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Case Reports
. 2025 Jun 22;17(6):e86519.
doi: 10.7759/cureus.86519. eCollection 2025 Jun.

Sodium Valproate-Induced Gingival Enlargement in a Pediatric Patient: A Case Report With Surgical Intervention

Nezy Varghese  1 , R Rajesh  1 , Darsana Krishnan  1 , Sreelakshmi Vasu  1
Affiliations
Case Reports

Sodium Valproate-Induced Gingival Enlargement in a Pediatric Patient: A Case Report With Surgical Intervention

Nezy Varghese et al. Cureus. .

Abstract

Gingival enlargement occurs secondary to the usage of anti-epileptics. The severity of overgrowth varies among different classes of drugs, with phenytoin having the highest incidence of reported cases, whereas cases associated with sodium valproate are minimal. Factors like drug dose, genetic factors, plaque, gingival inflammation, and periodontal health influence the degree of overgrowth. This case report presents one of the first surgically managed cases of generalized gingival enlargement in a pediatric patient due to chronic usage of sodium valproate.

Keywords: gingival overgrowth; gingivectomy; oral hygiene; plaque; sodium valproate.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Intraoral photographs showing sodium valproate-induced generalized gingival enlargement
Figure 2
Figure 2. Pocket depth marked using a pocket marker, with bleeding points visible
Figure 3
Figure 3. External bevel incision made at a 45-degree angulation
Figure 4
Figure 4. Postoperative photograph taken after gingivectomy and gingivoplasty, followed by oral hygiene prophylaxis
Figure 5
Figure 5. Perio-pack was placed to facilitate healing
Figure 6
Figure 6. Histologic slide showing features of inflammatory fibrous hyperplasia
Figure 7
Figure 7. Intraoral photograph showing satisfactory healing two months postoperatively
See this image and copyright information in PMC

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