Prevalence of Different Etiologies of Excessive Gingival Display: Identifying Diagnostic Patterns

This study is aimed at evaluating the prevalence of etiologies of excessive gingival display (EGD) in Egyptian females including gingival enlargement (GE), altered passive eruption (APE), incisor over-eruption (IO), protrusion (P), vertical maxillary excess (VME), short upper lip (SUL), and hyperactive upper lip (HUL) and to identify clinical diagnostic patterns.

A total of 160 participants showing EGD > 2 mm were recruited. Clinical photos, videos, and measurements of facial proportions, upper lip length, upper lip mobility, incisor display upon rest, clinical crown dimensions, occlusal plane discrepancies, probing depth, transgingival probing, and keratinized gingiva were recorded and analyzed.

Mean age was (27.62 ± 6.21) years. Overall prevalence of EGD 13.3% among them 55.8% EGD caused by single etiology, 44.3% EGD caused by multiple etiologies. 29.4% APE, 16.3% SUL + APE, 10% VME + APE, 8.8% VME, 6.3% HUL, 5% Incisor over-eruption, 3.8% GE, 3.8% SUL + GE, 3.1% VME + HUL, 2.5% SUL, 2.5% APE + HUL, 1.3% VME + GE, and 1.3% $\begin{array}{c}\text{VME}+\text{SUL}+\text{APE}\end{array}$ ….

APE both alone and combined with another etiology is the most prevalent cause of EGD and the most common diagnostic pattern is APE + SUL among Egyptian females. Single-factor and multifactorial EGD showed no significant difference in prevalence (p = 0.115), suggesting a similar likelihood of occurrence.

This study aimed to provide the clinician with a step-by-step guide for EGD comprehensive diagnosis, highlight the differences in prevalent etiologies between different populations and identify diagnostic patterns.