This is a case report of a patient with idiopathic gingival hyperplasia and an undiagnosed genetic disorder that demonstrated static encephalopathy, mental retardation, developmental delay, seizures, hypotonia, and severe gingival hypertrophy.
The clinical dental management and attempts to obtain a genetic diagnosis are described.
Introduction : Gingival hyperplasia can occur as an isolated form or part of a syndrome. Complications associated with gingival overgrowth may include retained primary teeth, delayed eruption of permanent teeth, increased distal spacing, drifting of teeth, poor plaque control, poor mastication, affected speech, esthetics, and malocclusion.
Several etiologies have been reported including drug-induced, hereditary, hormones-related (pregnancy, growth-hormone), inflammation, systemic (leukemia, neurofibromatosis), idiopathic, and syndrome associated. Depending on the cause, the overgrowth may vary in clinical presentation, severity, onset, and duration.
Cyclosporine, phenytoin, and nifedipine are the most common drugs associated with drug-induced gingival overgrowth.
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The affect is more commonly observed in children than adults, possibly due to immature fibroblasts having increased sensitivity to cyclosporine. Synergistic effects of nifedipine and cyclosporine have also been reported.
Rare cases of sodium valproate-related gingival enlargement have also been reported, including one involving infantile gingival overgrowth at birth secondary to maternal sodium valproate use.
Bien Lai / Joseph Muenzer and Michael W. Roberts