PMC4789408_01
A photo showing the initial presentation of the GE associated with all lower anterior teeth.
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On examination, there was gingival hyperplasia and pocketing of 5 mm (Figure 1).
A photo showing the histopathological picture of the GE. (a) Showing heavy inflammatory cell infiltrate (green arrows) and osseous metaplasia (black arrows), H&E x2. (b) Showing a higher magnification of some areas of osseous metaplasia, H&E x20. (c) Showing an area of osseous metaplasia surrounded by chronic inflammatory cells, H&E x40.
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Biopsy results showed the diagnosis was Fibrous Epulis with osseous metaplasia (Figure 2).
A photo showing the persistence of GE after the initial periodontal treatment. The inflammation decreased slightly. Oral hygiene improved after the initial treatment.
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However, the degree of inflammation decreased (Figure 3).
Showing disappearance of the GE and improvement of the overall periodontal condition after cessation of Felodipine together with strict oral hygiene measures.
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In the second review appointment, there was a significant reduction in GE (Figure 4).
An orthopantograph (OPG) showing mild to moderate bone loss around lower anterior teeth, which compromises the long term prognosis of these teeth and mandates strict oral hygiene measures and careful and regular monitoring.
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The OPG showed mild to moderate horizontal bone around the lower anterior teeth (Figure 5).