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Sachdeva S, Saluja H, Mani A. Idiopathic gingival fibromatosis with periodontitis: A rare case report and literature. JOURNAL OF MEDICAL SCIENCES 2021. [DOI: 10.4103/jmedsci.jmedsci_165_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gawron K, Łazarz-Bartyzel K, Kowalska A, Bereta G, Nowakowska Z, Plakwicz P, Potempa J, Fertala A, Chomyszyn-Gajewska M. Fibroblasts from recurrent fibrotic overgrowths reveal high rate of proliferation in vitro - findings from the study of hereditary and idiopathic gingival fibromatosis. Connect Tissue Res 2019; 60:29-39. [PMID: 30231645 DOI: 10.1080/03008207.2018.1517758] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE Investigate the content of fibrotic fibrils in gingival tissue and the proliferation of fibroblasts collected from recurrent and non-recurrent hereditary gingival fibromatosis (HGF) and idiopathic gingival fibromatosis (IGF). METHODS Gingival biopsies were collected from HGF (n = 3) and IGF (n = 3) donors with recurrent and non-recurrent gingival overgrowths and from a control group (Ctrl, n = 3). Hematoxylin staining was performed to evaluate the histomorphology of gingival tissue. Heidenhain's AZAN trichrome staining served for visualization of fibrotic fibrils in gingiva. Quantitative analysis of the content of fibrotic fibrils in gingival tissue was performed using a polarized light microscope. Proliferation was evaluated at 24 h, 48 h, and 72 h in fibroblast cultures using a cell proliferation ELISA assay based on 5-bromo-2'-deoxyuridine (BrdU). RESULTS Numerous blood vessels and fibroblasts were observed in recurrent overgrowths, whereas moderate blood vessels and moderate to scanty fibroblasts were detected in non-recurrent overgrowths. Heidenhain's staining revealed numerous collagen fibers in both recurrent and non-recurrent overgrowths. Quantitative analysis in a polarizing microscope showed significant accumulation of fibrotic fibrils exclusively in the overgrowths with the recurrence. In all time-points, increased proliferation of cells from all recurrent overgrowths was observed, but not from overgrowths which do not reoccur. CONCLUSIONS The study revealed that recurrent gingival overgrowths consist of highly fibrotic and dense connective tissue with numerous blood vessels and abundant fibroblasts. We also demonstrated that unlike fibroblasts derived from overgrowths, which did not present recurrence, fibroblasts derived from highly fibrotic and recurrent overgrowths maintain high rate of proliferation in vitro.
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Affiliation(s)
- Katarzyna Gawron
- a Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology , Jagiellonian University , Krakow , Poland
| | - Katarzyna Łazarz-Bartyzel
- b Department of Periodontology and Oral Medicine, Medical College , Jagiellonian University , Krakow , Poland
| | - Anna Kowalska
- a Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology , Jagiellonian University , Krakow , Poland
| | - Grzegorz Bereta
- a Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology , Jagiellonian University , Krakow , Poland
| | - Zuzanna Nowakowska
- a Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology , Jagiellonian University , Krakow , Poland
| | - Paweł Plakwicz
- c Department of Periodontology , Medical University of Warsaw , Warsaw , Poland
| | - Jan Potempa
- a Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology , Jagiellonian University , Krakow , Poland.,d Department of Oral Immunology and Infectious Diseases , School of Dentistry, University of Louisville , Louisville , KY , USA
| | - Andrzej Fertala
- e Department of Orthopaedic Surgery , Sidney Kimmel Medical College, Thomas Jefferson University , Philadelphia , PA , USA
| | - Maria Chomyszyn-Gajewska
- b Department of Periodontology and Oral Medicine, Medical College , Jagiellonian University , Krakow , Poland
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Aboujaoude S, Cassia A, Moukarzel C. Diode Laser Versus Scalpel in the Treatment of Hereditary Gingival Fibromatosis in a 6-Year Old Boy. Clin Pract 2016; 6:895. [PMID: 27994842 PMCID: PMC5136737 DOI: 10.4081/cp.2016.895] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 10/11/2016] [Indexed: 01/01/2023] Open
Abstract
Hereditary gingival fibromatosis (HGF) is a rare disease characterized by a benign enlargement of the gingiva involving both the mandible and the maxilla. This case is about a 6-year-old child with non syndromic HGF showing a severe gingival enlargement covering almost all surfaces of the teeth, in both arches, hence causing major aesthetic, phonetic and masticatory problems. The aim of the present article is to compare the outcomes of two therapeutical approaches: i) classical surgical removal with scalpel; and ii) diode laser resection. Compared to the surgical approach, the clinical results show that the main advantages of the diode laser technique are a better visibility during the intervention, minimal postoperative discomfort combined to a better gingival recontouring. However, the time consumption and the high cost of the laser equipment remain the main disadvantages of the systematic use of this technique.
