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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 Slide 1 Gingival enlargements Slide 2 Gingival enlargements Slide 3 Gingival enlargements Slide 4 Gingival enlargements Slide 5 Gingival enlargements Slide 6 Gingival enlargements Slide 7 Gingival enlargements Slide 8 Gingival enlargements Slide 9 Gingival enlargements Slide 10 Gingival enlargements Slide 11 Gingival enlargements Slide 12 Gingival enlargements Slide 13 Gingival enlargements Slide 14 Gingival enlargements Slide 15 Gingival enlargements Slide 16 Gingival enlargements Slide 17 Gingival enlargements Slide 18 Gingival enlargements Slide 19 Gingival enlargements Slide 20 Gingival enlargements Slide 21 Gingival enlargements Slide 22 Gingival enlargements Slide 23 Gingival enlargements Slide 24 Gingival enlargements Slide 25 Gingival enlargements Slide 26 Gingival enlargements Slide 27 Gingival enlargements Slide 28 Gingival enlargements Slide 29 Gingival enlargements Slide 30 Gingival enlargements Slide 31 Gingival enlargements Slide 32 Gingival enlargements Slide 33 Gingival enlargements Slide 34 Gingival enlargements Slide 35 Gingival enlargements Slide 36 Gingival enlargements Slide 37 Gingival enlargements Slide 38 Gingival enlargements Slide 39 Gingival enlargements Slide 40 Gingival enlargements Slide 41 Gingival enlargements Slide 42 Gingival enlargements Slide 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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