Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2015; 3(9): 779-788
Published online Sep 16, 2015. doi: 10.12998/wjcc.v3.i9.779
Gingival enlargements: Differential diagnosis and review of literature
Amit Arvind Agrawal
Amit Arvind Agrawal, Department of Periodontics, MGV’s KBH Dental college and hospital, Nashik, Maharashtra 422002, India
Author contributions: Agrawal AA solely wrote this paper.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Amit Arvind Agrawal, MDS, MPhil, Professor, Department of Periodontics, MGV’s KBH Dental college and hospital, Mumbai-Agra road, Nashik, Maharashtra 422002, India.
Telephone: +91-982-2107562 Fax: +91-253-2517354
Received: February 1, 2015
Peer-review started: February 2, 2015
First decision: May 13, 2015
Revised: June 8, 2015
Accepted: July 29, 2015
Article in press: August 3, 2015
Published online: September 16, 2015

Gingival enlargement is one of the frequent features of gingival diseases. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician. They can be categorized based on their etiopathogenesis, location, size, extent, etc. Based on the existing knowledge and clinical experience, a differential diagnosis can be formulated. Subsequently, after detailed investigation, clinician makes a final diagnosis or diagnosis of exclusion. A perfect diagnosis is critically important, since the management of these lesions and prevention of their recurrence is completely dependent on it. Furthermore, in some cases where gingival enlargement could be the primary sign of potentially lethal systemic diseases, a correct diagnosis of these enlargements could prove life saving for the patient or at least initiate early treatment and improve the quality of life. The purpose of this review article is to highlight significant findings of different types of gingival enlargement which would help clinician to differentiate between them. A detailed decision tree is also designed for the practitioners, which will help them arrive at a diagnosis in a systematic manner. There still could be some lesions which may present in an unusual manner and make the diagnosis challenging. By knowing the existence of common and rare presentations of gingival enlargement, one can keep a broad view when formulating a differential diagnosis of localized (isolated, discrete, regional) or generalized gingival enlargement.

Keywords: Differential diagnosis, Gingival hyperplasia, Gingival overgrowth, Gingival diseases, Decision tree

Core tip: In clinical dentistry, patients frequently report with isolated/regional or generalized gingival enlargements, which could fall under varied presentations. The diagnosis of these lesions is essential for their successful management and of the patient as a whole. This article revises the existing knowledge of different types of enlargements and highlights some important diagnostic features. A customized decision tree is designed, which will help clinicians to keep a broad view when formulating a differential diagnosis of localized (isolated, discrete, regional) or generalized gingival enlargement and arrive at a particular diagnosis is an easy and systematic manner.