This document discusses different types of gingival enlargement. It describes localized or generalized enlargement that is more prominent on the labial/buccal surface rather than lingual/palatal surfaces. It classifies enlargement as inflammatory, drug-induced, associated with systemic factors, idiopathic, neoplastic, or false enlargement. Inflammatory enlargement is due to chronic gingival irritation from factors like calculus or poor oral hygiene. Drug-induced enlargement can be caused by medications like anticonvulsants and immunosuppressants. Enlargement associated with systemic factors includes conditions like hormonal issues, nutritional deficiencies, or allergic reactions.

1. GINGIVAL ENLARGEMENT
Dr Madhu
Department of Oral Pathology
SRM DENTAL COLLEGE,Ramapuram,
Chennai

2. INTRODUCTION
• CAN BE LOCALIZED/GENERALIZED
• MORE PROMINENT ON THE LABIAL/BUCCAL
SURFACE RATHER THAN THE
LINGUAL/PALATAL SURFACE
• DOES NOT INVOLVE THE VESTIBULAR
MUCOSA
• MAY OVERFILL THE INTERPROXIMAL SPACES,
BALLOON OUT OVER THE TEETH, AND
PROTRUDE INTO THE ORAL CAVITY

3. CLASSIFICATION
• INFLAMMATORY
• DRUG-INDUCED
• ASSOCIATED WITH SYSTEMIC FACTORS
-CONDITIONED ENLARGEMENT
-DUE TO SYSTEMIC DISEASES
• IDIOPATHIC
• NEOPLASTIC
• FALSE ENLARGEMENT

4. INFLAMMATORY
ENLARGEMENT

5. INFLAMMATORY
ENLARGEMENT
• DUE TO PROLONGED CHRONIC GINGIVAL IRRITATION
• DUE TO LOCAL IRRITANTS LIKE CALCULUS, POOR OH
ETC.
• VARIATION IN HOST TISSUE RESPONSE TO PLAQUE
• C/F-GINGIVA IS SOFT, EDEMATOUS, GLOSSY, BLEEDS
EASILY, NON-STIPPLED, ERYTHEMATOUS AND
SENSITIVE
• H/F-NON-SPECIFIC; HYPEREMIA, LYMPHOCYTIC
INFILTRATION AND EDEMA
• DUAL ETIOLOGY MAY ALSO BE PRESENT

6. INFLAMMATORY
ENLARGEMENT

7. DRUG-INDUCED ENLARGEMENT

8. DRUG-INDUCED ENLARGEMENT
•ANTICONVULSANTS, IMMUNOSUPPRESSANTS, Ca
CHANNEL BLOCKERS
•PHENYTOIN-50% SHOW ENLARGEMENT
•DILANTIN –FIBROBLAST PROLIFERATION AND
DECREASES COLLAGEN DEGRADATION
•IDP ENLARGEMENT-INCREASED STIPPLING,
PEBBLED APPEARANCE, NO BLEEDING, DENSE
•ESTHETICS AFFECTED-SURGICAL REMOVAL-
RECURRENCE COMMON-DISCONTINUE THE DRUG
•DD-FIBROMA, KELOID

9. DRUG-INDUCED ENLARGEMENT

10. ENLARGEMENT ASSOCIATED
WITH SYSTEMIC FACTORS

11. CONDITIONED ENLARGEMENT
• SYSTEMIC CONDITION EXAGGERATING THE
USUAL GINGIVAL RESPONSE TO PLAQUE
• 3 TYPES-
-HORMONAL
-NUTRITIONAL
-ALLERGIC

12. HORMONAL ENLARGEMENT
• PUBERTY-EITHER HORMONAL
IMBALANCE/POOR OH
• PREGNANCY-DISTURBED NUTRITION, POOR
OH, SYSTEMIC FACTOR, INCREASED
ESTROGEN AND PROGESTERONE-INCREASE
VASCULAR PERMEABILITY-GINGIVAL EDEMA
• PREGNANCY TUMOR/PYOGENIC
GRANULOMA-FIBROBLASTS+LEUKOCYTES

13. HORMONAL ENLARGEMENT

14. NUTRITIONAL ENLARGEMENT
• VIT. C DEFICIENCY-SCURVY
• DEFICIENCY+INFLAMMATION
• RESPONSE TO PLAQUE
• SWOLLEN, EDEMATOUS, TENDER GINGIVA-
READY TO BLEED
• SULCUS FILLED WITH CLOTTED BLOOD, IDP
CREST –RED/PURPLE
• NECROSIS/ULCERATION OF IDP
• TREATMENT-VIT. C+GOOD OH

15. NUTRITIONAL ENLARGEMENT-
SCURVY

16. ALLERGIC ENLARGEMENT-PLASMA
CELL GINGIVITIS
• HYPERSENSITIVE REACTION TO ANY
COMPONENT OF DENTIFRICE, CHEWING GUM
ETC.
• MILD MARGINAL GINGIVAL ENLARGEMENT
• C/F-YOUNG FEMALES; SWOLLEN, EDEMATOUS,
BLEEDING GINGIVA
• H/F-HYPERPLASTIC, INTRACELLULAR EDEMA,
MICROABSCESSES, POLYCLONAL PLASMA CELLS
• TREATMENT-REMOVE THE ALLERGENS;
STEROIDS

17. PLASMA CELL GINGIVITIS

18. ENLARGEMENT DUE TO
SYSTEMIC DISEASES

19. ENLARGEMENT DUE TO SYSTEMIC
DISEASES
• LEUKEMIA
• GRANULOMATOUS DISEASES
• REGIONAL ENTERITIS-CROHN DISEASE

20. LEUKEMIC ENLARGEMENT

21. IDIOPATHIC GINGIVAL
ENLARGEMENT

22. FIBROMATOSIS GINGIVAE/ELEPHANTIASIS
GINGIVAE/CONGENITAL MACROGINGIVA
• AUTOSOMAL DOMINANT-HEREDITY
• C/F-LARGE MASSES OF DENSE, FIRM, RESILIENT,
INSENSITIVE GINGIVAL GROWTH OVER ALVEOLAR RIDGES
AND TEETH
• MAY INTERFERE WITH ERUPTION
• TEETH COMPLETELY COVERED
• SEVERE ESTHETIC DEFORMITY-LIPS PROTRUDE, PATIENT
CHEWS ON THEM
• H/F-HYPERPLASTIC EPITHELIUM; LONG RETE PEGS;DENSE
BUNDLES OF MATURE FIBROUS TISSUES IN CT
• TREATMENT-SURGERY

23. FIBROMATOSIS GINGIVAE

24. OTHER ENLARGEMENT-
NEOPLASTIC AND FALSE

25. • NEOPLASTIC-BENIGN OR MALIGNANT
GINGIVAL LESIONS
• FALSE-UNDERLYING BONE/DENTAL
ANOMALIES

26. Thank You