bevel incision gingivectomy was done along with extraction of #33, #34, #35, and 45 due to extensive grade III mobility (Figures 4 and 5).
Gingiva removed from the lower left quadrant and extracted teeth (#33, #34, and #35).
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An external bevel incision gingivectomy was done along with extraction of #33, #34, #35, and 45 due to extensive grade III mobility (Figures 4 and 5).
1 week after surgical excision of the lower left quadrant.
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Poor oral hygiene can be observed along the sutures which were surrounded by plaque and debris (Figure 6).
External bevel gingivectomy of the upper right quadrant.
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For the maxillary arch, an external bevel incision gingivectomy was done, and extraction of #11, #21, and #12 was done due to grade III mobility (Figures 7-9).
Gingiva removed from the upper left quadrant and extracted teeth (#11 and #21).
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For the maxillary arch, an external bevel incision gingivectomy was done, and extraction of #11, #21, and #12 was done due to grade III mobility (Figures 7-9).
External bevel gingivectomy of the upper left quadrant.
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For the maxillary arch, an external bevel incision gingivectomy was done, and extraction of #11, #21, and #12 was done due to grade III mobility (Figures 7-9).
Recall after 2 weeks of surgical intervention of maxillary arch. Pus and exudates were observed around teeth and sutures. Full exodontia was done for the remaining teeth in the upper arch.
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During the follow-up visits, the maxillary arch presented with signs of inflammation, pus, and exudates around the teeth and sutures (Figure 10).
1 month recall after surgical intervention of the mandibular arch. Recurrence was presented, and full-mouth exodontia was done for the lower arch.
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There also seemed to be recurrence of gingival overgrowth around the implant-retained 4 unit bridge in the anterior mandible (Figure 11).