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Background Methods Results Conclusions Key points Drug‐induced gingival enlargement (DIGE) is a common side effect of medications such as anticonvulsants, calcium channel blockers, and immunosuppressants. The treatment of choice for the condition is drug withdrawal or substitution in combination with the nonsurgical phase. In some cases, additional internal or external bevel gingivectomy is needed to achieve periodontal health. Special approaches may be needed in severe DIGE cases superimposed on periodontitis. The aim of this report is to describe the dual‐flap internal gingivectomy (DFIG) approach for the simultaneous management of soft and hard tissues via the simultaneous reduction of the connective tissue bulkiness from the superficial flap and preservation of keratinized tissues.A generalized Stage IV grade C periodontitis with DIGE was treated.  An initial partial thickness flap was elevated and thinned out to a thickness of 1.0–1.5 mm. Then, a second partial‐thickness flap was raised, and a thick band of connective tissue was removed. Proper positioning of the primary flap onto the periosteum was obtained and flap adaptation was achieved with localized gingivoplasty.Healthy soft tissue was developed with DFIG by debulking the enlarged connective tissues and apical gingival margin positioning with a predictable wide band of keratinized attached gingiva was achieved.   The DFIG surgical approach provides adequate access for root instrumentation and preserves KT width. The procedure effectively reduces soft tissue thickness and improves soft tissue contours, in DIGE cases superimposed to periodontitis. Gingival enlargement is related to excessive production and deposition of collagen in the inner layer of the connective tissue and the surface of the alveolar bone. The dual‐flap internal gingivectomy (DFIG) approach allows for targeted excision of the inner layer of the connective tissue from the buccal primary flap while preserving the width of the keratinized tissue. Adequate soft tissue contours and volume are obtained following the DFIG procedure. Gingival enlargement is related to excessive production and deposition of collagen in the inner layer of the connective tissue and the surface of the alveolar bone.The dual‐flap internal gingivectomy (DFIG) approach allows for targeted excision of the inner layer of the connective tissue from the buccal primary flap while preserving the width of the keratinized tissue.Adequate soft tissue contours and volume are obtained following the DFIG procedure. [ABSTRACT FROM AUTHOR]

Background: Hereditary gingival fibromatosis (HGF) is a rare hereditary condition characterized by abnormal enlargement of the gingival tissue with a variable clinical manifestation. Typically, the hyperplastic gingiva is normal in color and consistency, and the tendency of bleeding is minimal. The swelling may be limited to a particular location or generalized over the whole gingiva. Usually, the symptoms appear during and after the eruption of permanent dentition. Gingival proliferation in HGF causes a variety of esthetic and practical issues. Depending on the size and intensity of the overgrowth, speech and chewing may be impaired. Moreover, diastema and prolonged primary dentition retention may occur. Case Reports: This article describes the identification, management, and treatment approaches of four cases affecting a Syrian family who lived in Arbat refugee camp in Sulaymaniyah, Kurdistan, Iraq. Conclusion: Proliferative fibrous outgrowth of the gingival tissue, with different degrees of involvement, is a hallmark of HGF. Surgery is frequently necessary to restore function and appearance, though varying degrees of recurrence is anticipated. Nonetheless, the psychological advantages of cosmetic improvement exceed the dangers of recurrence by a wide margin, especially in teenagers. [ABSTRACT FROM AUTHOR]

Objective: While connective tissue graft shrinkage is a well‐documented post‐transplantation reaction, there is a literature gap concerning hyperplastic tissue response. Despite its infrequent occurrence, investigation is warranted due to its capacity to compromise esthetics, disrupt lip dynamics, and promote food retention. Moreover, efforts to mitigate hyperplastic tissue response often prove challenging, and there is a potential risk of exacerbating gingival tissue rebound. Clinical Considerations: This report presents a potential solution to managing tissue overgrowth after connective tissue grafting in five clinical cases. The patients underwent corrective surgery involving internal excision of excessive tissue while preserving the overlying mucosa. The surgical approach was tailored to excise hyperplastic tissue with minimal trauma, aiming to optimize esthetic outcomes. Subsequent follow‐up assessments spanning 1–5 years demonstrated stable results, with no indications of relapse or recurrence of tissue overgrowth. Conclusions: Within the limitations of this case series, surgical internal excision holds promise as a viable treatment modality for addressing post‐transplantation hyperplastic tissue response. Clinical Significance: This case series addresses the challenge of uncontrolled tissue overgrowth following connective tissue grafting, a concern for which previous attempts have proven unsuccessful. Internal in‐toto excision emerges as a promising approach for effectively eliminating overgrown tissue, offering potential advancements in the clinical management of this complication. [ABSTRACT FROM AUTHOR]

Peripheral cemento-ossifying fibroma is an unusual, localized reactive, benign lesion of the oral cavity that shows various degrees of fibrous maturation and calcification in the histopathology. The lesion is often misdiagnosed, hence appropriate radiographs and histopathological examination are crucial for its correct diagnosis and management. The lesion has a high recurrence rate. The present report highlights a case of peripheral cement-ossifying fibroma in a 24-year-old female patient who was surgically excised. The growth, however, recurred after 4 months which was then managed by scalpel excision as well as aggressive curettage and root planing.

Aim of the study The purpose of our study is to present the clinical aspects of gingival overgrowth induced by orthodontic therapy and to highlight the tissue changes of this gingival lesion. Materials and methods Biopsies of the gingival mucosa were taken from subjects diagnosed with gingival overgrowth and who were undergoing orthodontic therapy. The gingival mucosa samples were processed in the histology laboratory of University of Medicine and Pharmacy Craiova and the usual histological staining (hematoxylin-eosin) was performed. Results Gingival overgrowth (GO) is a condition characterized by an increase in gingival size, often observed in patients undergoing orthodontic therapy. The gingival enlargement begins o two or three months after the insertion of orthodontic appliance. The main causes of gingival overgrowth during orthodontic treatment include increased plaque accumulation due to challenges in maintaining oral hygiene with fixed appliances. Another cause is represented by the excessive pressure exerted by the orthodontic forces on the periodontium.Various factors influence the development of gingival overgrowth, including gender, age, and duration of orthodontic treatment. Conclusions Gingival overgrowth of orthodontic etiology can take on various clinical and morphological aspects and depends on the status of oral hygiene, the duration and correctness of orthodontic therapy.

