Leukemic gingival enlargement- A case report and review

Oral signs are an early indicator for a variety of systemic diseases. Gingival enlargement can be due to local factors, certain medications, hormonal changes, and malignant diseases. Leukemia is a malignancy characterized by the proliferation of abnormal white blood cells within the bone marrow; oral changes may be the first and only presenting feature in these patients, making it imperative for dental surgeons to make accurate diagnosis and timely referral to prevent a fatal situation. This article aims to discuss a case of acute myeloid leukemia (AML) that came with the chief complaint of swollen gums for 2-month duration. The case was provisionally diagnosed as a leukemic gingival enlargement on the basis of oral manifestation and lymph node examination. Accurate diagnosis and early initiation of chemotherapy for leukemic gingival enlargement can improve the prognosis of the patient and also helps in avoiding complications. Around 50–80% of patients with AML achieve complete remission, more often in children and patients under the age of 60. This paper aims at emphasizing the importance of thorough oral examination and careful investigations to identify the underlying life-threatening condition.

Non-surgical periodontal treatment for drug-influenced gingival enlargement: a four-year follow-up case report

ABSTRACT: Drug-influenced gingival enlargement is considered to be an important side effect related to the use of some medications and often produces important esthetic changes for patients, as well as clinical symptoms such as pain, bleeding, abnormal tooth movement and occlusion problems. Anticonvulsants, immunosuppressants and antihypertensive drugs have been reported as the main inducers of these periodontal disorders. This case report describes the 4-year clinical follow-up of a young patient with a history of excessive gingival enlargement as a consequence of drug therapy for epilepsy (phenytoin and phenobarbital); the nonsurgical periodontal treatment of the excessive gingival enlargement was associated with the replacement of the patient's epilepsy medications with valproic acid. We conclude that intensive mechanical control of bacterial biofilms, instruction on oral hygiene guidelines and behaviors and the substitution of alternative anticonvulsant medications are the best way to control the drug-influenced gingival enlargement.

Tratamiento no quirúrgico del agrandamiento gingival asociado a la pubertad: reporte de caso clínico / Non-surgical treatment of gingival enlargement associated with puberty: a clinical case report

RESUMEN Introducción: los agrandamientos gingivales suelen tratarse a través de terapias quirúrgicas de gingivectomías; su tratamiento no quirúrgico mecánico también es una opción sobre todo en los casos de gingivitis asociada a la pubertad como consecuencia de los cambios hormonales. Objetivo: describir el tratamiento no quirúrgico de una paciente de 12 años con agrandamiento gingival asociado a la pubertad y lesiones gingivales inducidas por biofilm dental. Presentación del caso: el caso presentó un agrandamiento gingival leve localizado que remitió al cabo de un mes a la primera fase de tratamiento, después de tres sesiones de fisioterapias con la remoción de biofilm calcificado se obtuvo una reducción del porcentaje del índice de higiene oral sin requerir intervención quirúrgica. A los cuatro años de seguimiento se observó reducción completa del agrandamiento gingival y bolsas periodontales. Conclusiones: la terapia periodontal mecánica es una alternativa eficaz en la reducción de la inflamación gingival inducida por hormonas durante la pubertad sin la necesidad de requerir intervenciones quirúrgicas para el tratamiento del agrandamiento gingival. Otras alternativas como las gingivectomías son aplicables; sin embargo requieren procedimientos más complejos, costosos y aumento de la morbilidad del paciente; en ese sentido el tratamiento mecánico no quirúrgico se muestra como una opción viable(AU)

ABSTRACT Introduction: Gingival enlargement is usually treated with gingivectomy as an alternative to surgery; however, non-surgical mechanical treatment is another option especially in cases of gingivitis associated with puberty as a result of hormonal changes. Objective: To describe the non-surgical treatment of a 12-year-old patient with gingival enlargement associated with puberty and gingival lesions induced by dental biofilm. Case presentation: The patient presented a localized mild gingival enlargement that relapsed to the first phase of treatment after one month. Three months after physiotherapy sessions with removal of calcified biofilm, a reduction in the percentage of oral hygiene index to "good" was obtained; therefore, surgical treatment was not required. Four years later, there was a complete reduction in gingival enlargement and periodontal pockets. Conclusions: Mechanical periodontal therapy is an effective alternative to reduce gingival inflammation induced by hormones during puberty not requiring surgical intervention to treat gingival enlargement. Other alternatives such as gingivectomies are performed; however, they require more complex, expensive procedures and they can also increase patient morbidity. In that sense, the uniqueness of the non-surgical mechanical treatment is chosen as a feasible option(AU)

Prevalence of Amlodipine Induced Gingival Enlargement - A Hospital Based Study.

