The gingival overgrowth is primarily due to an increase in which of the following?

• A. Extracellular matrix between epithelial cells.
• B. Number of capillaries in the lamina propria.
• C. Total number of connective tissue cells.
• D. Size of the individual epithelial cells.

Answer: (C)

Gingival overgrowth mainly reflects an expansion of the fibrous connective tissue due to increased activity and numbers of connective tissue cells, especially fibroblasts, that proliferate and produce more collagen and other matrix. This rise in cellularity, along with more extracellular matrix, thickens the gingival tissue and gives the characteristic fibrous enlargement seen in conditions like drug-induced gingival hyperplasia. While connective tissue matrix and some epithelial changes can accompany it, they don’t account for the primary bulk, which comes from more connective tissue cells.