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