📌 POINTS TO PONDER

🔹Hypertrophy is an increase in the size of cells causing the increase in the size of the tissues.

🔹Hyperplasia is an increase in number of cells in a tissue thus, contributing to an overall increase in the size. 

🔹Gingival hyperplasia is caused mainly by an increase in the number of local cellular elements and intercellular fibers.

🔹The clinical features of phenytoin-induced hyperplasia are  different from that of idiopathic fibrous hyperplasia.

🔹The administration of phenytoin often leads to overgrowth of the papillae, leaving the attached gingiva whereas in idiopathic fibrous hyperplasia there is involvement of all marginal, interdental and attached gingiva.

🔹 The allergens associated with plasma cell gingivitis are cinnamaldehyde and cinnamon used as flavoring agents in chewing gums and dentifrices.

🔹Pyogenic granuloma is not associated with pus and histologically it resembles angiomatous lesion rather than granulomatous lesion indicating that the term “pyogenic granuloma” is a misnomer.

📣 Occurrence of gingival overgrowth

Gingival overgrowth occurs in:

🔹About 50% of patients taking phenytoin

🔹About 30% of patients taking cyclosporine

🔹About 20% of patients taking nifedipine

📌 VIVA VOCE

Q1. What is hypertrophy and hyperplasia?

Ans. Hypertrophy: It is an increase in size of cells causing the increase in the size of the tissues.

Hyperplasia: It is an increase in number of cells in a tissue, thus contributing to an overall increase in the size.

Q2. Why the term gingival hyperplasia/hypertrophy was replaced with the term gingival enlargement/ overgrowth?

Ans. The term gingival hyperplasia/hypertrophy was replaced with term gingival enlargement/ overgrowth because histological analysis of gingiva did not accurately reflect increase in the size/number of fibroblasts, but accumulation of extracellular matrix within the gingival connective tissue. Hence, the term accepted is gingival overgrowth.

Q3. How clinically idiopathic gingival fibromatosis is different from phenytoin-induced hyperplasia?

Ans. Idiopathic gingival fibromatosis involves gingival margin, interdental papillae and attached gingiva whereas in phenytoin-induced hyperplasia only gingival margin and interdental papillae are involved.

Q4. Strawberry gums is seen in which type of gingival disease?

Ans. Wegener’s granulomatosis.

Q5. What are false enlargements?

Ans. These are gingival enlargement that occurs due to increase in size of the underlying osseous or dental tissues.

Q6. Which antibiotic decreases the severity of cyclosporine-induced gingival enlargement?

Ans. Azithromycin.

Q7. Why “pyogenic granuloma” is a misnomer?

Ans. Pyogenic granuloma is not associated with pus and histologically it resembles angiomatous lesion.

Q8. In which tumor of the gingiva horn pearls are present.

Ans. Squamous cell carcinoma.

Q9. What is gingival abscess?

Ans. Gingival abscess is a localized collection of pus involving marginal gingiva or interdental papilla.

Q10. What are papillomas?

Ans. Papillomas are benign proliferations of surface epithelium due to infection with the human papilloma virus.

📌 MULTIPLE CHOICE QUESTIONS MCQs

💡 Conditioned Gingival enlargements are usually notdue to:

A. Hormones

B. Leukemia

C. Granuloma pyogenicum

D. Drug induced

Answer : B

💡 Drug-induced gingival enlargement starts in:

A. Marginal gingiva

B. Attached gingiva

C.Interdental papilla

D. None of the above

Answer : C

💡 Gingival enlargement is caused when the daily dose of cyclosporine is greater than:

A. 500 mg

B. 200 mg

C. 300 mg

D. 100 mg

Answer: A