Gingival enlargement (GE) can result from gingival inflammation, fibrous overgrowth, or a combination of both factors. Various etiological factors contribute to GE, including low-grade trauma, iatrogenic causes, drug-induced effects, systemic diseases, plaque accumulation, hormonal influences, vitamin deficiencies, genetic predispositions, and idiopathic reasons. Effective treatment in clinical practice hinges on accurately diagnosing the underlying cause. Among these, plaque-induced inflammation is the most common, driven by the accumulation of plaque and calculus. One challenge in maintaining oral hygiene is orthodontic treatment, which can impact speech, chewing, aesthetics, and psychological well-being. In this case report, a 21-year-old female patient developed GE associated with orthodontic appliance use. To address this, excess gingival tissue was surgically removed under local anesthesia using gingivectomy and gingivoplasty procedures, and the excised tissue was sent for histopathological examination. Following the surgery, a periodontal dressing (GC Coe Pack™) was applied to protect the tissue and aid in healing. The case underscores that enlarged gingival tissue, covering nearly half of the dental crowns, led to plaque accumulation and aesthetic concerns. Post-procedure, achieving a proper gingival contour eliminated suprabony pockets and enhanced the aesthetic appearance. The patient showed positive outcomes with no remaining suprabony pockets, resulting in a natural gingival contour, improved aesthetics, and reduced plaque retention. Surgical gingivectomy and gingivoplasty proved to be successful interventions in this case.

Gingival inflammation and fibrous type of overgrowth, or a combination of both can lead to gingival enlargement (GE), and this negatively affects mainly masticatory function and esthetics, and sometimes causes psychological issues in patients. A typical characteristic of gingival diseases is gingival overgrowth, which can be brought on by fibrous overgrowth, gingival inflammation, or a combination of the two. It is a complex ailment arising from interactions between the environment and the host or different stimuli. Patients frequently have misaligned teeth, which encourages the buildup of bacterial plaque and unintentionally fuels gingival inflammation. Fixed orthodontic equipment can rectify this misalignment but they may also promote plaque buildup and the ensuing development of GE, gingival invaginations, and generalized hyperplastic gingivitis. The attachment of application and the rise in the amount of discernible supra- and subgingival plaque cause changes in microbial growth. Moreover, the force used in the treatment tends to activate the gingival soft tissue response. Clinical consequences such as persistent infection, inflammatory hyperplasia, gingival recession, attachment loss, or gingival overgrowth may arise after the device is placed. \'Plaque-induced\' and \'non-plaque-induced\' gingival disorders, such as gingival overgrowth, can be distinguished; however, a more precise fundamental etiology is frequently discernible. Several hereditary, systemic, or infectious diseases do not depend on plaque induction. Accompanying plaque accumulation in certain circumstances may make the clinical appearance worse. The case described here is of a 21-year-old female patient presenting with anterior maxillary GE associated with lateral incisors with orthodontic therapy. Surgical therapy was carried out to provide an excellent esthetic outcome for the patient.

UNASSIGNED: Beta-thalassemia major is a blood disorder caused by impaired synthesis of hemoglobin beta chain. Oral manifestations of beta-thalassemia major in pregnancy have rarely been reported.
UNASSIGNED: This study aimed to describe a case of oral manifestations in a pregnant woman with beta-thalassemia major for multidisciplinary management.
UNASSIGNED: A 27-year-old woman, suffering from beta thalassemia major who is undergoing therapy in the form of routine blood transfusions every month and taking anti-chelation drugs but is currently stopping this because she is pregnant, currently 16 weeks pregnant, complains complained of swollen gums, bleeding, and bad breath. Extraoral examination revealed dry, exfoliative lips. Intraoral examination revealed gingival hyperplasia with erythema, soft consistency, dark red rounded gingival margins, bleeding, true pockets and pain throughout the labial, buccal, palatal, and lingual. There was no history of systemic disease in this patient. Patient has never visited a dentist, either before or now, with complaints about her oral cavity. Hematological parameters showed abnormalities, and peripheral blood examination revealed an infection. The oral diagnoses included gingival enlargement and chronic periodontitis associated with pregnancy and β- thalassemia major.
UNASSIGNED: Dental management consisted of spooling with 3% hydrogen peroxide (H2O2) spooling, chlorine dioxide spray mouthwash, antibiotics, calculus removal, and oral hygiene instructions. Blood transfusions were administered once a month, and anti-chelation therapy was stopped during pregnancy. After three months of multidisciplinary management, the results were satisfactory.
UNASSIGNED: Multidisciplinary, collaborative dental and medical management with non-surgical therapy of oral manifestations in pregnant women with beta-thalassemia major showed satisfactory results.

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.

Pyogenic granuloma (PG) refers to an acquired benign proliferation most commonly seen within the oral cavity involving lips, palate, and gingiva. The term is misleading since it is a type of lobular capillary haemangioma but not an infection. It frequently recurs but lacks the capacity for malignant alteration. Depending on where the PG is located, one may experience discomfort or irritation. PGs often lead to differential diagnoses by clinicians, which include capillary hemangioma, neurofibroma, melanoma, and hyperplasia. Therefore, one must confirm a PG by diagnosing and analysing it by clinical and histopathological examinations, and treatment options should be formulated according to the evaluation. Sometimes, a biopsy of the lesion can be taken for final diagnosis. Various treatment approaches are available, including conventional scalpel excision, laser, electrocautery, and cryotherapy. Surgical excision is preferable due to the likelihood of malignancy, as it provides the best cosmetic appearance and produces a specimen for pathologic assessment. After confirming all the clinical evaluatory parameters and routine haematological examinations, which proved satisfactory and within normal ranges, this case of a 45-year-old female with soft tissue growth of the gingival origin was managed by electrocautery, and the PG was confirmed by a clinical-histopathological examination.

