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GINGIVAL ENLARGEMENTS

Flt.lt. Rumal Gunaratne

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Contents

Definition

Etiology

Classification

Clinical picture

Treatment

Questions

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DEFFINITION

Gingival enlargement refers to excessive growth of the gums, and may also be

known as gingival hyperplasia or hypertrophy.

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What are the possible causes?

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• Poor dental hygiene

• Smoking, mouth breathing and overcrowded teeth

• Systemic diseases

• Hormonal states: pregnancy, puberty;

• Nutritional deficiency: scurvy (vitamin C deficiency);

• Medications

• Genetic conditions, often present at birth (all rare conditions)

• Blood conditions such as acute leukaemia

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Classification

According to etiological and

pathological changes

According to location and distribution

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According to etiological and pathological changes

Inflammatory enlargement•Acute•Chronic

Drug-induced enlargement or

Non inflammatory

gingival enlargement

Enlargement associated with systemic diseases•Conditioned

enlargement•Systemic diseases

causing gingival enlargements

Neoplastic Enlargement

False Enlargement

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According to location and distribution

Localized Generalized Marginal Papillary Diffuse Discrete

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Acute inflammatory enlargement

Gingival abscess

Periodontal abscess

Periapical abscess

Pericoronal abscess

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Gingival Abscess

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Periodontal abscess

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Pericoronal abscess

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Periapical abscess

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Chronic inflammatory enlargement

Localized

GeneralizedDiscrete(tumor like)

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Localized

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Generalized

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Drug-induced enlargement or

Non inflammatory

gingival enlargement

Anti-convulsants Phenytoin

Calcium channel blockers Nifedipine

immunosuppressant's

Cyclosporine

Idiopathic Gingival Fibromatosis

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Phenytoin

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Cyclosporine

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Nifedipine

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Congenital familial

fibromatosis

Gingivomatosis

Elephantiasis gingivae

Hereditary

Idiopathic Gingival

Fibromatosis

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Idiopathic Gingival Fibromatosis

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Enlargements associated with systemic diseases

• Pregnancy• Puberty• Vitamin C deficiency• Plasma cell gingivitis• Non-specific conditioned enlargment

(Granuloma pyogenicum)

Conditional enlargement

• Leukemia• Granulomatous diseases

Systemic diseases causing

gingival enlargments

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pregnancy

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puberty

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Vitamin C deficiency

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Plasma cell gingivitis

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Non-specific conditioned enlargement (Granuloma pyogenicum)

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Leukemia

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Neoplastic enlargements

Benign tumors

Malignant tumors

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Benign

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Fibroma

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Papilloma

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Peripheral giant cell granuloma

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leukoplakia

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Gingival cyst

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Malignant

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Squamous cell carcinoma

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Malignant melanoma

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Treatment

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Scoring of gingival enlargement

Grade 0 •No sign of gingival enlargement

Grade 1 •Enlargement confined to the interdental papilla

Grade 2 •Enlargement involves papilla and marginal gingiva

Grade 3 •Enlargement covers three quarters or more of the crown

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Questions

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THANK YOU