Unilateral pathology associated with bilateral etiologies.

Area of Science:

• Oral Medicine
• Periodontology
• Endocrinology

Background:

• Hormonal fluctuations significantly impact oral health, particularly during puberty.
• These effects are often mediated by local factors, such as plaque accumulation, which are exacerbated by hormonal changes.
• Unilateral mastication can further complicate oral conditions by creating localized stress and plaque retention.

Observation:

• A 14-year-old female presented with a two-year history of swollen gums in the right maxillary and mandibular arches.
• The patient reported a lifelong habit of unilateral mastication on the left side.
• Clinical examination revealed gingival enlargement and signs of chronic generalized periodontitis.

Findings:

• The condition was attributed to the combined influence of pubertal hormonal changes and unilateral masticatory habits.
• Conventional periodontal therapy, including plaque control, scaling, root planing, and surgical soft tissue removal (Modified Widman Flap), was performed.
• Bone grafting was utilized to address periodontal attachment loss.

Implications:

• Successful treatment involved a combination of non-surgical and surgical periodontal interventions.
• The case highlights the importance of considering hormonal influences and masticatory habits in diagnosing and managing gingival enlargement.
• Early surgical removal of enlarged gingival tissue is crucial to prevent progressive periodontal attachment loss and bone destruction.