**3. Clinical features**

*Gingival Disease - A Professional Approach for Treatment and Prevention*

○ Chronic ○ Acute

• Drug induced enlargements:

○ Antihypertensive calcium antagonists

*Systemic diseases causing gingival enlargement*:

2.According to location and distribution:

Scoring of gingival enlargement:

• Grade 0: no signs of gingival enlargement.

• Grade I: enlargement confined to interdental papilla.

• Grade II: enlargement involves papilla and marginal gingiva.

• Grade III: enlargement covers three quarters or more of the crown.

• Neoplastic enlargements: (gingival tumors)

• Enlargements associated with systemic diseases:

• Non-specific conditioned enlargement (pyogenic granuloma)

• Localized: limited to the gingiva of a single or group of teeth.

• Diffuse: involving marginal and attached gingiva and papilla.

• Discrete: an isolated sessile or pedunculated or tumor like enlargement.

• Generalized: involving gingiva throughout the mouth.

• Marginal: confined to the gingival margin. • Papillary: confined to the interdental papilla.

• Granulomatous diseases (Wegener's granulomatosis, sarcoidosis, etc.)

○ Anticonvulsants

*Conditioned enlargements*

• Vitamin C deficiency • Plasma cell gingivitis

• Pregnancy • Puberty

• Leukemia

○ Benign tumors ○ Malignant tumors • False enlargements

○ Immunosuppressant • Idiopathic enlargement

**90**