Gingival enlargement is a complication associated with certain drugs (antihypertensives, anticonvulsants, and immunosuppressants). Amlodipine is a calcium antagonist and is structurally similar to nifedipine but pharmacodynamically different from it. The prevalence of amlodipine induced gingival enlargement is reported to be 3.3% which is lower than other calcium channel blockers. We wanted to determine the prevalence of amlodipine (calcium channel blocker) mediated gingival enlargement in patients undergoing treatment for hypertension for more than 6 months and explore how the patients' age, gender, treatment duration, and oral hygiene are related to gingival enlargement. METHODSPatients taking amlodipine were inspected for the presence of gingival enlargement using Bokenkamp and Bornhorst Index. Periodontal status of the patient was evaluated with Gingival Index, Plaque Index, Probing Pocket Depth and Clinical Attachment Loss. RESULTSIn our study, 5 patients out of 108 patients on amlodipine were clinically diagnosed with enlargement, patients were prescribed amlodipine with a dosage of 2.5 mg and 5 mg. Enlargement was seen in patients prescribed with a dosage of 5 mg/day. Enlargement was found to begin at the interdental papilla and progress to marginal gingiva. The frequency of gingival enlargement induced by Amlodipine was found to be 4.6%. The ratio of enlargement in males and females was 4:1. Plaque index and gingival index were found to be poor in patients with drug-induced enlargement. CONCLUSIONSDentists and/or periodontists should be aware of the complications of certain systemic drugs such as calcium channel blockers so as to diagnose complications or problems like gingival enlargement

Agrandamiento gingival generalizado en un paciente con trasplante renal / Generalized gingival enlargement in a patient with renal transplant

Introducción: El agrandamiento gingival es el aumento exagerado y desfigurante del volumen de la encía. Su aparición se asocia a fármacos, entre los que se encuentran los inmunosupresores y los bloqueadores de los canales de calcio como la ciclosporina A y amlodipino. Objetivo: Describir un caso clínico de agrandamiento gingival asociado a ciclosporina A y amlodipino, con periodontitis crónica subyacente, su tratamiento y prevención de recidiva. Presentación del caso: Paciente masculino, de 50 años de edad, antecedentes de hipertensión arterial, asma bronquial y hepatitis C, además de presentar insuficiencia renal crónica para la cual se le realizó un trasplante renal. Recibe tratamiento con ciclosporina A y amlodipino. Al examen clínico se observaron aumento de volumen generalizado en la encía, que cubría completamente la corona de los dientes, bolsas periodontales de 5 a 8 mm, sangramiento gingival y movilidad dentaria. Principales comentarios: El proceso diagnóstico permitió comprobar que además del agrandamiento gingival generalizado existía una periodontitis crónica generalizada. Conclusiones: La ingestión de un inmunosupresor como la ciclosporina A con el uso de un bloqueador de los canales de calcio, el amlodipino, y la influencia de factores de connotación local, parecen ser los responsables de la aparición combinada del agrandamiento gingival generalizado y la periodontitis crónica concomitante. La fase higiénica contribuyó considerablemente a mejorar el estado periodontal, cuya solución definitiva se alcanzó con la cirugía periodontal convencional. Se corrobora la importancia del examen periodontal en pacientes candidatos a trasplantes de órganos(AU)

Introduction: Gingival enlargement is an exaggerated and disfiguring increase in gum volume, associating its appearance with drugs like immunosuppressants and calcium channel's blockers such as cyclosporine A and Amlodipine. Objective: To describe a clinical case of gingival enlargement associated to cyclosporine A and amlodipine, presenting chronic underlying periodontitis, its treatment and prevention in case of recurrence. Case Presentation: Male patient, 50 years old with a history of arterial hypertension, bronchial asthma and hepatitis C, and presenting chronic renal failure leading renal transplant. The patient was treated with cyclosporine A and amlodipine. In the clinical examination was observed an increased volume in the gum, which completely covered the crown of the teeth, also periodontal bags of 5 to 8 mm, gingival bleeding and dental mobility. Main Comments: The diagnostic process allowed to verify that in addition to the generalized gingival enlargement there was a generalized chronic periodontitis. Conclusions: The ingestion of an immunosuppressant such as Cyclosporin A with the use of a calcium channel's blocker, amlodipine, and the influence of local connotation factors seem to be responsible for the combined appearance of generalized gingival enlargement and concomitant chronic periodontitis. The hygienic phase contributed considerably to improve the periodontal state, whose definitive solution was achieved with conventional periodontal surgery. The importance of periodontal examination in patients who are candidates for organ transplants is corroborated(AU)

