Gingival Fibrous Hyperplasia

and calcium channel blockers such as nifedipine, am-lodipine and verapamil (~10% patients). The enlargements may be generalised or more localised. The anterior interdental papillae tend to be the most severely affected areas, particularly on the labial aspect. The gingiva tend to enlarge laterally and this growth pattern may result in the formation of vertical clefts between adjacent overgrowths. The normal gingival stippling may be enhanced, producing an orange-peel appearance. The condition is exacerbated by poor oral hygiene and meticulous attention to tooth cleaning may help prevent the development of the condition.

Microscopy of generalised gingival fibrous hyperplasia tends to be the same irrespective of the cause. There is fibrous hypertrophy of the affected gingiva, often containing myofibroblastic cells. An increase in the amount of myxoid ground substance material is also common. In areas distant from the gingival sulcus there is usually no significant inflammatory component. There is often elongation and fusing of the rete process of the overlying epithelium. It is unusual for these lesions to become ulcerated

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