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GINGIVAL ENLARGEMENTS

1/26/2014

Flt.lt. Rumal Gunaratne
1
Contents
Definition

Etiology

Classification

Clinical picture

Treatment

Questions

1/26/2014

2
DEFFINITION
Gingival enlargement refers to
excessive growth of the gums, and may
also be known as gingival hyperplasia
or ...
What are the possible causes?

1/26/2014

4
• Poor dental hygiene
• Smoking, mouth breathing and overcrowded teeth
• Systemic diseases
• Hormonal states: pregnancy, p...
According to
etiological and
pathological changes
Classification
According to location
and distribution

1/26/2014

6
According to etiological and
pathological changes
Inflammatory
enlargement
• Acute
• Chronic

1/26/2014

Drug-induced
enla...
According to location and distribution

Localized

1/26/2014

Generalized

Marginal

Papillary

Diffuse

Discrete

8
Gingival
abscess

Pericoronal
abscess

Acute
inflammatory
enlargement

Periodontal
abscess

Periapical
abscess
1/26/2014

...
Gingival Abscess

1/26/2014

10
Periodontal abscess

1/26/2014

11
Pericoronal abscess

1/26/2014

12
Periapical abscess

1/26/2014

13
1/26/2014

14
Localized

1/26/2014

15
Generalized

1/26/2014

16
Calcium channel
blockers

immunosuppressa
nt's

Nifedipine

Cyclosporine

Anti-convulsants

Phenytoin

1/26/2014

Drug-ind...
Phenytoin

1/26/2014

18
Cyclosporine

1/26/2014

19
Nifedipine

1/26/2014

20
Congenital
familial
fibromatosis

Gingivomatosis

Idiopathic
Gingival
Fibromatosis
Elephantiasis
gingivae

Hereditary

1/2...
Idiopathic Gingival Fibromatosis

1/26/2014

22
Enlargements associated with systemic
diseases
Conditional
enlargement

Systemic
diseases causing
gingival
enlargments
1/2...
pregnancy

1/26/2014

24
puberty

1/26/2014

25
Vitamin C deficiency

1/26/2014

26
Plasma cell gingivitis

1/26/2014

27
Non-specific conditioned enlargement
(Granuloma pyogenicum)

1/26/2014

28
Leukemia

1/26/2014

29
Neoplastic enlargements

Benign
tumors
1/26/2014

Malignant
tumors
30
Benign

1/26/2014

31
Fibroma

1/26/2014

32
Papilloma

1/26/2014

33
Peripheral giant cell granuloma

1/26/2014

34
leukoplakia

1/26/2014

35
Gingival cyst

1/26/2014

36
Malignant

1/26/2014

37
Squamous cell carcinoma

1/26/2014

38
Malignant melanoma

1/26/2014

39
Treatment

1/26/2014

40
Scoring of gingival enlargement
Grade 0

Grade 1

Grade 2

• No sign of gingival enlargement

• Enlargement confined to th...
Questions

1/26/2014

42
THANK YOU

1/26/2014

43
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Gingival enlargements

  1. 1. GINGIVAL ENLARGEMENTS 1/26/2014 Flt.lt. Rumal Gunaratne 1
  2. 2. Contents Definition Etiology Classification Clinical picture Treatment Questions 1/26/2014 2
  3. 3. DEFFINITION Gingival enlargement refers to excessive growth of the gums, and may also be known as gingival hyperplasia or hypertrophy. 1/26/2014 3
  4. 4. What are the possible causes? 1/26/2014 4
  5. 5. • 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 1/26/2014 5
  6. 6. According to etiological and pathological changes Classification According to location and distribution 1/26/2014 6
  7. 7. According to etiological and pathological changes Inflammatory enlargement • Acute • Chronic 1/26/2014 Drug-induced enlargement or Non inflammatory gingival enlargement Enlargement associated with systemic diseases • Conditioned enlargement • Systemic diseases causing gingival enlargements Neoplastic Enlargement False Enlargement 7
  8. 8. According to location and distribution Localized 1/26/2014 Generalized Marginal Papillary Diffuse Discrete 8
  9. 9. Gingival abscess Pericoronal abscess Acute inflammatory enlargement Periodontal abscess Periapical abscess 1/26/2014 9
  10. 10. Gingival Abscess 1/26/2014 10
  11. 11. Periodontal abscess 1/26/2014 11
  12. 12. Pericoronal abscess 1/26/2014 12
  13. 13. Periapical abscess 1/26/2014 13
  14. 14. 1/26/2014 14
  15. 15. Localized 1/26/2014 15
  16. 16. Generalized 1/26/2014 16
  17. 17. Calcium channel blockers immunosuppressa nt's Nifedipine Cyclosporine Anti-convulsants Phenytoin 1/26/2014 Drug-induced enlargement or Non inflammatory gingival enlargement Idiopathic Gingival Fibromatosis 17
  18. 18. Phenytoin 1/26/2014 18
  19. 19. Cyclosporine 1/26/2014 19
  20. 20. Nifedipine 1/26/2014 20
  21. 21. Congenital familial fibromatosis Gingivomatosis Idiopathic Gingival Fibromatosis Elephantiasis gingivae Hereditary 1/26/2014 21
  22. 22. Idiopathic Gingival Fibromatosis 1/26/2014 22
  23. 23. Enlargements associated with systemic diseases Conditional enlargement Systemic diseases causing gingival enlargments 1/26/2014 • Pregnancy • Puberty • Vitamin C deficiency • Plasma cell gingivitis • Non-specific conditioned enlargment (Granuloma pyogenicum) • Leukemia • Granulomatous diseases 23
  24. 24. pregnancy 1/26/2014 24
  25. 25. puberty 1/26/2014 25
  26. 26. Vitamin C deficiency 1/26/2014 26
  27. 27. Plasma cell gingivitis 1/26/2014 27
  28. 28. Non-specific conditioned enlargement (Granuloma pyogenicum) 1/26/2014 28
  29. 29. Leukemia 1/26/2014 29
  30. 30. Neoplastic enlargements Benign tumors 1/26/2014 Malignant tumors 30
  31. 31. Benign 1/26/2014 31
  32. 32. Fibroma 1/26/2014 32
  33. 33. Papilloma 1/26/2014 33
  34. 34. Peripheral giant cell granuloma 1/26/2014 34
  35. 35. leukoplakia 1/26/2014 35
  36. 36. Gingival cyst 1/26/2014 36
  37. 37. Malignant 1/26/2014 37
  38. 38. Squamous cell carcinoma 1/26/2014 38
  39. 39. Malignant melanoma 1/26/2014 39
  40. 40. Treatment 1/26/2014 40
  41. 41. Scoring of gingival enlargement Grade 0 Grade 1 Grade 2 • No sign of gingival enlargement • Enlargement confined to the interdental papilla • Enlargement involves papilla and marginal gingiva • Enlargement covers three quarters or more of the crown Grade 3 1/26/2014 41
  42. 42. Questions 1/26/2014 42
  43. 43. THANK YOU 1/26/2014 43
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