Relationship of orthodontic treatment and periodontal soft tissue health / 华西口腔医学杂志

With the increasing number of the orthodontic patients, the relationship between periodontal and orthodontic becomes increasingly close. Orthodontic treatment can improve periodontal status, but the adverse clinical problems of periodontal tissue during orthodontic treatment are relatively common. In this paper, we discuss the problems of soft tissue, including causes, prevention, and treatment of gingivitis, gingival enlargement, gingival recession, and gingival invagination in orthodontic treatment.

Agrandamiento gingival inducido por medicamentos. Reporte de un caso clínico / Drug-Induced Gingival Enlargement. A Clinical Case Report

Antecedentes: El agrandamiento gingival inducido por medicamentos es una condición clínica frecuente en pacientes que ingieren anticonvulsivos, inmunosupresores y bloqueadores de los canales de calcio. La prevalencia de agrandamiento gingival inducido por medicamentos es del 3 % al 20 % en el grupo de las condiciones gingivales inflamatorias. Todos estos medicamentos producen lesiones clínicas y características histológicas indistinguibles unas de otras, que llegan a afectar la función y la estética de los pacientes afectados. Objetivo: Describir el manejo terapéutico integral y el seguimiento a 12 meses de una paciente con agrandamiento gingival inducido por tacrolimus y amlodipino. Descripción del caso: Una mujer de 22 años con discapacidad mental limítrofe y receptora de trasplante renal se remitió al servicio de Odontología del Hospital Infantil Universitario de San José (Bogotá, Colombia) por presentar agrandamiento gingival. El examen clínico mostró un índice de placa de O'Leary del 84,3 %, in flamación generalizada y bolsas gingivales de 4-6 mm. El equipo de trasplante renal revisó el protocolo de tratamiento periodontal que incluyó: trabajo con la familia para red de apoyo, diseño de un programa personalizado de higiene oral, gingivectomía y mantenimientos periodontales periódicos. Esta estrategia terapéutica permitió reducir el índice de placa y lograr un resultado clínico favorable. Conclusión: La condición sistêmica y psicológica de la paciente requirió desarrollar un plan de tratamiento ajustado a sus necesidades. Pacientes susceptibles deben ser instruidos sobre la importancia de tener prácticas adecuadas de higiene oral y ameritan ser incluidos en programas de mantenimiento periodontal.

Background: Gingival enlargement induced by the use of drugs is a frequent clinical condition in patients who take anticonvulsants, immunosuppressive agents and calcium channel blockers. The gingival enlargement prevalence, as induced by drug use, is from 3% to 20% in the group with inflammatory gingival conditions. All these drugs cause clinical lesions and histological characteristics indistinguishable from one another, which eventually affect the function and aesthetics of the patients. Objective: To describe a comprehensive therapeutic management and the 12-month following in a patient with gingival enlargement induced by the use of tacrolimus and amlodipine. Case Description: A 22 year-old woman with Borderline Personality Disorder who also underwent a kidney transplant was referred to the dental service in the Hospital Infantil Universitario de San José (Bogotá, Colombia) due to gingival enlargement. The clinical examination showed an O'Leary plaque index of 84.3%, extended inflammation and gingival pockets about 4-6 mm. The kidney transplant team checked the periodontal treatment protocol that included: partnering with the family as a support network, design of a customized oral hygiene program, gingivectomy and regular periodontal maintenance. This therapeutic strategy allowed to reduce the plaque index and resulted in a favorable clinical condition. Conclusion: The systemic and psychological status of the patient required to design a treatment plan customized to her needs. Susceptible patients should be educated on how important it is to follow the appropriate oral hygiene practices and are eligible for periodontal maintenance programs.