BACKGROUND: Tuberous sclerosis complex (TSC) is a rare, complex genetic disorder characterized by hamartomas and neoplastic lesions in various organ systems. With the development of radiology and gene testing, the diagnostic criteria for TSC were updated in 2012 at the International Consensus Conference. Intraoral fibromas have long been associated with TSC. However, the incidence of giant cell angiofibroma (GCA) in TSC patients is extremely rare. Here, we report the first case of GCA in the gingival tissue of a patient with TSC.
METHODS: A 41-year-old woman first visited the Department of Oral and Maxillofacial Surgery, Chonnam National University Dental Hospital, complaining of gingival enlargement. Clinical examination revealed several manifestations associated with TSC, including intraoral fibromas, facial angiofibromas, dental enamel pits, ungual fibromas, \"confetti\" skin lesions, hypomelanotic macules, and a shagreen patch. Intraoral examination revealed a 6.0 × 5.0 cm gingival overgrowth on the left mandible. Surgical excision was performed, and subsequent histopathological examination confirmed the diagnosis of GCA. There was no evidence of recurrence within the 24- months of surgery.
CONCLUSIONS: We report the first case of GCA in the gingival tissue of a patient with TSC. This report would contribute to an improved understanding of this rare disease. However, further case reports are necessary to clarify the relationship between GCA and TSC.

Gingival enlargement is a side effect of different drug classes, with calcium channel blockers being among the most often cited examples. Most often accompanied by a disruption in the oral biofilm, this form of gingival overgrowth, with histological signs of hyperplasia and hypertrophy, becomes a chronic inflammatory condition with the oral biofilm a primary cause. This periodontal disease is now classified as \'dental biofilm-induced gingivitis\', and its preferred name is drug-influenced gingival expansion. The present study presented the case of a patient with gingival enlargement while being treated with nifedipine for cardiac disease. This patient had factors that contributed to the retention of bacteria, ranging from poor oral hygiene practices to poorly adapted prosthodontics. After reducing these factors, a multimodal treatment was conducted, including bacterial mechanical decontamination through guided biofilm therapy protocol, laser bacterial decontamination, and surgical laser gingivectomy. The patient was referred to their cardiologist for substituting the calcium channel blocker medication. Clinical evaluations followed each treatment step. At 12 months, the patient presented positive, stable results, with an improvement in gingival status (no gingival overgrowth in the area where all risk factors were eliminated and minimal overgrowth in the area where old poorly marginally adapted prosthodontics were kept in place and no/minimal signs of gingival inflammation).

Orofacial granulomatosis (OFG) is an uncommon clinicopathological condition describing patients who have oral lesions characterized by persistent labial enlargement, oral ulcers and a variety of other orofacial features. Sarcoidosis is a systemic non-caseating granulomatous disorder of unknown etiology that may affect multiple organ systems. As a systemic disease, it is well documented in existing literature. However, the rarity and its often non-specific oral manifestation emphasize the need to reinforce the literature with more clinical case examples and draw additional attention to clinical features that general practitioners may encounter. In this report, a rare case is presented with definite association of sarcoidosis and orofacial granulomatosis with two years follow up after treatment. This report aims to expand the literature surrounding orofacial sarcoidosis and support oral and general health practitioners in recognizing its orofacial manifestations along with the clinical presentations that all led to a diagnosis of sarcoidosis in this case.

The aetiology of gingival enlargement (GE) is highly distinct. Plaque-induced gingival inflammation can be the sole reason for gingival enlargement. Poor dental hygiene, irritation from anatomical variations, and ineffective restorative and orthodontic appliances are all factors that encourage the formation and retention of plaque. In the given case report, a case of gingival enlargement associated with an orthodontic appliance of a 23-year-old female patient referred from the Department of Orthodontics was reported to the Department of Periodontics. Under local anaesthesia, the excess gingival tissue is removed using a scalpel by gingivectomy and gingivoplasty procedures. The gingivectomy and gingivoplasty procedures using a scalpel gave the best results in the orthodontic treatment associated with gingival enlargement. After achieving hemostasis, the periopack (Coe-pack) was placed to assist healing by protecting the tissue. The above case report can appreciate the gingival tissue covering almost half of the crown, causing plaque retention and presenting the patient with aesthetic concerns. After the surgical procedure, a proper gingival contour eliminates suprabony pockets and provides pleasant esthetics. This case report demonstrates that eliminating the suprabony pockets by gingivectomy and gingivoplasty leads to a physiologic gingival contour and eliminates plaque retention. The conventional scalpel gingivectomy procedure is an effective form of treatment when indicated.

Vascular malformations are anomalies that are caused by disturbances in vasculogenesis. Depending upon the dominant structure present histologically, they may be found in different combinations of vascular elements and are named hemangiolymphangioma (HLA) or lymphangiohemangioma (LHA). HLA occurs in multiple anatomical sites, such as the head and neck, axilla, abdominal cavity, extremities, and urinary bladder, but it is infrequent in the oral cavity. An 18-year-old male with a history of abdominal tuberculosis presented with an asymptomatic mandibular gingival swelling that was histologically diagnosed as HLA. A six-month follow-up revealed no recurrence. The observations reported in this case are unusual, and our literature review revealed no previously documented case of gingival HLA.