1.

prevent organ rejection

Action 2. treatment of autoimmune
disease

1. Nephrotoxicity.
I. CYCLOSPORINE-A Side effect 2. Hypertension .
affect the rate of cell death (turn over rate), (SANDIMMUNE) 3. Gingival enlargement.
rather than the rate of cell division → tissue Pathogenesis:
2- Calcium Channel
overgrowth
Blockers 1. Often undistinguishable from
gingival enlargement for about 20 -44% of treated (Nifedipine) that happened by phenytoin.
C/P 3- Immunosuppressants
patients. C/P 2. Originates in the interdental
area
3. All segements maybe affect

1. Recently used rather than cyclosporine-A

II. TACROLIMUS:
2. Less side effect
DRUG-INDUCED
GINGIVAL
Unknow Pathogenesis ENLARGEMENT
1- Anticonvulsants
(Phenytoin or
1. age : younger patient
Dilantin Sodium) 1. C/P of different drugs are similar
2. In about of 60%
C/P 2. painless, beadlike
3. receiving the drug
4. Not related to dose C/P 3. Begin in interdental papillae

5. spontaneous disappear and may recurrent 4. Extend facio-lingullaly of GM

5. If no infl: mulberry shaped, firm
6. If infl: red and no lobulated surface

1. Scaling and Root planning

2. Oral hygiene
3. Systemic Antibiotic:
Non surgical
4. Folic acid
5. Antiseptic Mouthwashes
6. Change in Medication
Management
1. enlargement with significant fibrotic component
indication
2. size of the enlargement interferes with the access

Surgical
• Scalpel gingivectomy
• Electro-surgery
Examples:
• Laser gingivectomy
• Flap surgery