Management of Gingival Enlargement to Tooth Malposition Maxillary Left Lateral Incisor and Canine in an Untreated Hypertensive Patient: A Case Report

Abstract

Background: Tooth malposition leads to increased plaque retention, resulting in inflammation and gingival enlargement. Gingivectomy is an effective treatment; however, in patients with hypertension, pre-operative assessment and the selection of appropriate anaesthesia are required to reduce cardiovascular risk. Purpose: This case report focuses on the management of gingival overgrowth caused by plaque accumulation associated with tooth malposition, using gingivectomy in a patient with uncontrolled hypertension. Case(s): A 22-year-old female patient was referred with a complaint of gingival enlargement in the anterior region of the upper jaw, associated with malposition of teeth 22 and 23, which was compromising oral hygiene and aesthetics. Pre-operative examination revealed that the patient’s blood pressure was within the range of uncontrolled hypertension. Case Management: Following initial periodontal therapy, a gingivectomy was performed under local anaesthesia contained ephinefrin at the recommended dose, with blood pressure monitored throughout the procedure. The post-operative period showed good healing, a reduction in inflammation, improved gingival contour and enhanced aesthetics, with no cardiovascular complications. Conclusion: Gingivectomy is an effective treatment for gingival enlargement associated with malpositioned tooth and is safe to perform in patients with uncontrolled hypertension, provided that pre-operative assessment is carried out and local anaesthesia with ephinefrin is used in accordance with recommendations.