Resolución del agrandamiento gingival mediante terapia periodontal no quirúrgica: reporte de caso / Gingival enlargement resolution by means of non-surgical periodontal therapy: case report

Resumen: El agrandamiento gingival es una lesión crónica inflamatoria, cuyo factor causal es la placa bacteriana. Se presenta como una tumefacción a nivel de la papila interdental y/o la encía marginal, puede estar de manera localizada o generalizada, siendo de progresión lenta e indolora, pudiendo ser exacerbado por efectos hormonales o por el uso de fármacos. Este artículo reporta el caso de una paciente con agrandamiento gingival y lesiones gingivales inducidas por placa bacteriana resuelto mediante terapia periodontal no quirúrgica. Se realizó la terapia manual y antibióticoterapia sistémica por siete días. Al mes de reevaluación se evidencio la resolución del agrandamiento; reducción de la inflamación, supuración, porcentaje de bolsas y grado de movilidad dental, se realiza mantenimiento periodontal. A los tres meses se observa reducción en el porcentaje de bolsas periodontales y grado de movilidad dental; se realizó terapia periodontal de mantenimiento.

Abstract: Gingival enlargement is a chronic inflammatory lesion caused by bacterial plaque. It appears as a tumefaction at the level of the inter-dental papilla and/or marginal gingival tissue; it can be localized or generalized. It exhibits slow and painless progression and can be exacerbated by hormonal causes or use of drugs. The present article studies the case of a patient afflicted with gingival enlargement and gingival lesions induced by bacterial plaque. The case was resolved with use of non surgical periodontal therapy. For seven days, antibiotic therapy and manual therapy were conducted. Re-evaluation one month later revealed resolution of the enlargement, decrease of inflammation, suppuration, periodontal pocket percentage and degree of dental mobility; periodontal maintenance was executed at that point. After three months, decrease of periodontal pockets percentage and degree of dental mobility were observed; at that point maintenance periodontal therapy was conducted.

Amlodipine Induced Gingival Enlargement – A Case Report.

Gingival enlargement can be caused by various factors like chronic inflammation, local factors, drug and systemic disorders. Drug induced gum hypertrophy is rarely observed. Here we report a case of 50 years old male, known case of hypertension on amlodipine since 1 year for its rarity.

Changing spectrum of Zimmerman-Laband syndrome: a six years follow up case report of a family.

The Zimmermann-Laband syndrome (ZLS) is a rare genetic disorder inherited as an autosomal dominant fashion, with clinical characters like, gingival fibromatosis, bulbous soft nose, thick floppy ears, nail dysplasia, joint hyperextensibility, hepatosplenomegaly, skeletal anomalies and occasional mental retardation. Idiopathic gingival enlargement is a hereditary condition; it can be expressed as autosomal dominant inheritance. Here association of Idiopathic gingival enlargement has been reported in a family, with an autosomal dominant inheritance diagnosed to be ZLS. Other clinical features associated are, hypertrichosis, bulbous soft nose, thick floppy ears, nail dysplasia, joint hyper extensibility, bimaxillary protrusion and enlarged palm and fingers with flat feet. The unusual clinical presentations of massive gingival fibromatosis, unusual length of upper limbs and bimaxillary protrusion supported the variable spectrum of phenotype expression of the ZLS. The Biopsy report confirmed the diagnosis of gingival fibromatosis. Gingivectomy was carried out in all four quadrants for exposing the natural teeth and to bring back the original contour of the gingiva. But there was recurrence of the enlargement found to be associated during 6 years follow up.

Association between gingivitis and anterior gingival enlargement in subjects undergoing fixed orthodontic treatment

OBJECTIVE: The aim of this study was to investigate the association among gingival enlargement (GE), periodontal conditions and socio-demographic characteristics in subjects undergoing fixed orthodontic treatment. METHODS: A sample of 330 patients undergoing fixed orthodontic treatment for at least 6 months were examined by a single calibrated examiner for plaque and gingival indexes, probing pocket depth, clinical attachment loss and gingival enlargement. Socio-economic background, orthodontic treatment duration and use of dental floss were assessed by oral interviews. Associations were assessed by means of unadjusted and adjusted Poisson's regression models. RESULTS: The presence of gingival bleeding (RR 1.01; 95% CI 1.00-1.01) and excess resin around brackets (RR 1.02; 95% CI 1.02-1.03) were associated with an increase in GE. No associations were found between socio-demographic characteristics and GE. CONCLUSION: Proximal anterior gingival bleeding and excess resin around brackets are associated with higher levels of anterior gingival enlargement in subjects under orthodontic treatment. .

