A patient presents with severe drug-induced gingival enlargement that is not responding to improved oral hygiene and scaling. What is the most appropriate surgical treatment?

Gingivectomy is the treatment of choice for drug-induced gingival enlargement that does not resolve with drug substitution and improved oral hygiene. The procedure involves surgical excision of the excess gingival tissue to restore normal gingival contour, eliminate pseudopockets, and improve oral hygiene access. Scaling and root planing are important supportive measures and may reduce the severity of inflammation-associated enlargement, but they cannot remove fibrotic hyperplastic tissue. Where possible, the causative medication should be changed in consultation with the patient's physician prior to surgery, as recurrence is common if the drug is continued.