This study aimed to identify risk factors for amlodipine-induced gingival enlargement, assess quality of life, and analyze gingival tissue. This cross-sectional study involved hypertensive patients on amlodipine, divided into groups with and without gingival enlargement. Assessments included sociodemographic data, clinical evaluations, and clinical parameters. Quality of life was assessed using OHIP-14 and WB-HRQoL scales. Gingival tissue samples were analyzed for oxidative status and key molecules using RT-PCR and colorimetric assays. The study included 32 patients with no significant sociodemographic differences between groups (p > 0.05). Patients with gingival enlargement had higher systolic blood pressure (139.63 ± 10.743 vs. 128.38 ± 7.249, p = 0.028) and higher OHIP-14 scores. The RT-PCR analysis showed significant differences in IL-6, TNF-α, IL-33, ST2, TGF-β1, FGF-2, CTGF, VEGF-D, and KGF expression. IL-6, TNF-α, ST2, and FGF-2 expression levels were lower in patients taking amlodipine, with and without gingival enlargement. TGF-β1 and CTGF expression levels were highest in patients with amlodipine-induced gingival enlargement. SOD activity was also highest in these patients, whereas MDA levels were higher in patients with gingival enlargement without amlodipine. Our study highlights the impact of amlodipine-induced gingival enlargement on oral health and quality of life, emphasizing fibrosis and oxidative stress, and suggests the need for integrated healthcare approaches and further research. [ABSTRACT FROM AUTHOR]

Background. Orthodontic therapy is a complex process involving a series of specialists in the dental field: the oral-maxillo-facial surgeon, the periodontologist, sometimes even the prosthetist, implantologist, or general practitioners. The injuries of the oral mucosa induced by orthodontic therapy include gingival overgrowths, traumatic lesions of the oral mucosa, different degrees of periodontal damage manifested by gingival retraction, alveolar bone resorption. Methods. From a total of 327 subjects who came to the Dental Clinic in Craiova 74 subjects were selected, who presented with gingival overgrowth associated with fixed orthodontic therapy. Subjects’ age ranged from 14 to 56 years and experienced bleeding and gingival discomfort as well as alterations in physiognomic function. None of the patients included in the study have systemic diseases and are not under medical treatment. The clinical and statistical study took place between May 2022 and December 2023. Each patient was given a personal record containing personal data as well as oral and systemic health status. The examination of the periodontal status aimed at the evaluation of the following indices: assessment of oral hygiene using the OHI-S index and the O’Leary plaque index, assessment of superficial periodontal status using the Löe/ Silness gingival inflammation index, periodontometry was performed in order to determine the depth of periodontal pockets, the level of gingival insertion, and the McGaw gingival overgrowth index. OHI-S index comprises two elements: the Debris Index and the Calculus Index. The purpose of our study is to present the incidence of cases of gingival overgrowth induced by fixed orthodontic therapy and to highlight how certain irritating factors can exacerbate the symptoms of gingival overgrowth of orthodontic etiology. Results. The majority of patients were female, aged between 30 and 55 years. Most clinically examined patients have presented with Grade II gingival hyperplasia. Factors that have exacerbated the symptoms of orthodontically induced gingival overgrowth include: incorrectly adapted prosthetic restorations, unpolished massive coronal fillings, root remnants, bacterial plaque, and tartar. Clinical examination of the oral cavity revealed the presence of gingival inflammation (localized or generalized), simple or complicated, treated and untreated odontal lesions, and coronal fillings made of light-curing composite material of significant size, being unfinished and unpolished, sometimes with sharp edges directly injuring the adjacent gingival mucosa, marginally incorrectly adapted prosthetic works. In the case of child and adolescent patients, significant amounts of bacterial plaque and tartar buildup were observed. In most of the cases examined, it was observed that the gingival overgrowth had a firm consistency, pinkish-reddish colour and gingival bleeding was evident during probing. Conclusion. Gingival overgrowth caused by orthodontics induces a number of important periodontal changes. It is worth noting that gingival overgrowth induced by fixed orthodontic therapy, in most of the cases examined, co-exists with favouring factors that amplify its severity. In our study, the favouring factors were bacterial plaque and calculus accumulation, sharp-edged odontal lesions, marginally ill-fitting prosthetic restorations or massive unfinished crown fillings. Therefore, removing the contributing factors can help improve the symptoms but also to reverse the inflammatory phenomena. [ABSTRACT FROM AUTHOR]

Gingival enlargement is a common clinical sign in the gingival diseases associated with orthodontic treatment. Its biological mechanisms are not completely understood; nevertheless, the biochemical changes associated with these inflammatory and overgrowth processes could alter the post-translational protein modifications occurring in various locations within the mouth. Here, changes in the profiles of the carbonylated and phosphorylated proteins in saliva were examined in donors with gingival enlargement (seven men and seven women) and healthy donors (six men and eight women). The sociodemographic characteristics of both groups did not present significant differences. Carbonylation was measured by a quantitative immunoassay (Dot Blot), whereas the profiles of the phosphorylated proteins were visualized by SDS-PAGE with quercetin staining. Some phosphopeptides were also identified using a typical LC-MS-MS approach. Our results showed that gingival enlargement induced a significant increase in oxidative damage in salivary proteins. While a significant reduction in phosphorylation was observed at the stain level in SDS-PAGE, there was a slight increase in the number of phosphorylated proteins identified by MS in samples with gingival enlargement. [ABSTRACT FROM AUTHOR]

Introduction Drug-induced gingival overgrowth is a condition characterized by a series of modifications in the gingival mucosa, including tumefaction, changes in color, and gingival bleeding. This condition can involve a variety of drugs, such as anticonvulsants and calcium channel blockers. Aim of the study To present the clinical modifications of hypertrophic gingival overgrowth of systemic and drug etiology, as well as to highlight therapeutic alternatives. Results Key aspects of drug-induced gingival overgrowth include the risk of recurrence, the importance of eliminating predisposing factors such as poor oral hygiene and bacterial plaque, as well as treatment options, such as surgical excision, which can be performed with diode dental laser or traditional techniques. Conclusions A personalized therapeutic approach, considering clinical and morphological aspects, is essential for achieving an optimal outcome in managing this condition.