OBJETIVO: o objetivo desse estudo foi verificar a associação entre volume gengival (AG) com condições periodontais e características sócio-demográficas em sujeitos com aparelho ortodônticos fixo. MÉTODOS: uma amostra, de 330 participantes com aparelho ortodôntico fixo, por pelo menos seis meses, foi examinada, por um único examinador calibrado, para os índices de placa e gengivais, profundidade de sondagem, nível de inserção clínico e aumento de volume gengival. O status socioeconômico, tempo com aparelho ortodôntico fixo e uso de fio dental foram verificados por entrevista oral. A verificação das associações foi realizada por meio de modelos de regressão de Poisson sem ajuste e ajustados. RESULTADOS: a presença de sangramento gengival (RR 1.01; 95% IC 1.00-1.01) e o excesso de resina em torno dos braquetes (RR 1.02; 95% IC 1.02-1.03) foram associadas a um aumento do AG. Não foram encontradas associações entre características sócio-demográficas e AG. CONCLUSÃO: sangramento gengival proximal na região anterior e excesso de resina no entorno dos braquetes estão associados a níveis mais altos de aumento de volume gengival na região anterior em sujeitos com aparelho ortodôntico fixo. .

Pregnancy Induced Gingival Enlargement-A Case Report.

Gingival enlargement is a common clinical problem, sometimes associated with specific conditions. This condition finds a unique place in the literature, because it has been associated with a variety of local and systemic factors.In puberty and pregnancy, gingival enlargement can be due to poor oral hygiene, inadequate nutrition, or systemic variation in hormonal stimulation. This case report present the clinical , histopathological features as well as the treatment of the inflammatory gingival enlargement in pregnancy, where pregnancy altered the tissue metabolism which disturbed the aesthetics and masticatory function of the patient.

A rare case of isolated idiopathic gingival fibromatosis.

Idiopathic gingival fibromatosis (IGF) is a rare condition. It is genetically heterogeneous and is usually part of a syndrome or, rarely, an isolated disorder. This study presents a rare case of 13 year old boy who was diagnosed with isolated IGF. This diagnosis has been based on clinical examination and after ruling out family, drug, and medical histories. External bevel gingivectomy has been done to remove excess gingival tissues. Excised tissue has been examined histologically. The patient has been followed up for a period of two and half years. No recurrence has been observed.

Down Syndrome with Gingival Enlargement.

Down syndrome is the commonest autosomal chromosomal anomaly with an incidence of 1 in 600 to 1000 live births in all races and economic groups. In this condition extra genetic material causes mental and physical retardation. The physical features and medical problems associated with Down syndrome can vary widely. Generally, these patients now live longer due to increase medical attention. Dental practitioners are challenged by the high incidence of early onset aggressive dentine problems. The complex anatomy, physiology, immunology, and microbiology underscore the need to describe a case report of a 15-year old male patient with the classical features of Down syndrome with gingival enlargement and its dental treatment.

Hereditary gingival fibromatosis - a case report and management using a novel surgical technique

Introduction: Hereditary gingival fibromatosis (HGF) is a rare condition presenting varied degrees of gingival enlargement. HGF can present as an isolated entity or as part of a syndrome. Current literatures report a defect in the Son of sevenless-1 gene (SOS-1) on chromosome 2p21-p22 (HGF1) as a possible cause of this condition. Case report: A case of a 16-year-old female is reported who presented generalized extensive gingival overgrowth, involving the maxillary and mandibular arches covering almost two thirds to three quarters of all teeth. Diagnosis of HGF was substantiated by the patient's clinical features, family history and histopathological examination. Treatment was excision of the gingival tissue by a modified gingivectomy technique with both manual instrumentation and electrosurgery. The postoperative course was uneventful and the patient's aesthetic concerns were addressed. Post-surgical follow-up after 18 months demonstrated no recurrence. Conclusion: Hereditary gingival fibromatosis stands apart from other gingival enlargements in the varied treatment options available and the nature of recurrence post treatment. There is no consensus among authors related to the mode of treatment. Here, in this present case report we highlight a novel surgical technique to deal with the extensive nature of enlargement seen in HGF cases.

