Plaque induced inflammation appears to be a general stimulating effect regardless of the mechanism of gingival. Oral manifestations of acute leukemia are often the first indications of disease. Soft, edematous, tender gingiva with ease to bleeding is a sign in blood disorders. Systemic conditions such as hormonal changes, drug therapy, or tumor infiltrates may also cause or contribute to the severity of gingival enlargement.
Alekuemic to all leukemias are the tendency to bleed and the resultant anemia and increased susceptibility to infection. The possibility of druginduced enlargement was ruled out based on the medical history. It usually occurs in people older men above age aleukemic granulocytic sarcoma and leukemia cutis. Gingival enlargement in dogs vetlexicon canis from. Gingival enlargement as an early diagnostic indicator in therapy. Leukemic gingival enlargements occur in aml because gingival tissue supports continuous trafficking of myeloid cells and contains specialized postcapillary. Down syndrome is associated with gingival enlargement observed in acute leukemia is due to a 14 year old boy presents with bilateral white thickening of the buccal mucosa which has been present since birth. In some pathological conditions, gingivitis caused by plaque accumulation can be more severe, with the result of an overgrowth. Gender has not been described as a risk factor for developing this manifestation. In addition to oral ulceration and infection and gingival bleeding, oral and periodontal manifestations of leukemia consist of infiltration of gingivae by leukemic cells, resulting in gingival overgrowth, which develops into pseudopockets where dental biofilm accumulates producing, in turn, a second inflammatory lesion that contributes to gum enlargement, so that, gingival enlargement is as much the result of leukemic infiltration as of reactive gingival hyperplasia. Gingival enlargement observed in acute leukemia is due to vitality tests are used to differentiate between median anterior maxillary cysts occur in the ameloblastomas originate from the it is possible to misdiagnose the midline palatal suture as a the lamina dura is if the image of a supernumerary tooth appears in a second radiograph to have. The role of oral lesions as a diagnostic indicator is. Leukaemia cell gingival infiltrate is not observed in edentulous individuals, suggesting that local irritation and trauma associated with the presence of teeth may play a role in the pathogenesis of this abnormality 6,7. This is a case report of gingival enlargement in acute lymphoblastic leukemia.
Acute myloid leukemia, gingival hyperplasia, oral manifestations ab s tr c acute myeloblastic leukemia aml is a malignant disease of bone marrow, usually presenting gingival overgrowth as its first. Gingival enlargement is a ordinary finding in clinical practice and the appropriate treatment depends on correctly diagnosing the cause of the enlargement. In recent years,flap surgery have been used more often to treat gingival enlargement than gingivectomy. Oral signs of leukemia and dental management literature. Gingival enlargement is an increase in the size of the gingiva gums. Gingival hypertrophy in a patient of acute biphenotypic leukemia. Gingival enlargement gingival enlargement or overgrowth is usually caused by local inflammatory conditions such as poor oral hygiene, food impaction, or mouth breathing. Abnormalities may also be seen in peripheral blood smears. A case of acute monocytic leukemia in a 25 year old pregnant lady who reported with gingival enlargement is presented here. Even though many cases of gingival enlargement associated. Recently it is known that gingival overgrowth may be a consequence of the administration of three groups of medicaments anticonvulsants 2, calcium channel blockers. Surgical treatment of gingival overgrowth with 10 years of.
Gingival enlargement has been studied in 46 patients taking diltiazem n 32 or verapamil n 14 compared with 49 cardiovascular controls who had never taken them 24 c. Introduction gingival enlargement is a common feature of gingival disease and may be caused by fibrous. Read gingival enlargement as a diagnostic indicator in leukaemia. The case described here had adequate local factors which are the predisposing factor for gingival enlargement. Leukemia, oral manifestations, gingival hyperplasia. Management of druginduced gingival enlargement australian. Case report, australian dental journal on deepdyve, the largest online rental service for scholarly research with thousands of academic. A 46yearold woman who was not taking any medications presented with anemia and gingival hypertrophy that had. Rapidly forming gingival hyperplasia is usually the first sign of this disease.
Jun 25, 2019 abnormalities may also be seen in peripheral blood smears. Chronic lymphocytic leukemia cll is the most prevalent type of. Note that the enlargement is more prominent in the maxilla and is associated with greater plaque accumulation b, lingual view of gingival enlargement in a patient with subacute monocytic. One of the rarest sites of extramedullary involvement is. Pdf gingival enlargement leading to the diagnosis of acute.
Nevertheless, the overgrowth involves the gingival margin with extension to the interdental papilla. Gingival inflammation and platelet count in patients with. Acute monoblastic leukemia aleukemic leukemia presenting as gingival enlargement. Signs and local symptoms of leukemia in the oral cavity include paleness of the oral mucosa with gingival bleeding that develops into painless gingival hyperplasia, hemorrhages, and ulcerative. Tissue enlargement may progress to the point that the tissue obscures the teeth and may interfere. Aug 12, 2010 in some pathological conditions, gingivitis caused by plaque accumulation can be more severe, with the result of an overgrowth. Enlargements associated with systemic diseases periodontal. Acute myloid leukemia, gingival hyperplasia, oral manifestations ab s tr c acute myeloblastic leukemia aml is a malignant disease of bone marrow, usually presenting gingival overgrowth as its first clinical manifestation. Gingival hyperplasia as an early manifestation of acute. Cyclosporin is an immunosuppressant which has been reported to cause gingival enlargement in 2580% of patients.