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Affiliation(s)
- Samia Aboujaoude
- Department of Pediatric Dentistry, Lebanese University , Beirut, Lebanon
| | - Antoine Cassia
- Department of Oral Pathology and Diagnosis, Lebanese University , Beirut, Lebanon
| | - Carla Moukarzel
- Department of Pediatric Dentistry, Lebanese University , Beirut, Lebanon
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Gawron K, Łazarz-Bartyzel K, Potempa J, Chomyszyn-Gajewska M. Gingival fibromatosis: clinical, molecular and therapeutic issues. Orphanet J Rare Dis 2016; 11:9. [PMID: 26818898 PMCID: PMC4729029 DOI: 10.1186/s13023-016-0395-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/20/2016] [Indexed: 12/28/2022] Open
Abstract
Gingival fibromatosis is a rare and heterogeneous group of disorders that develop as slowly progressive, local or diffuse enlargements within marginal and attached gingiva or interdental papilla. In severe cases, the excess tissue may cover the crowns of the teeth, thus causing functional, esthetic, and periodontal problems, such as bone loss and bleeding, due to the presence of pseudopockets and plaque accumulation. It affects both genders equally. Hereditary, drug-induced, and idiopathic gingival overgrowth have been reported. Hereditary gingival fibromatosis can occur as an isolated condition or as part of a genetic syndrome. The pathologic manifestation of gingival fibromatosis comprises excessive accumulation of extracellular matrix proteins, of which collagen type I is the most prominent example. Mutation in the Son-of-Sevenless-1 gene has been suggested as one possible etiological cause of isolated (non-syndromic) hereditary gingival fibromatosis, but mutations in other genes are also likely to be involved, given the heterogeneity of this condition. The most attractive concept of mechanism for drug-induced gingival overgrowth is epithelial-to-mesenchymal transition, a process in which interactions between gingival cells and the extracellular matrix are weakened as epithelial cells transdifferentiate into fibrogenic fibroblast-like cells. The diagnosis is mainly made on the basis of the patient's history and clinical features, and on histopathological evaluation of affected gingiva. Early diagnosis is important, mostly to exclude oral malignancy. Differential diagnosis comprises all pathologies in the mouth with excessive gingival overgrowth. Hereditary gingival fibromatosis may present as an autosomal-dominant or less commonly autosomal-recessive mode of inheritance. If a systemic disease or syndrome is suspected, the patient is directed to a geneticist for additional clinical examination and specialized diagnostic tests. Treatments vary according to the type of overgrowth and the extent of disease progression, thus, scaling of teeth is sufficient in mild cases, while in severe cases surgical intervention is required. Prognosis is precarious and the risk of recurrence exists.
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Affiliation(s)
- Katarzyna Gawron
- Microbiology Department, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387, Krakow, Poland.
| | - Katarzyna Łazarz-Bartyzel
- Department of Periodontology and Oral Medicine, Jagiellonian University, Medical College, Institute of Dentistry, 30-387, Krakow, Poland.
| | - Jan Potempa
- Microbiology Department, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387, Krakow, Poland.
