Initial Assessment• Measure plasma vitamin C (&gt;5.6 μg/dL target)• Assess periodontal status: probing depths, bleeding on probing, plaque index• Rule out drug-induced causes• Evaluate metabolic factors: LAP, γ-GTP• Perform scaling &amp; root planing to reduce pathogens (Pg, Pi)

Supplementation & Non-Surgical Therapy• Oral ascorbic acid: 600 mg/day for 4 months - Acute scurvy: 1 g/day x 30 days• Reinforce oral hygiene• Sonic scaling• Local vitamin C injections for persistent pockets• Lifestyle modifications: diet optimization, smoking cessation

Surgical Intervention (If Needed)• Gingivectomy with open-flap debridement for fibrotic overgrowth• Supportive periodontal maintenance every 3 months

Monitoring & Follow-Up• Clinical photos & periodontal indices• Repeat labs: vitamin C, HbA1c, lipids at 4, 12, 24 months• Expectation: marked reduction in gingival overgrowth by 4 months; low recurrence with compliance

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