Gingival enlargement is a side effect of several different medication, including immunosuppressants, anticonvulsants, and calcium channel blockers. It is an inflammatory response that starts when plaque and calculus build up on the tooth surface. The most prevalent long-term neurological condition affecting people is epilepsy. In affluent nations, the prevalence of epilepsy is ~ 1%, whereas in less developed countries, it may >2%. The preferred medication for the condition, phenytoin, has major side effects include gingival enlargement. In addition to being visually disfiguring, this enlargement frequently affects speech, chewing and eating. Furthermore, those with poor dental hygiene, causes disabilities with motor coordination and muscular limitations leading to mental disability and physical impairments are more prone to periodontal disease. This article enlightened the mechanism of drug induced gingival enlargement clinically, microbiologically, and surgically. [ABSTRACT FROM AUTHOR]

Background: Gingival enlargement (GE) is a common clinical observation among orthodontic patients, yet its underlying causes remain unclear. This study aims to investigate the potential involvement of salivary matrix metalloproteinase (MMP)-2 and MMP-9 activity in orthodontic-induced GE. Materials and Methods: In this case-control study, we enrolled 50 subjects, including 25 individuals with GE and 25 without. The participants, aged 10-35 years, were in the 4th or 5th month of their orthodontic treatment. Comprehensive clinical assessments, encompassing plaque index, gingival index, and GE score were performed, and saliva samples were subjected to gelatin zymography to assess enzyme activity. Statistical analysis, including the Chi-square test for age distribution, independent samples t-test for age comparison between study groups, Mann-Whitney U test for MMP activity comparison, and Wilcoxon signed-rank test for comparison of data from the 4th to 5th months of treatment, was performed using SPSS version 23.0, with a significance level set at 0.05. Results: MMP-2 activity was undetectable in the zymograms. In the 4th month of treatment, MMP-9 activity was more prominent in the case group, though this disparity did not reach statistical significance in the 5th month. Furthermore, MMP-9 activity did not exhibit a correlation with the GE score. Conclusion: The activity of MMP-9 in the saliva of orthodontic patients with GE increases during the 4th month of treatment, but no correlation exists with the degree of GE. [ABSTRACT FROM AUTHOR]

Background: Enamel renal syndrome is a rare genetic disorder transmitted through an autosomal recessive mode. It is featured by a hypoplastic amelogenesis imperfecta, delayed tooth eruption, gingival fibromatosis, and nephrocalcinosis. The aim of this study was to describe clinically, radiologically, and histologically the main features of enamel renal syndrome and to point out the role of dentists in early diagnosing this genetic disease. Materials and methods: Our case of enamel renal syndrome was initially described by clinical, radiographic, and genealogic data, then complemented by ultrasound examination of the kidneys and microscopic observation of gingivae. Results: The study showed the presence of amelogenesis imperfecta (AI), several teeth impaction, gingival hyperplasia, bilateral nephrocalcinosis, and multiple calcifications in pulp, gingiva, dental follicle, and kidneys. Conclusion: The patient was followed for a full mouth rehabilitation and also referred to a nephrology for global medical checkup. The dentist plays a key role in diagnosing genetic diseases and in referring patients for medical comprehensive care. [ABSTRACT FROM AUTHOR]

Giant cell lesion of the oral cavity in a pediatric population is a very rare entity. Peripheral giant cell granuloma (PGCG) is one such non-neoplastic lesion-causing gingival tumor. Here, a case of successful management of PGCG in a 12-year-old child is presented with a two-year follow-up. Clinical, radiographic, and histological features of PGCG are discussed with the importance of a long-term follow-up of the lesion. [ABSTRACT FROM AUTHOR]

Introduction: Drug-Induced Gingival Overgrowth (DIGO) is a pathological growth of the gingival tissue, which may occur as a side effect of certain drugs including some antihypertensive drugs, anti-epileptics and immunosuppressants. The literature reports a prevalence of gingival overgrowth among antihypertensive drug users, ranging from 13.5 to 83%. The aims of this study were to determine the prevalence of (DIGO) and the risk factors associated with it in a group of patients who were taking antihypertensive drugs attending. Erbil Cardiac Center in Erbil, Iraq. Methods: This cross-sectional study evaluated 50 hypertensive patients treated with antihypertensive agents in Erbil Cardiac Center in Erbil region. Gingival overgrowth was clinically assessed using the gingival enlargement index (Miranda-Barent), gingival enlargement index (Miller & Dann) and (Silnes-Leo) Plaque index. Data on age, gender, smoking status, type/dose of antihypertensive medication, and duration of use were collected. Results: Mean age was 58.3±12.9 years, and mean duration of antihypertensive medication uses was less than 5 years in (52%) of the patients, more than half were male (58.0%). The most commonly used antihypertensive agents were Amlodipine (48%), combination therapy contains Amlodipine 5mg (24%), and non-calcium channel blocker (28%). The prevalence of Gingival Overgrowth (GO) was 83%, in Calcium Channel Blockers (CCBs) group with the majority being grade I (42%). Gingival overgrowth was significantly associated with amlodipine dose, age and duration of drug use (p<0.05). Conclusions: The prevalence of (DIGO) in patients taking (CCBs) among other antihypertensive medications was significant. Major risk factors were greater doses of Amlodipine, older age, longer duration of drug intake, and larger amount of plaque in the sulcus or pocket along the free gingival margin. [ABSTRACT FROM AUTHOR]

Peripheral cemento-ossifying fibroma is an unusual, localized reactive, benign lesion of the oral cavity that shows various degrees of fibrous maturation and calcification in the histopathology. The lesion is often misdiagnosed, hence appropriate radiographs and histopathological examination are crucial for its correct diagnosis and management. The lesion has a high recurrence rate. The present report highlights a case of peripheral cement-ossifying fibroma in a 24-year-old female patient who was surgically excised. The growth, however, recurred after 4 months which was then managed by scalpel excision as well as aggressive curettage and root planing. [ABSTRACT FROM AUTHOR]

This article from the Romanian Journal of Oral Rehabilitation explores the clinical and morphological aspects of gingival overgrowth caused by fixed orthodontic therapy. The study involved analyzing biopsies of gingival mucosa from patients undergoing orthodontic treatment to understand the tissue changes. The main causes of gingival overgrowth during orthodontic treatment are increased plaque accumulation and excessive pressure from orthodontic forces. The article emphasizes the importance of oral hygiene and the correct duration and approach to orthodontic therapy in preventing gingival overgrowth. It also discusses the different types of gingival overgrowth and the need for a collaborative approach involving dentists, orthodontists, and maxillofacial surgeons for effective treatment. [Extracted from the article]