- Oral Health and Systemic Disease Research Group, School of Dentistry, University of Louisville, Louisville, KY, USA.
| | - Maria Chomyszyn-Gajewska
- Department of Periodontology and Oral Medicine, Jagiellonian University, Medical College, Institute of Dentistry, 30-387, Krakow, Poland.
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Wu Y, Wang XD, Wang F, Huang W, Zhang Z, Zhang Z, Kaigler D, Zou D. Restoration of Oral Function for Adult Edentulous Patients with Ectodermal Dysplasia: A Prospective Preliminary Clinical Study. Clin Implant Dent Relat Res 2015; 17 Suppl 2:e633-42. [PMID: 25728861 DOI: 10.1111/cid.12296] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Therapy with zygomatic implants (ZIs) or conventional implants (CIs) has proven to be an effective method to restore oral function for systemically healthy patients. However, it is still a major challenge to fully restore oral function to edentulous adult patients with ectodermal dysplasia (ED). PURPOSE The aim of this study was to determine an effective treatment protocol for restoring oral function using ZIs and CIs to edentulous adult ED patients. MATERIALS AND METHODS Ten edentulous adult ED patients were treated in this study. The treatment protocol involved the following: (1) bone augmentation in the region of the anterior teeth; (2) placement of two ZIs and four CIs in the maxilla, and four CIs in the mandible; (3) fabrication of dental prosthesis; and (4) psychological and oral education. Following treatment of these patients, implant success rates, biological complications, patient satisfaction, and psychological changes were recorded. RESULTS Although there was evidence of bone graft resorption in the maxilla, bone augmentation of the mandible was successful in all patients. Nine CIs in the maxilla failed and were removed. All ZIs were successful, and the CIs success rates were 77.50% in the maxilla and 100% in the mandible, with a mean of 88.75%. The mean peri-implant bone resorption for the CIs ranged from 1.3 ± 0.4 mm to 1.8 ± 0.6 mm, and four cases exhibited gingival hyperplasia in the maxilla and mandible. One hundred percent of the patients were satisfied with the restoration of their oral function, and >50% of the patients exhibited enhanced self-confidence and self-esteem. CONCLUSIONS This study demonstrates that oral function can be restored in edentulous adult ED patients using a comprehensive and systematic treatment protocol involving psychological and oral education, bone augmentation, implant placement, and denture fabrication. Despite these positive outcomes, bone augmentation remains challenging in the anterior region of the maxilla for edentulous adult ED patients.
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Affiliation(s)
- Yiqun Wu
- Department of Oral Implant, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - Xu Dong Wang
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - Feng Wang
- Department of Oral Implant, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - Wei Huang
- Department of Oral Implant, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - Zhiyong Zhang
- Department of Oral Implant, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - Zhiyuan Zhang
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - Darnell Kaigler
- Department of Periodontics and Oral Medicine, Department of Biomedical Engineering, Michigan Center for Oral Health Research, University of Michigan, Ann Arbor, MI, USA
| | - Duohong Zou
- Department of Dental Implant Centre, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
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Hereditary nonsyndromic gingival fibromatosis: report of family case series. Case Rep Dent 2013; 2013:835989. [PMID: 24191204 PMCID: PMC3804051 DOI: 10.1155/2013/835989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 09/04/2013] [Indexed: 11/18/2022] Open
Abstract
Hereditary gingival fibromatosis (HGF) is a rare, benign disorder with slowly progressive enlargement of maxillary and mandibular gingiva. Herewith, we report the first case series of HGF presenting among mother and all of her 3 children. Their complaints included unaesthetic appearance due to gingival growth, malocclusion, and difficulty in mastication. Conventional gingivectomy with oral hygiene measures and regular followup is the treatment of choice for such presentation.
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Devi PK, Kumar GP, Bai YD, