Dr. Mina Saad
-12 years old female come with unusual gingival enlargement and on examination it was obvious that there is a “double gingiva” pseudo gingiva which is easily detached and beneath the true attached one…. She had a history of lip trauma causing injury in the lip inside , suturing the wound caused narrowing of the labial sulcus as the wound edges were approximated to reach the attached gingiva and the alveolar mucosa were disappeared.
-She had a previous tonsillectomy since 7 years while the tonsils were inflamed and as a complication , Rheumatic factor appeared leading to rheumatic arthritis
-She had also a mouth breathing habit.
Investigations was done including CBC , Rheumatic factor (RF)
Investigations were within normal and rheumatic factor was negative after treatment and her physician gave me the permission to perform her surgery.
- Correction of the double gingiva to reveal the true attached gingiva and remove the pseudo one which is highly vascular and easily inflamed that resulted from the false wound suturing , this will be done by Gingivectomy.
- Sulcus deepening to correct the shallow sulcus which resulted from the false suturing of the wound.
- Habit breaking appliance “oral screen” to treat the mouth breathing to prevent enlargement of the gingiva.
- Orthodontic treatment. N.B: Treatment is in progress and further Gingivoplasty will be done after fabrication of the oral screen.
Preoperative photo of the double gingiva presenting with shallow sulcus.
The outer “pseudo” layer of gingiva & the inner true keratinized gingiva.
Strip of the pseudo gingiva excised as a one piece.
Post operative photo immediately after surgical excision of the pseudo gingiva & sulcus deepening to correct the shallow sulcus.
Post operative healing following one week.