Abstract:Gingival enlargement or overgrowth (GO) is a common complication of the anticonvulsant drug phenytoin (PHT). GO is evident in almost half of the patients receiving PHT therapy. PHT-induced gingival overgrowth (PGO) is more common in children than in adults and affects both males and females equally. PGO may vary from mild to severe and does not seem to be dose dependant. It is supposed that PHT and its metabolites cause a direct effect on the periodontal tissues; however, poor oral hygiene may contribute to th… Show more
“…Hyperplastic gingiva usually presents a normal coloration or can be erythematous. Periodontal problems, such as bleeding and bone loss, might occur due to the excess of gingival tissue, presence of pseudopockets and plaque accumulation [ 17 , 28 – 30 ]. Fig.…”
Gingival fibromatosis is a rare and heterogeneous group of disorders that develop as slowly progressive, local or diffuse enlargements within marginal and attached gingiva or interdental papilla. In severe cases, the excess tissue may cover the crowns of the teeth, thus causing functional, esthetic, and periodontal problems, such as bone loss and bleeding, due to the presence of pseudopockets and plaque accumulation. It affects both genders equally. Hereditary, drug-induced, and idiopathic gingival overgrowth have been reported. Hereditary gingival fibromatosis can occur as an isolated condition or as part of a genetic syndrome. The pathologic manifestation of gingival fibromatosis comprises excessive accumulation of extracellular matrix proteins, of which collagen type I is the most prominent example. Mutation in the Son-of-Sevenless-1 gene has been suggested as one possible etiological cause of isolated (non-syndromic) hereditary gingival fibromatosis, but mutations in other genes are also likely to be involved, given the heterogeneity of this condition. The most attractive concept of mechanism for drug-induced gingival overgrowth is epithelial-to-mesenchymal transition, a process in which interactions between gingival cells and the extracellular matrix are weakened as epithelial cells transdifferentiate into fibrogenic fibroblast-like cells. The diagnosis is mainly made on the basis of the patient’s history and clinical features, and on histopathological evaluation of affected gingiva. Early diagnosis is important, mostly to exclude oral malignancy. Differential diagnosis comprises all pathologies in the mouth with excessive gingival overgrowth. Hereditary gingival fibromatosis may present as an autosomal-dominant or less commonly autosomal-recessive mode of inheritance. If a systemic disease or syndrome is suspected, the patient is directed to a geneticist for additional clinical examination and specialized diagnostic tests. Treatments vary according to the type of overgrowth and the extent of disease progression, thus, scaling of teeth is sufficient in mild cases, while in severe cases surgical intervention is required. Prognosis is precarious and the risk of recurrence exists.
“…Hyperplastic gingiva usually presents a normal coloration or can be erythematous. Periodontal problems, such as bleeding and bone loss, might occur due to the excess of gingival tissue, presence of pseudopockets and plaque accumulation [ 17 , 28 – 30 ]. Fig.…”
Gingival fibromatosis is a rare and heterogeneous group of disorders that develop as slowly progressive, local or diffuse enlargements within marginal and attached gingiva or interdental papilla. In severe cases, the excess tissue may cover the crowns of the teeth, thus causing functional, esthetic, and periodontal problems, such as bone loss and bleeding, due to the presence of pseudopockets and plaque accumulation. It affects both genders equally. Hereditary, drug-induced, and idiopathic gingival overgrowth have been reported. Hereditary gingival fibromatosis can occur as an isolated condition or as part of a genetic syndrome. The pathologic manifestation of gingival fibromatosis comprises excessive accumulation of extracellular matrix proteins, of which collagen type I is the most prominent example. Mutation in the Son-of-Sevenless-1 gene has been suggested as one possible etiological cause of isolated (non-syndromic) hereditary gingival fibromatosis, but mutations in other genes are also likely to be involved, given the heterogeneity of this condition. The most attractive concept of mechanism for drug-induced gingival overgrowth is epithelial-to-mesenchymal transition, a process in which interactions between gingival cells and the extracellular matrix are weakened as epithelial cells transdifferentiate into fibrogenic fibroblast-like cells. The diagnosis is mainly made on the basis of the patient’s history and clinical features, and on histopathological evaluation of affected gingiva. Early diagnosis is important, mostly to exclude oral malignancy. Differential diagnosis comprises all pathologies in the mouth with excessive gingival overgrowth. Hereditary gingival fibromatosis may present as an autosomal-dominant or less commonly autosomal-recessive mode of inheritance. If a systemic disease or syndrome is suspected, the patient is directed to a geneticist for additional clinical examination and specialized diagnostic tests. Treatments vary according to the type of overgrowth and the extent of disease progression, thus, scaling of teeth is sufficient in mild cases, while in severe cases surgical intervention is required. Prognosis is precarious and the risk of recurrence exists.