Objectives: To identify etiologic variants and perform deep dental phenotyping in patients with amelogenesis imperfecta (AI). Methods: Three patients of two unrelated families were evaluated. Genetic variants were investigated by exome and Sanger sequencing. An unerupted permanent third molar (AI1) from Patient1 and a deciduous first molar (AI2) from Patient2, along with three tooth‐type matched controls for each were characterized. Results: All three patients harbored biallelic pathogenic variants in FAM20A, indicating AI1G. Of the four identified variants, one, c.1231C > T p.(Arg411Trp), was novel. Patient1 possessed the largest deletion, 7531 bp, ever identified in FAM20A. In addition to hypoplastic enamel, multiple impacted teeth, intrapulpal calcification, pericoronal radiolucencies, malocclusion, and periodontal infections were found in all three patients, gingival hyperplasia in Patient1 and Patient2, and alveolar bone exostosis in Patient3. Surface roughness was increased in AI1 but decreased in AI2. Decreased enamel mineral density, hardness, and elastic modulus were observed in AI1 enamel and dentin and AI2 dentin, along with decreased phosphorus, increased carbon, and increased calcium/phosphorus and carbon/oxygen ratios. Severely collapsed enamel rods and disorganized dentin–enamel junction were observed. Conclusions: We report a novel FAM20A variant and, for the first time, the defective mineral composition and physical/mechanical properties of AI1G teeth. [ABSTRACT FROM AUTHOR]

The prevalence of inherited bleeding disorders (BDs) is low in the general population (10-20 per 100,000 individuals), particularly hemophilia B cases, which may remain undiagnosed for a very long time until exposed to some surgical procedure. The dental professional must be aware of the possibility that patients with no previous history of abnormal bleeding may manifest their first bleeding episode in the dental office. Particularly as periodontists, we often encounter patients with bleeding gums and severe bleeding complications may precipitate while performing routine periodontal procedures. Hence, we must have a thorough knowledge of BDs and their management in challenging hemorrhagic situations. Management of such patients necessitates a multidisciplinary approach by involving the patient's hematologist and advanced laboratory facilities. The present case report is an attempt to discuss the diagnosis and management of a bleeding episode that occurred post periodontal flap surgery in an undiagnosed hemophilia B patient. [ABSTRACT FROM AUTHOR]

Introduction and purpose: Hypertension is a global public health issue, affecting over 1.4 billion people and is responsible for a significant portion of deaths due to heart disease and strokes. Pharmacotherapy, especially antihypertensive drugs, can lead to undesirable effects, including gingival overgrowth, which is a known drug-dependent phenomenon. Despite the availability of numerous drugs from various pharmaceutical classes, gingival overgrowth still remains a serious health problem, particularly among older patients. State of knowledge: Drugs such as calcium channel blockers are commonly used in the treatment of hypertension. Amlodipine, a popular calcium channel blocker, is associated with gingival overgrowth, although the incidence of this effect can vary depending on the dose and duration of use. Gingival overgrowth may have multifactorial mechanisms, including drug-cell interactions and the patient's genetic predispositions. Summary: Drug-induced gingival overgrowth, including amlodipine, is a rare but significant phenomenon that can complicate treatment and lead to serious consequences for the patient. Implementing prophylactic measures, monitoring periodontal state, and continuing periodontal therapy are crucial to minimalize the risk of DIGO. In cases of intensification of symptoms, surgical intervention may be necessary, however, prognosis depends on individual factors, and recurrence can be an issue for susceptible patients.

The most common inflammatory reactions in the oral mucosa are found at the gingival level. The treatment of these inflammations requires, first of all, the removal of the causative factor; often, this maneuver is sufficient. The aim of this retrospective study was to evaluate clinical and histopathological changes that occur in terms of gingival and palatal mucosa enlargement during palatal expansion treatment and their evolution during treatment. Twenty-five (n = 25) research participants, aged between thirteen and twenty-six years old, were examined in this retrospective study. At the end of the treatment, fragments of tissue from the affected level were obtained via incisional biopsy and sent to the histopathology laboratory for a specialized examination. The changes identified were specific to mechanical traumatic injuries, thus excluding hyperplasia from other etiologies (infectious, tumoral, or non-mechanical traumatic). The examined fragments showed hyperplasia. The histopathological examination revealed the mechanical character of the lesion, strengthening the causal relationship between the insertion of the expander and the occurrence of hyperplasia of the palatal mucosa. The type of palatal expander influenced the degree of inflammation, with the severity of hyperplasia being more pronounced in the case of mini-implant-anchored rapid palatal expander (MARPE) usage than in the case of tooth-borne rapid palatal expander (RPE) usage. The analysis of the distance between the expander and the palatal mucosa did not provide conclusive results; the incidence and severity of the reaction were variable in patients with the same distance between the expander and the palatal or gingival mucosa. [ABSTRACT FROM AUTHOR]

This study aimed to identify risk factors for amlodipine-induced gingival enlargement, assess quality of life, and analyze gingival tissue. This cross-sectional study involved hypertensive patients on amlodipine, divided into groups with and without gingival enlargement. Assessments included sociodemographic data, clinical evaluations, and clinical parameters. Quality of life was assessed using OHIP-14 and WB-HRQoL scales. Gingival tissue samples were analyzed for oxidative status and key molecules using RT-PCR and colorimetric assays. The study included 32 patients with no significant sociodemographic differences between groups (p > 0.05). Patients with gingival enlargement had higher systolic blood pressure (139.63 ± 10.743 vs. 128.38 ± 7.249, p = 0.028) and higher OHIP-14 scores. The RT-PCR analysis showed significant differences in IL-6, TNF-α, IL-33, ST2, TGF-β1, FGF-2, CTGF, VEGF-D, and KGF expression. IL-6, TNF-α, ST2, and FGF-2 expression levels were lower in patients taking amlodipine, with and without gingival enlargement. TGF-β1 and CTGF expression levels were highest in patients with amlodipine-induced gingival enlargement. SOD activity was also highest in these patients, whereas MDA levels were higher in patients with gingival enlargement without amlodipine. Our study highlights the impact of amlodipine-induced gingival enlargement on oral health and quality of life, emphasizing fibrosis and oxidative stress, and suggests the need for integrated healthcare approaches and further research.

