Management of drug-induced gingival enlargement with orthodontic complications.

Gingival enlargement (GE) may be induced by cyclosporin A, phenytoin or calcium channel blockers, used either singly or in combination. The lesion can cause significant disfigurement and functional difficulty as it interferes with eating and speech, impedes effective plaque control, and disturbs occlusal relationships. Orthodontic problems may originate independently of the soft tissue lesion or they may develop secondary to the GE. Management of drug-induced GE with orthodontic complications requires co-operative teamwork. This will be discussed in the management of cases with medical, orthodontic and periodontal interventions.