May 22, 2014 genetically induced gingival enlargement appears pink in color with minimal signs of inflammation, has a slow growth rate, and is firm in consistency. Extramedullary involvement of leukemia can occur in up to 40% of patients. Gingival enlargement and its treatment authorstream presentation. Rieder cell leukemia a form of acute myelogenous leukemia in which the blood contains the abnormal cells called rieders lymphocytesasynchronously developed lymphocytes that have.
Genetically induced gingival enlargement appears pink in color with minimal signs of inflammation, has a slow growth rate, and is firm in consistency. Gingival enlargement is one of the frequent features of gingival diseases. However, the available literature on this topic consists. Due to its high morbidity rate, early diagnosis and appropriate medical therapy is essential. Druginduced gingival enlargement was first observed in patients who were taking phenytoin for epilepsy, with approximately 50% having gingival overgrowth. How common is gingival infiltration as a manifestation of aml m5.
Evaluation of medical history revealed that the patient was under chemotherapy for 1 year ending 5 months before, for a curetted mole which had appeared. Gingival hyperplasia is most commonly seen with the aml subtypes acute monocytic leukemia m5 66. Dental professionals should be aware of clinical manifestations and complications asso ciated with these malignant. Gingival enlargement can be caused by a number of factors, including inflammatory. Clinical stomatology gingival swellings columbia ctl. Gingival enlargement a common feature of gingival disease which can be caused by gingival inflammation, fibrous overgrowth, or a combination of the two. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician. Cyclosporineinduced gingival enlargement is more vascularized than phenytoin enlargement figures 1610 and 1611. A case of diffuse gingival enlargement in acute myeloblastic leukemia aml m1 jadhav varsha sukhdeo1, jadhav avinash sukhdeo2, singhal kapil3 tuteja neeraj4 1mds, junior resident, department of periodontology and oral implantology, govt dental college and. Oral changes may be the first and only presenting signs in leukemic patients. Nevertheless, the overgrowth involves the gingival margin. Chronic lymphocytic leukemia cll is the most prevalent type of adult lymphoproliferative disorder, but oral manifestations are uncommon. Plaque induced inflammation appears to be a general stimulating effect regardless of the mechanism of gingival enlargement.
Dental professionals should be aware of clinical manifestations and complications asso ciated with these malignant neoplastic diseases to aid in diagnosis and subsequent treatment and management. Although many cases of gingival enlargement in patients with acute myeloid leukemia have been reported in literature, cases of gingival hypertrophy secondary to acute lymphoblastic leukemia in adult female are rare. In addition to gingival enlargement, cyclosporine induces other major side effects such as 1 nephrotoxicity 2 hypertension, and 3 hyperthricosis. Gingival hyperplasia complicating acute myelomonocytic leukemia. Pdf the oral cavity manifests signs of various systemic diseases. To the right is an example of a localized gingival enlargement associated with pregnancy. The acute leukemias are a group of neoplastic diseases that are characterized by proliferation of immature white cells in the bone marrow andor blood and are often associated with severe leucopenia, anemia and.
Gingival enlargement or hypertrophy are the two other terms used to describe the condition. It is widely recognized that the main manifestation of aml could be gingival hyperplasia and bleeding. Case report, australian dental journal on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Gingival hyperplasia is more common in acute than chronic leukemia, in adults and in people with aleukemia or subleukemic forms of leukemia. This entails thorough examination of the oral mucosa, gingiva, teeth, tongue. Leukemia has been associated with oral manifestations. Tissue enlargement may progress to the point that the tissue obscures the teeth and may interfere with occlusion enlargement tissue appear firm fibrotic, pale pink and resilient, has little tendency to bleed, and has lobed surface appearance enlargement usually through out the mouth and appear more pronounced in the. There was more gingival enlargement in the patients taking diltiazem compared with controls. Oral lesions occur in both acute and chronic form of all types of leukaemias. Go is characterized by the accumulation of extracellular matrix in gingival connective tissues, particularly collagenous components, with varying degrees of inflammation. To get the facts on exactly how to eliminate your uterine fibroids from. Although many cases of gingival enlargement in patients with acute myeloid leukemia have been reported in literature, cases of gingival hypertrophy secondary to acute lymphoblastic leukemia in adult. Gingival hyperplasia can be seen in patients with familial gingival enlargement, pregnancy and leukemia. Identifying gingival overgrowth as an initial oral manifestation of leukemic infiltration is extremely important for establishing an early diagnosis of acute leukemia 5.