Background: Gingival enlargement (GE) is a common clinical observation among orthodontic patients, yet its underlying causes remain unclear. This study aims to investigate the potential involvement of salivary matrix metalloproteinase (MMP)-2 and MMP-9 activity in orthodontic-induced GE. Materials and Methods: In this case–control study, we enrolled 50 subjects, including 25 individuals with GE and 25 without. The participants, aged 10–35 years, were in the 4th or 5th month of their orthodontic treatment. Comprehensive clinical assessments, encompassing plaque index, gingival index, and GE score were performed, and saliva samples were subjected to gelatin zymography to assess enzyme activity. Statistical analysis, including the Chi-square test for age distribution, independent samples t-test for age comparison between study groups, Mann–Whitney U test for MMP activity comparison, and Wilcoxon signed–rank test for comparison of data from the 4th to 5th months of treatment, was performed using SPSS version 23.0, with a significance level set at 0.05. Results: MMP-2 activity was undetectable in the zymograms. In the 4th month of treatment, MMP-9 activity was more prominent in the case group, though this disparity did not reach statistical significance in the 5th month. Furthermore, MMP-9 activity did not exhibit a correlation with the GE score. Conclusion: The activity of MMP-9 in the saliva of orthodontic patients with GE increases during the 4th month of treatment, but no correlation exists with the degree of GE.

Gingival enlargement is a common clinical sign in the gingival diseases associated with orthodontic treatment. Its biological mechanisms are not completely understood; nevertheless, the biochemical changes associated with these inflammatory and overgrowth processes could alter the post-translational protein modifications occurring in various locations within the mouth. Here, changes in the profiles of the carbonylated and phosphorylated proteins in saliva were examined in donors with gingival enlargement (seven men and seven women) and healthy donors (six men and eight women). The sociodemographic characteristics of both groups did not present significant differences. Carbonylation was measured by a quantitative immunoassay (Dot Blot), whereas the profiles of the phosphorylated proteins were visualized by SDS-PAGE with quercetin staining. Some phosphopeptides were also identified using a typical LC-MS-MS approach. Our results showed that gingival enlargement induced a significant increase in oxidative damage in salivary proteins. While a significant reduction in phosphorylation was observed at the stain level in SDS-PAGE, there was a slight increase in the number of phosphorylated proteins identified by MS in samples with gingival enlargement.

Key Clinical Message: Drug‐induced gingival overgrowth can occur as a side effect of specific drugs and lead to poor oral function. Appropriate dental management of the overgrowth may improve oral function and improve cognitive deficits after cerebrovascular accidents. [ABSTRACT FROM AUTHOR]

Copyright of Acta Odontologica Turcica is the property of Acta Odontologica Turcica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pregnancy tumour, also known as granuloma gravidarum is a type of pyogenic granuloma. It commonly occurs in pregnant women with fair to poor oral hygiene. It presents as an erythematous, exophytic, painless sessile or pedunculated overgrowth that bleeds readily on slightest provocation. It mainly affects the gingiva, although it can also be found in places that experience regular trauma, such as the lower lip, tongue, oral mucosa, and palate. The growth usually appears around or after the third month of pregnancy and has the potential to grow quickly and become enormous, necessitating surgical excision. The current case report highlights the successful management of a pregnancy tumour using diode laser and six-months follow-up of the patient revealed no recurrence of the lesion. [ABSTRACT FROM AUTHOR]

Hereditary gingival fibromatosis (HGF) is an uncommon, inherited condition with slow and progressive fibrous hyperplasia of the gingiva. The fibrous nature of the enlargement interferes with eruption, mastication, speech, and occlusion. This condition is more commonly noted during the transition from deciduous to permanent dentition. This can have overbearing effects on the psychology and function of the individual, thus making early diagnosis and precise management important. The conventional mode of treatment includes scalpel gingivectomy (external/internal bevel). In young patients, gingivectomies involving the entire dentition can be a therapeutic challenge. Lasers have proven themselves as viable substitutes for conventional gingival surgeries. The use of Light amplification by the stimulated emission of radiation (LASER) for gingivectomy may also present added advantages such as lack of bleeding, increased patient cooperation, and better compliance. This case report presents the diagnosis and treatment of HGF in a 9-year-old girl emphasizing the unique advantage of LASER in the clinical scenario. [ABSTRACT FROM AUTHOR]

Introduction: General practitioners have misdiagnosed a number of rare entities by using the term “fibroma” to describe any soft tissue gingival lesion. In teenage female patients, gingival lesions are frequently observed clinically. Case Report: The lesion’s location is important since it influences the rarity of these lesions, both in terms of size and location. However, there is still disagreement regarding which condition should be diagnosed: peripheral odontogenic fibroma (POF) or peripheral ossifying fibroma. POF is also known as “calcifying fibroblastic granuloma,” “calcifying or ossifying fibrous epulis,” “peripheral fibroma with calcification,” and “peripheral cementifying fibroma.” Conclusion: This case report discusses the treatment of a female adolescent patient with an unusual instance of POF on the labial side of her maxillary incisors. Five months were spent monitoring the patient following her surgical excision. [ABSTRACT FROM AUTHOR]

Key Clinical Message Drug‐induced gingival overgrowth can occur as a side effect of specific drugs and lead to poor oral function. Appropriate dental management of the overgrowth may improve oral function and improve cognitive deficits after cerebrovascular accidents.

Introduction: Gingival fenestration (GF) is scarcely reported in the literature. We present a unique case of GF defect combined with gingivitis and altered passive eruption (APE). Case Presentation: An 18‐year‐old female patient with gingivitis, APE, and GF in the mandibular left central incisor presented for periodontal treatment. The gingival lesion was successfully treated with basic periodontal therapy gingivectomy, and gingivoplasty and resulted in an excellent aesthetic long‐term outcome. This case report shows its 8‐year clinical follow‐up. Conclusion: There are no earlier reports dealing with the use of gingivoplasty for the treatment of GF, as it is not the usual therapeutic intervention for these defects. Gingivoplasty proved to be effective in treating GF. Why is this case new information?Available literature on gingival fenestration defects does not describe gingivectomy and gingivoplasty as a treatment of choice.Gingivectomy and gingivoplasty proved to be effective in treating gingival fenestration defects. What are the keys to successful management of this case?Proper diagnosis. What are the primary limitations to success in this case?Gingival fenestration has been defined when the overlying gingiva is denuded, exposing the root to the oral cavity. However, in this case report, only the crown was exposed because the patient had altered passive eruption. [ABSTRACT FROM AUTHOR]

