been a couple of things ive wanted to write about but never got round to, so here i am with an urge to write and some time to kill!
1) the nefedipine hyperplasia patient
uncle Carranza tells me that a good 1 in 5 of these patients will have some form of gingival hyperplasia. at the least, this makes SAP into a messy affair as they will bleed like animals in a slaughterhouse. at worst... a week or 2 ago, i saw a patient who had nifedipine hyperplasia superimposed on severe generalised chronic periodontitis. his papillae were swollen to the point where they were actually touching his CEJ. in 20min i could only root plane half his mouth...
considering that the hyperplasia is actually a fibrotic overgrowth of tissue that will not go away by itself even after OH improves or nefedipine is substituted (the only improvement being reduction in oedema) there really should be a lot of business for gingivoplasty via either the gingivectomy or modified Widman technique...
2) the periodontal abscess patient
1) the nefedipine hyperplasia patient
uncle Carranza tells me that a good 1 in 5 of these patients will have some form of gingival hyperplasia. at the least, this makes SAP into a messy affair as they will bleed like animals in a slaughterhouse. at worst... a week or 2 ago, i saw a patient who had nifedipine hyperplasia superimposed on severe generalised chronic periodontitis. his papillae were swollen to the point where they were actually touching his CEJ. in 20min i could only root plane half his mouth...
considering that the hyperplasia is actually a fibrotic overgrowth of tissue that will not go away by itself even after OH improves or nefedipine is substituted (the only improvement being reduction in oedema) there really should be a lot of business for gingivoplasty via either the gingivectomy or modified Widman technique...
2) the periodontal abscess patient
with no Graceys, can there be adequate debridement? since im not exactly equipped with the funkiest of root planing ultrasonics, it usually means some form of hand-instrumented root planing will be needed. and when the fall-back is a set of single-ended 2L+2R... gyaaaa!
No comments:
Post a Comment