Gingival overgrowth: Part 1: aetiology and clinical diagnosis

Abstract

Most commonly, gingival overgrowth is a plaque-induced inflammatory process, which can be modified by systemic disease or medications. However, rare genetic conditions can result in gingival overgrowth with non-plaque-induced aetiology. It is also important to appreciate the potential differential diagnoses of other presentations of enlarged gingival tissues; some may be secondary to localised trauma or non-plaque-induced inflammation and, albeit rarely, others may be manifestations of more sinister diseases or lesions. A definitive diagnosis will then enable an appropriate management strategy. This paper aims to discuss clinical features and diagnoses for conditions presenting with gingival overgrowth and other enlargements of gingival tissues.

Change of TGF-β1 Gene Expression and TGF-β1 Protein Level in Gingival Crevicular Fluid and Identification of Plaque Bacteria in a Patient with Recurrent Localized Gingival Enlargement before and after Gingivectomy

“…This condition nowadays is known as gingival enlargement or gingival overgrowth [1]. This term has replaced gingival hyperplasia (increase in cell number) and gingival hypertrophy (increase in cell size) as these are histological diagnosis and do not accurately describe the varied pathological processes seen within the tissues [2]. …”

“…Based on distribution, gingival enlargement may be described as localized or generalized [2, 4]. Localized gingival enlargements are limited to the gingiva adjacent to a single tooth or a group of teeth that started as ballooning papillae and then progressed to involve the marginal gingiva and in more severe cases can cover occlusal aspects of dentition [1, 2].…”

“…Localized gingival enlargements are limited to the gingiva adjacent to a single tooth or a group of teeth that started as ballooning papillae and then progressed to involve the marginal gingiva and in more severe cases can cover occlusal aspects of dentition [1, 2]. Historically, this condition termed as epulis refers to any solitary/discrete, pedunculated, or sessile masses of the gingiva with no histologic characterization of a particular lesion.…”

“…Historically, this condition termed as epulis refers to any solitary/discrete, pedunculated, or sessile masses of the gingiva with no histologic characterization of a particular lesion. The precise term “reactive lesion of the gingiva” seems to be more appropriate for these swelling conditions [2, 4]. …”

“…This condition has the clinical appearance such as soft, edematous, hyperemic or cyanotic, and usually painful or at least sensitive. These gingivae bleed quickly when probed and have smooth and distended appearance; the normal stippling has usually been lost clinically as well [2, 5]. …”