Copyright of Acta Stomatologica Croatica is the property of Acta Stomatologica Croatica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the association between the prevalence of cyclosporin A‐induced gingival overgrowth and the expression of the epithelial‐to‐mesenchymal transition factors in the gingival tissues of renal transplant patients. Background: Gingival overgrowth (GO) is a frequent complication in organ transplant patients treated with the immunosuppressant cyclosporin A (CsA). The epithelial‐to‐mesenchymal transition (EMT) is considered a factor contributing to CsA‐induced GO. However, current knowledge on this topic is sparse. Methods: Sixty‐three renal transplant patients were divided into two groups according to the occurrence of GO: those with gingival overgrowth (GO+ group) and those without gingival overgrowth (GO− group). Data on age, sex, and use of immunosuppressant and calcium channel blocker medications, serum creatinine values, peak concentrations of blood CsA, and gingival hyperplasia scores were recorded to identify clinically pathogenic factors. Gingival tissues from five patients with CsA‐induced GO and five healthy subjects were selected for histomorphological observation with hematoxylin–eosin staining, Masson staining, and immunohistochemical staining. The mRNA expression of EMT factors was detected with reverse transcription–quantitative PCR. Results: The use of CsA significantly increased the prevalence of GO in renal transplant patients. The expression of α‐SMA, SMAD4, and TGM2 was upregulated and that of E‐cadherin was downregulated in the gingival tissues of patients with CsA‐induced GO compared with those of the corresponding controls. Conclusion: Treatment with CsA is closely related to the occurrence of GO in renal transplant patients and EMT plays an important role in CsA‐induced gingival tissue hyperplasia. [ABSTRACT FROM AUTHOR]

Objectives: Numerous indices have been used to grade the severity of gingival overgrowth which led to suspicion regarding the results concerning its prevalence and pathogenicity. The aim of this study was to assess the concordance of three different gingival overgrowth indices, which were used widely in previous studies, and check their reliability and reproducibility. Material and Methods: A total of 30 full-mouth plaster casts and 90 intraoral photographs collected from 30 patients diagnosed with gingival overgrowth were included in our study. Three trained examiners performed measurements twice on plaster casts using gingival hyperplasia index (A index) and hyperplastic index (B index). Intraoral photographs were assessed also twice using (C index). Results: Concordance of intra-examiner and inter-examiner reliability of the recorded measurements was carried out for each index using weighted kappa (K), with a confidence interval of 95%. The A index revealed intra-examiner total kappa values between 0.724-0.876 for horizontal measurement and 0.512-0.823 for vertical measurement, and inter-examiner total kappa values between 0.255-0.626 horizontally and 0.235-0.279 vertically. The B index presented intra-examiner total kappa values between 0.587-0.868 horizontally and 0.653-0.855 vertically; and inter-examiner total kappa values between 0.393-0.595 and 0.372-0.635 for horizontal and vertical measurements, respectively. The C index achieved the highest intra-examiner concordance with total kappa values between 0.758-0.855 and inter-examiner total kappa values between 0.716-0.804. Conclusions: The C index evaluated through intraoral photographs is considered the most reliable and applicable method to be utilized. The C index is suggested to be used in large scale populations with its definite detailed criteria.

Gingival overgrowth is one of the most undesirable consequences that often lead to impaired esthetics and masticatory functions, compromised oral hygiene maintenance often requiring surgical excision of the excessive tissue. Gingival overgrowth belongs to a common group of lesions designated as focal reactive overgrowths. These growths are reactive in nature. A definitive diagnosis will then enable an appropriate management strategy. Peripheral giant-cell granuloma (PGCG) is a reactive focal overgrowth, ordinarily presents as an epulis-like growth. This is of a reactive rather than neoplastic nature and its pathogenesis is uncertain. It is widely considered to originate from the cells of the periodontal ligament, occurring as a response to irritants such as dental calculus, plaque, microorganisms, dental appliances, and restorations. The purpose of this article is to report the clinical, histopathological features and treatment of a case with PGCG arising from mandibular posterior alveolus in a 34-year-old female. The overgrowth was well defined along with the bone defect, involving the buccal aspect of the mandibular gingiva. The tooth was endodontically treated, the lesion was completely excised, and the osseous defect was filled with regenerative material. The 12-month follow-up radiograph revealed successful healing with no more recurrence.

Various systemic diseases can manifest oral signs and symptoms early, which may be crucial for diagnosis and outlining the treatment plan. This case report highlights the presentation of acute leukemia (a malignancy of white blood cells) in a young female. An 11-year-old girl presented with gingival overgrowth and bleeding from the gingiva, weakness, and recent history of weight loss. A detailed workup consisting of complete blood count, bone marrow examination, flow cytometric immunophenotyping, cytogenetics, and molecular studies were carried out. The investigations confirmed the infiltration of blast cells of myelomonocytic origin, and a confirmatory diagnosis of acute myeloid leukemia (French–American–British classification M5) was made. The patient was put on induction chemotherapy and responded well. She developed febrile neutropenia following chemotherapy, which was managed conservatively. Gingival overgrowth subsided after the chemotherapy, and at the time of discharge, she was asymptomatic and hemodynamically stable. The oral health-care professionals must recognize that gingival overgrowth/enlargement may represent an initial manifestation of an underlying systematic disease.

Localized gingival overgrowth occurs as a result of local irritation or as a response to an underlying systemic condition. When present, it results in a diagnostic dilemma – it could be due to pyogenic granuloma, peripheral ossifying fibroma (POF), peripheral giant cell fibroma, or peripheral odontogenic fibroma. Proper history and clinical and histopathological examination aid in diagnosis and treatment. POF is a focal, slow-growing, reactive lesion that is often present as a painless mass in the gingiva. POF can be sessile or pedunculated and predominately seen in the second decade of life with a female predilection. This article presents the diagnosis and management of POF in the maxillary premolar region of a 28-year-old female patient. [ABSTRACT FROM AUTHOR]

