This was an interesting case of (Acute) Necrotizing Ulcerative Gingivitis that I have followed after initial treatment from December, 2017. This 11 year old healthy male presented to my service complaining of ulcerated gingival areas which were denuded and featured bleeding on flossing paired with extreme sensitivity. Loesche et al (1982) characterized the anaerobic flora to contain species amongst which B. melanogenicus, T. denticum, Fusobacterium and P. intermedia were prevalent.
A1: Initial presentation with ANUG affecting the 23-25 region.
A2: Reassessment in 1 week following Rx: 1) Amoxicillin (500mg) q8h x 7 days, 2) Metronidazole (200mg) q8h x 7 days. Residual area of tenderness but significantly better.
A3 : Re-presentation 1 week later with near-complete resolution of 23-25 region but exacerbation of ANUG in 14-15 region. Rx: 1) Clindamycin (600mg) q8h x 7 days; 2) Metronidazole (200mg) q8h x 7 days.
1 week later, the patient experienced a flare up of NUG in 25, 13, 14, 15 regions. Decision to use dual-wavelength diode (810nm, 980nm) in an uninitiated mode over affected areas at a distance of 4mm (0.6W continuous) for 20 seconds.
As the patient featured excellent oral hygiene, bloodwork was completed for this patient which revealed elevated antibodies to Epstein-Barr virus. With a non-invasive approach, the Ultradent Gemini was used in a painless manner to negate progression of the lesions and accelerate healing.
#Ultradent #Gemini #blackmagic #laserlighttherapy