Classification and Causes of Gingival Enlargement
- Gingival hyperplasia and gingival hypertrophy are imprecise descriptions of gingival enlargement.
- The term 'gingival enlargement' is more appropriate.
- Gingival enlargement is classified into 5 general groups based on cause.
- The groups include inflammatory enlargement, drug-induced enlargement, enlargement associated with systemic diseases or conditions, neoplastic enlargement, and false enlargement.
- Chronic inflammatory gingival enlargement is caused by tissue edema and infective cellular infiltration.
- Mouth breathers may experience gingivitis and gingival enlargement due to irritation from surface dehydration.
- The accumulation and retention of plaque is the chief cause of inflammatory gingival enlargement.
- Risk factors include poor oral hygiene and physical irritation from improper appliances.
- Drug-induced enlargement can be caused by anticonvulsants, calcium channel blockers, and immunosuppressants.

Mechanism and Management of Gingival Enlargement
- Drug-induced gingival overgrowth can be fibrotic or inflammatory type.
- Fibrotic type is associated with elevated CTGF protein and TGF-β.
- Inflammatory type is still not fully understood.
- Inflammation may play a role in drug-induced enlargement.
- Improved oral hygiene can reduce the severity of gingival hyperplasia.
- Improved oral hygiene is the first line of management for gingival overgrowth.
- Surgical removal of excess tissue (gingivectomy) may be necessary in some cases.
- Discontinuing the culprit drug resolves drug-induced enlargement in most cases.
- Alternative drug therapy may be employed to avoid this side effect.
- Tacrolimus is an alternative to cyclosporine with less severe gingival overgrowth.

Epidemiology and Research on Gingival Enlargement
- Gingival enlargement is common.
- More information is needed to fully understand the epidemiology.
- Further research is necessary to expand this section.
- Role of mast cells in drug-induced gingival overgrowth.
- Molecular and clinical aspects of drug-induced gingival overgrowth.
- Possible therapeutic targets for drug-induced gingival overgrowth.
- Review article on orofacial granulomatosis.
- Periodontal disease in small animals.

Medications Associated with Gingival Overgrowth
- Phenytoin
- Cyclosporine
- Nifedipine
- Tacrolimus
- Isradipine

Genetic Factors and Clinical Management of Gingival Overgrowth
- Hereditary gingival fibromatosis
- Genetic predisposition to gingival overgrowth
- Farmed silver fox with hereditary hyperplastic gingivitis
- Genetic aspects of individuals with epilepsy
- Gummy smile: possible genetic influence
- CO2 laser treatment for gingival enlargement
- Pharmacological interventions for gingival overgrowth
- Surgical interventions for gingival overgrowth
- Management of gingival overgrowth in organ transplantation
- Regression of gingival hyperplasia with calcium channel blocker switch