Background and Objectives: Gingival overgrowth caused by phenytoin is proposed to be associated with Ca2+ signaling; however, the mechanisms that increase the intracellular Ca2+ concentration ([Ca2+]i) are controversial. The current study aimed to elucidate the mechanism underlying the phenytoin-induced increase in [Ca2+]i in human gingival fibroblasts (HGFs). Methods: Effects of 100 μM phenytoin on [Ca2+]i in HGFs were examined at the single-cell level using fluorescence images of fura-2 captured by an imaging system consisting of an EM-CCD camera coupled to an inverted fluorescence microscope at room temperature. Results: Exposure of HGFs to 100 μM phenytoin induced a transient increase in [Ca2+]i in the absence of extracellular Ca2+, indicating that the phenytoin-induced increase in [Ca2+]i does not require an influx of extracellular Ca2+. In addition, phenytoin increased [Ca2+]i in HGFs depleted of intracellular Ca2+ stores by thapsigargin, indicating that neither Ca2+ release from stores nor inhibition of Ca2+ uptake is involved. Furthermore, the phenytoin-induced [Ca2+]i elevation was reduced to 18.8% in the absence of extracellular Na+, and [Ca2+]i elevation upon removal of extracellular Na+ was reduced to 25.9% in the presence of phenytoin. These results imply that phenytoin increases [Ca2+]i of HGFs by suppressing the Na+/Ca2+ exchanger. Suppression of intracellular Ca2+ excretion is thought to enhance the Ca2+ responses induced by various stimuli. Analysis at the single-cell level showed that stimulation with 1 μM ATP or 3 μM histamine increased [Ca2+]i in 20–50% of cells, and [Ca2+]i increased in many unresponsive cells in the presence of phenytoin. Conclusion: Our findings demonstrate that phenytoin induced increase in [Ca2+]i by the inhibition of Ca2+ efflux in HGFs. It was also found that phenytoin strongly enhanced small Ca2+ responses induced by stimulation with a low concentration of ATP or histamine by inhibiting Ca2+ efflux. These findings suggest a possibility that Background and Objectives: Gingival overgrowth caused by phenytoin is proposed to be associated with Ca2+ signaling; however, the mechanisms that increase the intracellular Ca2+ concentration ([Ca2+]i) are controversial. The current study aimed to elucidate the mechanism underlying the phenytoin-induced increase in [Ca2+]i in human gingival fibroblasts (HGFs). Methods: Effects of 100 μM phenytoin on [Ca2+]i in HGFs were examined at the single-cell level using fluorescence images of fura-2 captured by an imaging system consisting of an EM-CCD camera coupled to an inverted fluorescence microscope at room temperature. Results: Exposure of HGFs to 100 μM phenytoin induced a transient increase in [Ca2+]i in the absence of extracellular Ca2+, indicating that the phenytoin-induced increase in [Ca2+]i does not require an influx of extracellular Ca2+. In addition, phenytoin increased [Ca2+]i in HGFs depleted of intracellular Ca2+ stores by thapsigargin, indicating that neither Ca2+ release from stores nor inhibition of Ca2+ uptake is involved. Furthermore, the phenytoin-induced [Ca2+]i elevation was reduced to 18.8% in the absence of extracellular Na+, and [Ca2+]i elevation upon removal of extracellular Na+ was reduced to 25.9% in the presence of phenytoin. These results imply that phenytoin increases [Ca2+]i of HGFs by suppressing the Na+/Ca2+ exchanger. Suppression of intracellular Ca2+ excretion is thought to enhance the Ca2+ responses induced by various stimuli. Analysis at the single-cell level showed that stimulation with 1 μM ATP or 3 μM histamine increased [Ca2+]i in 20–50% of cells, and [Ca2+]i increased in many unresponsive cells in the presence of phenytoin. Conclusion: Our findings demonstrate that phenytoin induced increase in [Ca2+]i by the inhibition of Ca2+ efflux in HGFs. It was also found that phenytoin strongly enhanced small Ca2+ responses induced by stimulation with a low concentration of ATP or histamine by inhibiting Ca2+ efflux. These findings suggest a possibility that [ABSTRACT FROM AUTHOR]

Drug-induced gingival overgrowth (DIGO) is one of the side effects produced by therapeutic agents, most commonly phenytoin, nifedipine and cyclosporin A. However, the precise mechanism of DIGO is not entirely understood. A literature search of the MEDLINE/PubMed databases was conducted to identify the mechanisms involved in DIGO. The available information suggests that the pathogenesis of DIGO is multifactorial, but common pathogenic sequelae of events emerge, i.e., sodium and calcium channel antagonism or disturbed intracellular handling of calcium, which finally lead to reductions in intracellular folic acid levels. Disturbed cellular functions, mainly in keratinocytes and fibroblasts, result in increased collagen and glycosaminoglycans accumulation in the extracellular matrix. Dysregulation of collagenase activity, as well as integrins and membrane receptors, are key mechanisms of reduced degradation or excessive synthesis of connective tissue components. This manuscript describes the cellular and molecular factors involved in the epithelial–mesenchymal transition and extracellular matrix remodeling triggered by agents producing DIGO. [ABSTRACT FROM AUTHOR]

The main objective of this study was to evaluate the improvement of periodontal health in patients with periodontitis treated with non-surgical periodontal therapy and subgingival-administrated local and systemic antimicrobial agents. A female teenager with periodontitis-associated health issues and a history of dental trauma was selected for this study. Clinical indices were obtained, and radiographic examination was performed at the beginning of the study. The patient was treated with periodontal therapy and administration of antibiotics. After this therapy, visits were scheduled at regular intervals to observe the clinical changes. Non-surgical periodontal therapy and administration of local and systemic antibiotics resulted in a reduction in the patient pocket depth probing, plaque index, and bleeding on probing. Gingival and periodontal health improved in terms of gingival overgrowth, plaque, tartar index, and tooth mobility. Suppuration was eliminated, and no gingival inflammation signs were observed. [ABSTRACT FROM AUTHOR]

