Abstract
There are many reasons for gingival hyperplasia, mostly proper oral hygiene is sufficient to achieve normal healthy gingiva. In some situation, however, gingival hyperplasia is drug induced or can be a manifestation of a genetic disorder such as hereditary gingival fibromatosis, or a manifestation of some syndromes. Extreme gingival hyperplasia was periodontally treated, by removal of all gingival excess using periodontal flaps and gingivectomies. Periodontal check-ups were important to control the gingival inflammation and prevent recurrence of the gingival over growth.