Unilateral pathology associated with bilateral etiologies

Hormonal fluctutaions affect not only a woman's reproductive system but surprisingly they have a strong influence on the oral cavity also. These changes are not necessarily the result of direct hormonal action on the tissue, but are perhaps best explained as the effects of the local factors (e.g. plaque on tissues exacerbated by hormonal activity). One such case of pubertal induced gingival enlargement associated with chronic generalized periodontitis caused by the combined influence of hormones and the habit of unilateral mastication is presented here. A 14-year-old girl reported with a complaint of swollen gums in the right maxillary and mandibular arches of the mouth since 2 years. The patient also had the habit of unilateral mastication (left side) since childhood which was revealed upon history. Amelioration of the gingival inflammation and the periodontal attachment loss was obtained through conventional periodontal therapy, including plaque control, scaling, root planing, and surgical removal of the soft tissue using Modified Widman Flap and bone grafting. Postoperative follow-up did not show any signs of recurrence. Pubertal induced gingival enlargement with unilateral masticatory habit needs early removal of enlargement to prevent further bone loss.