Localized Gingival Enlargements: Clinical, Histopathological and Surgical Evaluation in Five Cases

Abstract

Background: Localized gingival enlargements (GEs) are frequently encountered reactive lesions with various etiologies, including chronic irritation, trauma, systemic conditions, hormonal influences, and medication use. Despite their benign nature, these lesions can significantly affect oral function and aesthetics and may occasionally mimic neoplastic processes. This case series aims to present the clinical and histopathological (HP) features of five patients with localized GEs, describe different surgical approaches including scalpel and diode laser excision, and report short-term clinical outcomes. Case presentations: Five patients with gingival overgrowths of varying etiology were evaluated. All underwent thorough periodontal debridement and oral hygiene instruction prior to surgical intervention. HP evaluation followed surgical excision. Patients were monitored for recurrence for at least three months. Lesions included inflammatory epithelial hyperplasia, cavernous hemangioma, and squamous cell papilloma. One case revealed immunoglobulin G4 (IgG4)-positive plasma cells and was referred to Rheumatology Department. A suspected vascular lesion was successfully managed with laser excision to minimize bleeding. One patient exhibited recurrence of a papillomatous lesion, prompting referral to infectious disease. No major complications occurred during the follow-up period. Conclusions: Localized GEs can present diverse HP profiles. Biopsy remains essential for definitive diagnosis, especially when clinical features are ambiguous. Laser surgery proved beneficial in vascular lesions by reducing intraoperative bleeding and enhancing patient comfort. Identifying and managing underlying systemic or local factors is crucial to prevent recurrence.