2.According to location and distribution:


Scoring of gingival enlargement:


**91**

*Treatment of Gingival Enlargement*

**3.1 Inflammatory enlargement**

**3.2 Acute inflammatory enlargement**

along the lateral aspect of the root.

**3. Clinical features**

*DOI: http://dx.doi.org/10.5772/intechopen.82664*

It may be chronic or acute. This usually results from accumulation of local deposits. Factors resulting in plaque accumulation predisposes to inflammatory enlargement. Chronic inflammatory enlargement originates as slight ballooning of interdental papilla and marginal gingival. A life preserver shaped bulge appears around the involved teeth. This can increase in size until it covers the crown. It is

Inflammatory enlargement may be localized or generalized. Localized enlargement may appear as tumor like mass or nodule, sessile or pedunculated. It may involve interdental papilla, marginal gingival or attached gingiva. They may undergo spontaneous reduction in size, followed by exacerbation and continued enlargement. Painful ulceration sometimes occurs in the fold between the mass and the adjacent gingiva [2]. Chronic inflammatory enlargement may also occur because of presence of mouth breathing habits. Anterior region predominantly papilla is involved. The mouth breathing habit results in dryness of the mucosa. There is a clear demarcation between normal and involved gingival [2] (**Figure 1**).

Acute form of gingival enlargement includes abscesses of the periodontium. They results in a localized painful area of purulent material which needs to be drained. Lindhe et al. [3] classified as (a) periodontitis-related abscess, infection caused by the bacteria present at the subgingival biofilm in a deepened periodontal pocket, (b) non-periodontitis-related abscess, infection caused by the bacteria originating from another local source, such as a foreign body impaction or from alterations in the integrity of the root leading to bacteria colonization. Meng [4] classified as gingival abscesses (in previously healthy sites and caused by impaction of foreign bodies), periodontal abscesses (either acute or chronic, in relation to a periodontal pocket), and pericoronal abscesses (at incompletely erupted teeth). The gingival abscess involves the marginal gingival and interdental tissues. The periodontal abscess is an acute destructive process in the periodontium, resulting in the localized collection of pus, communicating with the oral cavity through gingival sulcus or other periodontal sites and not arising from tooth pulp. The pericoronal

abscess is associated with the crown of a partially erupted tooth [4, 5].

results when drainage into the pocket space is impaired.

occurs in the sealed-off portion of the pocket.

Periodontal abscess (**Figure 2**) formation may occur in the following ways [6]:

1.Extension of infection from a periodontal pocket deeply into the supporting periodontal tissues, and localization of the suppurative inflammatory process

2.Lateral extension of inflammation from the inner surface of a periodontal pocket into the connective tissue of the pocket wall. Localization of the abscess

3. Formation in a pocket with a tortuous course around the root. A periodontal abscess may form in the cul-de-sac, the deep end of which is shut off from the surface.

4.Incomplete removal of calculus during treatment of a periodontal pocket. The gingival wall shrinks, occluding the pocket orifice, and a periodontal abscess

usually painless until trauma or acute infection is superimposed [2].
