Gingival enlargement induced by cyclosporine in Medullary aplasia: A case report

Figure 1 Gingival enlargement in the adult patient treated with cyclosporine. In general, severe inflammation, redness of tissue, nodules, and calculus deposits were observed. A: Inter-occlusal view; B: Left side view; C: Upper occlusal view; D: Lower occlusal view.

Figure 2 Periodontograms. A: Upper; B: Lower.

Figure 3 Images from complete periapical study. Generalized bone loss is evident, with greater loss in the incisors. A: Upper; B: Lower.

Figure 4 Gingival histopathology. A: Fibroconnective tissue growth, elongated epithelial nails, and pseudo-epithelionomatous hyperplasia; B: Connective tissue showing large focal areas of chronic inflammatory infiltration and lymphoplasmacytic dispersion in a stroma of collagen fibers and active fibroblasts.

Figure 5 Tissue conditions 3 mo after initial phase. The features depict decreased inflammation, pink coloration in interproximal areas, and smaller nodules. A: Inter-occlusal view; B: Upper sextant.

Figure 6 Corrective phase. A: Vestibular reflected flap; B: Palatine reflected flap; C: Modified horizontal mattress sutures (vestibular view); D: Modified horizontal mattress sutures (palatal view).

Figure 7 Healing at postoperative 2 wk. A slight inflammation was observed in line with the healing process, and the sutures were removed. A: Upper; B: Lower.

Figure 8 Postoperative view of the lower anterior sextant. Depicting modified horizontal mattress sutures.

Figure 9 Lower anterior sextant at postoperative 2 wk. Inflammation was observed in line with the healing process, and the sutures were removed.

Figure 10  Photographs 3 mo after corrective phase. The figure depicts a general improvement in tissue conditions. A: Inter-occlusal view; B: Right side view; C: Left side view.

Figure 11  Comparative photographs. A and C: Tissue conditions when the patient attended the periodontics clinic; B and D: Tissue status after three phases of periodontal treatment.