Drugs inducing
gingival enlargement

Drugs induce excessive
fibroblast proliferation
along with connective
tissue accumulation

Inhibition of sodium
and calcium influx

Decreased cellular folate
uptake within fibroblasts

Changes in TIMP-1 and
MMP-1/MMP-2 synthesis

Failure to activate collagenase
and decreased turnover
of collagen

Increased accumulation of
extracellular matrix

Drugs inducing
gingival enlargement

Drugs induce excessive
fibroblast proliferation
along with connective
tissue accumulation

Inflammation due to
release of bacterial
endotoxins and
virulence factors

Inhibition of sodium
and calcium influx

Decreased cellular folate
uptake within fibroblasts

Changes in TIMP-1 and
MMP-1/MMP-2 synthesis

Failure to activate collagenase
and decreased turnover
of collagen

Increased accumulation of
extracellular matrix