Case Study Gingival Enlargement

RARE IS ALWAYS RARE - AN UNUSUAL PRESENTATION OF INFLAMMATORY GINGIVAL ENLARGEMENT

ABSTRACT
Increase in the size of gingiva is called as gingival enlargement. Gingival enlargement is classified according to etiology, pathogenesis, location and distribution. It may be inflammatory, non inflammatory or a combination of both. A number of local and systemic factors such as plaque retention, hormonal changes, drug intake and heredity can cause or influence gingival enlargement. Here is a rare case report of a 30 year old female patient with aggressively looking massive unilateral gingival enlargement which on histopathological evaluation, turned out to be the common inflammatory gingival enlargement.
Key words: gingival, unilateral, inflammatory

The enlargement was smaller in size initially which gradually increased and attained present size. Patient did not give any relevant medical or family history. No history of any drug intake was noted. Patient has undergone uneventful extraction of first molars in all quadrants other than second quadrant. On general examination patient was slightly poorly built for her age.
Extra oral examination revealed incompetent lips with the enlarged gingiva palpable on the right cheek.
On intra oral examination diffuse gingival enlargement which is pinkish red in colour, involving the marginal, papillary and attached gingival in relation to the labial aspect of 11 to 14, buccal aspect of 41 to 48 and lingual aspect of 43 to 45. The enlargement is firm in consistency. Pathologic migration of 11, 12 and 13 was noted. Minimal subgingival calculus deposits were noted in relation to the enlargement. Bleeding on probing was present. A probing depth of 10mm was present in relation to the enlargement. Grade II mobility was noted in 22, 47, 48 and grade III mobilty was noted in 45. A generalized probing depth of 3mm was noted in other areas and 5mm in 26. The occlusion was bilateral and non

Gingival enlargement may be localized or generalized in distribution[2]. Sometimes the gingival enlargement may be influenced by factors like unilateral chewing habits, hormonal changes, drug therapy or neoplastic infiltrates[4]. Few cases of unilateral gingival enlargement associated with aggressive periodontitis, hormonal discrepancies and idiopathic gingival enlargement has been reported in the literature. But unilateral presentation of massive inflammatory gingival enlargement in the absence of specific etiologic or contributing factors as in our case is quite rare.
In the present case the patient is a 30 year old female, had a fair oral hygiene with some amount of subgingival deposits in relation to the enlargement. Whereas, on the opposite side, the gingiva appeared to be healthy and normal. Other contributing factors like unilateral chewing habits, hormonal discrepancies, drug intake was ruled