Introduction: Patients with the PTEN hamartoma tumor syndrome (PHTS) have an 81%–90% cumulative lifetime risk of developing cancer. Around 90% of these patients have recognizable oral features. Receiving a diagnosis may save these patients' lives. This is the first presentation of a family with the PHTS diagnosis with focus on the oral and periodontal findings and treatments. Case Presentation: All three children (one son and two daughters) inherited the same heterozygous variant in the PTEN gene from their father. Gingival overgrowth was observed in all patients in addition to macrocephaly. Other findings included fissured tongue, high arched palate, papules, and trichilemmomas. The father had experienced severe tooth loss. Surgery was performed to treat the gingival overgrowth and periodontal pockets; however, the treatment was characterized by multiple recurrences of the overgrowth. Conclusions: Oral changes, macrocephaly, tumors, and/or a family history of benign or malignant lesions are important features that oral clinicians should be aware of for a possible PHTS diagnosis. Patients suspected of having PHTS should be referred to a medical practitioner, specifically a geneticist, for further diagnostic investigations. The periodontal problems seemed to be difficult to control for these patients. They will likely need an active and frequent maintenance therapy to control the persistent inflammation and gingival overgrowth. In addition, they need a thorough monitoring for benign or malignant changes in the orofacial regions. Why are these cases new information?Oral features are found in 90% of the cases with the PHTS diagnosis.The periodontal findings showed a persistent recurrence of gingival overgrowth with a strong probability of serious periodontal diseases. What are the keys to successful management of these cases?A suspicion of a PHTS diagnosis with a referral to a medical practitioner, specifically a geneticist, for complete workup may help save these patients' lives.Close monitoring during maintenance therapy with re‐treatment as needed to prevent further periodontal complications.Continued monitoring and treatment throughout the patient's lifetime for development of recurrent or new, benign or malignant lesions at relevant sites. What are the primary limitations to success in these cases?A failure to identify the PHTS syndrome with the accompanying oral and periodontal complications. Complications may lead to a delay in appropriate treatment.Inability to control the persistent gingival overgrowth and a deteriorating periodontal condition.A failure to discover benign and malignant lesions in the orofacial region. [ABSTRACT FROM AUTHOR]

Various systemic diseases can manifest oral signs and symptoms early, which may be crucial for diagnosis and outlining the treatment plan. This case report highlights the presentation of acute leukemia (a malignancy of white blood cells) in a young female. An 11-year-old girl presented with gingival overgrowth and bleeding from the gingiva, weakness, and recent history of weight loss. A detailed workup consisting of complete blood count, bone marrow examination, flow cytometric immunophenotyping, cytogenetics, and molecular studies were carried out. The investigations confirmed the infiltration of blast cells of myelomonocytic origin, and a confirmatory diagnosis of acute myeloid leukemia (French–American–British classification M5) was made. The patient was put on induction chemotherapy and responded well. She developed febrile neutropenia following chemotherapy, which was managed conservatively. Gingival overgrowth subsided after the chemotherapy, and at the time of discharge, she was asymptomatic and hemodynamically stable. The oral health-care professionals must recognize that gingival overgrowth/enlargement may represent an initial manifestation of an underlying systematic disease. [ABSTRACT FROM AUTHOR]

The most common inflammatory reactions in the oral mucosa are found at the gingival level. The treatment of these inflammations requires, first of all, the removal of the causative factor; often, this maneuver is sufficient. The aim of this retrospective study was to evaluate clinical and histopathological changes that occur in terms of gingival and palatal mucosa enlargement during palatal expansion treatment and their evolution during treatment. Twenty-five (n = 25) research participants, aged between thirteen and twenty-six years old, were examined in this retrospective study. At the end of the treatment, fragments of tissue from the affected level were obtained via incisional biopsy and sent to the histopathology laboratory for a specialized examination. The changes identified were specific to mechanical traumatic injuries, thus excluding hyperplasia from other etiologies (infectious, tumoral, or non-mechanical traumatic). The examined fragments showed hyperplasia. The histopathological examination revealed the mechanical character of the lesion, strengthening the causal relationship between the insertion of the expander and the occurrence of hyperplasia of the palatal mucosa. The type of palatal expander influenced the degree of inflammation, with the severity of hyperplasia being more pronounced in the case of mini-implant-anchored rapid palatal expander (MARPE) usage than in the case of tooth-borne rapid palatal expander (RPE) usage. The analysis of the distance between the expander and the palatal mucosa did not provide conclusive results; the incidence and severity of the reaction were variable in patients with the same distance between the expander and the palatal or gingival mucosa.

Aim: A common side effect of calcium channel blockers, which are frequently used in the treatment of patients with hypertension and cardiovascular problems, is that they can cause overgrowth in gingiva. Gingival overgrowths should be treated because they create inaccessible areas, making oral hygiene practices difficult due to increased plaque retention. In this case series, clinical properties of gingival overgrowths deriving from the usage of amlodipine, which is a type of calcium channel blockers and its treatment protocols are explained. Methods: Three male patients aged 15, 60 and 45 applied to our clinic with the complaints of gingival overgrowth and bleeding. In the anamnesis, it was learned that they were using antihypertensive medication containing amlodipine. In the first session, scaling and root planning applications were performed. Then, the patients who were given detailed oral hygiene instructions, consulted with the relevant physicians. It was deemed appropriate to replace the drug the patients were using with another antihypertensive drug, which is an alternative that does not lead to gingival overgrowth. After the controls performed at certain time intervals and oral hygiene evaluations, it was observed that a perfect recovery was achieved. In addition to these, gingivoplasty was performed using classic surgical method under local anesthesia on one case. Results: All three patients showed uneventful healing without any complications. During periodic controls, it was observed that patients’ complaints disappeared, the gingiva regained their natural physiological form, aesthetically pleasing results were achieved, no recurrences were observed in the 6th month and periodontal health could be maintained. Conclusion: The treatment protocol for gingival overgrowth due to drug use includes the replacement or discontinuation of the current drug with an alternative drug with the physician's consultation, after the initial periodontal treatment and oral hygiene practices, periodontal surgical procedures and regular controls in severe cases.

Gingival overgrowth is one of the most undesirable consequences that often lead to impaired esthetics and masticatory functions, compromised oral hygiene maintenance often requiring surgical excision of the excessive tissue. Gingival overgrowth belongs to a common group of lesions designated as focal reactive overgrowths. These growths are reactive in nature. A definitive diagnosis will then enable an appropriate management strategy. Peripheral giant-cell granuloma (PGCG) is a reactive focal overgrowth, ordinarily presents as an epulis-like growth. This is of a reactive rather than neoplastic nature and its pathogenesis is uncertain. It is widely considered to originate from the cells of the periodontal ligament, occurring as a response to irritants such as dental calculus, plaque, microorganisms, dental appliances, and restorations. The purpose of this article is to report the clinical, histopathological features and treatment of a case with PGCG arising from mandibular posterior alveolus in a 34-year-old female. The overgrowth was well defined along with the bone defect, involving the buccal aspect of the mandibular gingiva. The tooth was endodontically treated, the lesion was completely excised, and the osseous defect was filled with regenerative material. The 12-month follow-up radiograph revealed successful healing with no more recurrence. [ABSTRACT FROM AUTHOR]

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