Gingival enlargement and its treatment authorstream. Orofacial complications of leukemia include lymphadenopathy, gingival bleeding, petechiae, ulceration, gingival enlargement and infections. Gingival fine needle aspiration cytology in acute leukemia. Acute myeloblastic leukemia aml is a malignant disease of bone marrow. Gingival enlargement an overview sciencedirect topics. Gingival enlargement associated with multiple factors is leading to gingival dimorphism agrawal, 2015. This paper aims to throw light on an interesting case of acute leukemia diagnosed on. Large infiltration of chronic lymphocytic leukemia in the. A case of gingival enlargement in acute myeloid leukemia. Gingival hyperplasia secondary to infiltration of the gingival tissue with leukemia cells is thoroughly described in the literature.
Gingival enlargement as oral manifestation in acute myeloid. Gingival overgrowth go is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers. Gingival enlargement in leukemia occurs due to infiltration of premature leukocytes. Feb 21, 2017 the enlargement can be inflammatory,fibrotic or a combination of both.
A case of diffuse gingival enlargement in acute myeloblastic. A 21 year old male presented with fever, weakness and petechiae. Gingival hyperplasia is a disease in which the gum tissues overgrow abnormally. The enlargement can be inflammatory,fibrotic or a combination of both.
Gingival enlargement observed in acute leukemia is due to. The differential diagnosis included enlargement due to drugs e. Gingival hyperplasia in acute leukemia extramedullary involvement of leukemia can occur in up to 40% of patients. Regimens are devised regularly and are tailored to specific illnesses. Aleukemic leukemia definition of aleukemic leukemia by medical dictionary s. One of the main drugs associated with go is the antiepileptic.
Typical oral manifestations of acute leukemia include gingival swelling, oral ulceration, spontaneous gingival bleeding, petechiae, mucosal pallor, herpetic. Many types of leukemia gingival infiltrate assoc with myelomonocytic type generally bone marrow involvement leukemic infiltrate age and gender. Children with aml in general may present with a broad variety of. Systemic causes of gingival enlargement there are numerous physiologic and systemic conditions that may promote localized andor generalized gingival enlargement such as pregnancy, hormonal imbalances, and leukemia. Oral lesions occur in both acute and chronic form of all types of. Gingival hyperplasia is a condition marked by the enlargement of the gingiva, or the soft tissue found in the mouth popularly known as the gums. Acute myeloblastic leukemia aml is a malignant disease of bone marrow, usually presenting gingival overgrowth as its first clinical manifestation. Gingival inflammation and platelet count in patients with leukemia. Gingival enlargement leading to the diagnosis of acute lymphoblastic leukemia in an 8year old girl.
A case of diffuse gingival enlargement in acute myeloblastic leukemia aml m1 jadhav varsha sukhdeo1, jadhav avinash sukhdeo2, singhal kapil3 tuteja neeraj4 1mds, junior resident. One of the rarest sites of extramedullary involvement is the oral cavity, with only 5% or less of all patients with aml present with gum infiltration. Oral manifestations of acute promyelocytic leukemia. Jun, 2012 gingival hypertrophy in a patient of acute biphenotypic leukemia. The oral manifestations of leukaemia include gingival enlargement, oral ulcerations, gingival bleeding, petechia and mucosal pallor. Gingival enlargement can be caused by a number of factors, including inflammatory conditions and the side effects of certain medications. Gingival enlargement as a diagnostic indicator in leukaemia. Gingival enlargment is a clinical term, referring to an increase in the size or thickness of gingiva. Gingival hyperplasia in acute leukemia stanford medicine. Gingival hyperplasia in acute leukemia stanford medicine 25. Down syndrome is associated with gingival enlargement observed in acute leukemia is due to a 14 year old boy presents with bilateral white thickening of the buccal mucosa which has been present since. Learn the shocking truth about uterine fibroids, drugs and surgeries. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Jun 28, 2019 rieder cell leukemia a form of acute myelogenous leukemia in which the blood contains the abnormal cells called rieders lymphocytesasynchronously developed lymphocytes that have immature cytoplasm and a lobulated, indented, comparatively more mature nucleus.
However, the oral manifestations are far more common in the acute stages. Gingival enlargement observed in acute leukemia is due to vitality tests are used to differentiate between median anterior maxillary cysts occur in the ameloblastomas originate from the it is possible to. Systemic causes of gingival enlargement there are numerous physiologic and systemic conditions that may promote localized andor generalized gingival enlargement such as pregnancy, hormonal. To get the facts on exactly how to eliminate your uterine fibroids from the root 100% naturally and permanently and achieve lasting freedom from pcos related symptoms without spending your hardearned money on drugs and over the counters. The lesion may involve the interproximal spaces, and become so extensive that the teeth are displaced and their crowns covered.
1397 1080 1369 766 245 834 1431 1034 1432 1397 1081 506 871 415 338 95 1287 746 637 1115 1089 97 407 1280 238 33 791 629 894 1045 84 1013 1493