“…11 Substitution of phenytoin with an effective antiepileptic drug should be considered in consultation with a neurologist as phenytoin therapy affects the quality of life of the child patient. 2 Good oral hygiene and surgical excision of severely overgrown tissues are most effective in the treatment of phenytoin-induced gingival overgrowth. 8…”
Section: Discussionmentioning
confidence: 99%
“…1 It is more commonly seen in children as compared to adults and affects both genders equally. 2 Histologically, elongated retepegs are present in the overlying surface epithelium along with an increased amount of fibrous connective tissue in lamina propria. 3 There is the presence of increased vascularity and chronic inflammatory cellular infiltrate consisting of lymphocytes and plasma cells in patients with secondary inflammation.…”
Drug-induced gingival overgrowth is medication-related gingival overgrowth commonly associated with certain systemic medications. Gingival overgrowth is a common adverse effect of phenytoin therapy. The condition is more frequently seen in children as compared to adults, affects both genders equally, and may vary from mild to severe. It may be associated with difficulty in mastication, delayed eruption of teeth, tissue trauma, and secondary inflammation. It can be managed by both surgical and nonsurgical therapies. A case of dental management of phenytoin-induced gingival enlargement in a 7-year-old girl is presented with a brief literature review.
“…Kết quả nghiên cứu trên phù hợp với số liệu trong nghiên cứu của Lucas.J [9] trên 59 nạn nhân bị điện giật ở Bắc Ireland với gần 60% nạn nhân đang hành nghề. Kumar S và cộng sự [1] cũng đưa ra kết luận tương tự.…”
Section: Một Số đặC đIểm Chung Của đốI Tượng Nghiên Cứuunclassified
“…Điện giật là thuật ngữ chỉ khi có dòng điện chạy qua người [1]. Kể từ khi trở thành một sản phẩm thương mại vào năm 1849, điện trở thành một trong những "hàng hóa" nguy hiểm nhất trong xã hội.…”
Tóm tắt: "Điện giật" là thuật ngữ chỉ khi có dòng điện chạy qua cơ thể. Bên cạnh những lợi ích to lớn trong đời sống xã hội, điện cũng gây ra những hậu quả nặng nề về kinh tế, nguy hiểm tới tính mạng con người nếu thiếu hiểu biết và không tuân thủ các biện pháp phòng hộ trong sinh hoạt và sản xuất. Chúng tôi thu thập được 37 nạn nhân tử vong do điện giật có hồ sơ giám định y pháp do Bộ môn Y pháp -Trường Đại học Y Hà Nội, Viện Pháp y Quân đội tiến hành giám giám định từ tháng 5/2001 đến tháng 7/2016. Kết quả số nạn nhân nam gấp 8,3 lần nữ. Nhóm tuổi từ 18 đến 30 chiếm tỷ lệ cao nhất (37,8%), độ tuổi trung bình là 36,6. Dấu điện có mặt ở 78,4% số nạn nhân, chủ yếu là dấu điện vào 78,4%, tần suất xuất hiện dấu điện cao nhất ở tay phải 29,7%.Từ khóa: Điện giật, giám định y pháp, bỏng điện, dấu điện.
Đặt vấn đề Điện giật là thuật ngữ chỉ khi có dòng điện chạy qua người [1]. Kể từ khi trở thành một sản phẩm thương mại vào năm 1849, điện trở thành một trong những "hàng hóa" nguy hiểm nhất trong xã hội. Thương tích do điện luôn tỷ lệ thuận với việc sử dụng rộng rãi trong xã hội [2]. Chức năng của giám định pháp y trong các vụ chết do điện một mặt xác định nguyên nhân tử vong, dựng lại hiện trường vụ việc và nghiên cứu đặc điểm tổn thương của những nạn nhân tử vong với mục đích tìm hoặc đưa ra những biện pháp phòng tránh, mặt khác giúp các nhà lâm sàng trong hoạt động chuyên môn (chẩn _______ Tác giả liên hệ. ĐT.: 84-945963399.Email: drlshung@gmail.com https://doi.org/10.25073/2588-1132/vnumps.4094 đoán, hồi sức cấp cứu, tiên lượng,…), điều trị những người bị chấn thương điện được tốt hơn [3]. Từ những nhận thức về tầm quan trọng của vấn đề nêu trên, chúng tôi thực hiện đề tài "Nghiên cứu các hình thái tổn thương do điện trong giám định y pháp".
Đối tượng và phương pháp nghiên cứu
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