INFORMATIVE ARTICLES
Systemic Drugs as a Risk Factor for Periodontal Disease Initiation and Progression
By Robert A. Levine, D.D.S., P.C.
Terry D. Rees, DMD
(Compend Contin Educ Dent, Vol. 16, No. 1, Pg 20, Jan 1995)
Extensive overgrowth of gingival tissues in humans has been described for many years. The enlargement can occur as a fibrotic or edematous response to inflammatory gingival disease, or as a hereditary or occasionally idiopathic fibrous enlargement of attached and nonattached gingivae (fig 1). Hereditary gingivae fibromatosis (elephantiasis gingivae) was first described more than 100 years ago. It often occurs in association with a variety of multisystem syndromes that can feature epilepsy, mental retardation, excessive hair growth (hypertrichosis), and abnormalities of bones or soft tissues.
Classically, developmental gingival enlargement manifests at or near the time of eruption of the permanent dentition, although the fibrous tissue can appear during eruption of the deciduous teeth or even be represent at birth. Fibrotic gingival hyperplasia can affect isolated areas of the maxilla or mandible, although generalized involvement of the whole gingiva most commonly occurs. Histologically, gingival fibrosis features hyperplasia of mature collagenous connective tissue accompanied by a slight thickening of the overlying epithelium. It represents a true hyperplastic fibrous connective overgrowth.
Inflammatory gingival enlargement can occur in association with various systemic disorders , including leukemia, uncontrolled diabetes mellitus, hypothyroidism, scurvy, and hormonal changes associated with puberty and pregnancy. Fibrotic enlargement has also been identified in patients suffering from tuberous sclerosis, neurofibromatosis, and cherubism.
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