Peripheral ossifying fibroma: a clinical report / Fibroma osificante periférico: un reporte clínico

Localized growths are commonly seen on the gingiva. Many of these enlargements are considered to be reactive rather than neoplastic in nature. Clinically differentiating one from the other as a specific entity is often not possible. Histopathologic examination is needed in order to positively identify the lesion. The peripheral ossifying fibroma is one such lesion. We report in this study, the clinical report of a 20-yr-old male patient with a peripheral ossifying fibroma in the maxilla exhibiting significant size with the disease duration of 1 year. The signs of recurrence in spite of thorough excision and debridement exposed the need for further study of the causes of recurrence and possible modes to avoid the situation. Clinical, radiographical and histological characteristics are discussed and recommendations regarding treatment and follow-up are provided.

Aumentos de volumen localizados se observan con frecuencia en la encía. Muchos de estos crecimientos se consideran de tipo reaccional más que de naturaleza neoplásica. Clínicamente diferenciar uno del otro como una entidad específica no siempre es posible. El examen histopatológico es necesario con el fin de identificar positivamente a la lesión. El fibroma osificante periférico es una de estas lesiones. Se presenta en este estudio, el informe clínico de un paciente de sexo masculino de 20 años de edad con un fibroma osificante periférico en el maxilar de un tamaño significativo con 1 año de duración de la lesión. Los signos de recurrencia a pesar de la escisión completa y desbridamiento expusieron la necesidad de estudiar más a fondo las causas de la recurrencia y los posibles modos de evitar la situación. Las características clínicas, radiográficas e histológicas son discutidas junto a recomendaciones sobre el tratamiento y seguimiento.

Idiopathic Gingival Fibromatosis With Aggressive Periodontitis – A Rare Case Report

Idiopathic gingival fibromatosis is a rare benign oral condition characterized by a slowly progressive, non-hemorrhagic, fibrous enlargement of maxillary and mandibular attached and non-attached gingivae. A 14 year old female patient suffered from unusual gingival enlargement, more on the left side along with generalized aggressive periodontitis. The enlarged gingiva covered more than two-thirds of the clinical crowns. Marked inflammatory hyperplasia of epithelium and connective tissue of the gingiva was observed histopathologically. Perioscan test was performed, the results of which were negative. The diagnosis of Idiopathic gingival fibromatosis with aggressive periodontitis was made. Conventional periodontal therapy was performed followed by excision of the enlargement using gingivectomy procedure.

Leukemic gingival enlargement: a report of two cases

Most of the systemic diseases manifest signs and symptoms in oral cavity. Periodontal lesions are common in patients with acute leukemia throughout the course of the disease. Although many cases of gingival enlargement in patients with acute myeloid leukemia have been reported in literature, cases of gingival hypertrophy secondary to acute lymphoblastic leukemia in adult female are rare. This is a case report of gingival enlargement in acute lymphoblastic leukemia along with a case of gingival enlargement in patient with acute myeloid leukemia.

Gingival Fibromatosis with Chronic Periodontitis – A Rare Case Report

Gingival fibromatosis is frequently an isolated condition of little consequence apart from a cosmetic problem and occasional associations with uncommon syndromes. This case report of a 38 year old female patient describes the gingival enlargement associated with chronic periodontitis. The enlargement extended beyond the middle thirds of the clinical crowns of the teeth. It was associated with generalized mobility, pocket formation and bone loss. The patient also complained of bleeding gums and difficulty in speech and mastication. This is the first case report of gingival fibromatosis associated with chronic periodontitis.

The effect of non-surgical treatment in gingival enlargement / 대한치주과학회지

PURPOSE: It is well recognized that gingival enlargement is induced by unwanted effect associated with three major drugs/drug groups - phenytoin, cyclosporine, and the calcium channel blockers. The present case report describes the effect and limitation of non-surgical treatment in gingival enlargement cases. MATERIALS AND METHODS: Three cases included 2 drug-influenced gingival enlargement patients and a idiopathic gingival fibromatosis patient. For the drug-influenced gingival enlargement patients, the medication was replaced with other medication. And then, all the patients were treated non-surgically. RESULTS: Drug-influenced gingival enlargements had been reduced after non-surgical treatment and the results were well-maintained. In the idiopathic gingival fibromatosis case, non-surgical treatment resulted in only limited reduction of gingival enlargement, and surgical periodontal treatment was unavoidable. CONCLUSION: These case reports indicated that non-surgical periodontal treatment with change in medication was effective in the treatment of drug-influenced gingival enlargements. Non-surgical approach can be considered as the primary management to reduce the gingival enlargement. If non-surgical treatment encounters a limitation, surgical treatment should be considered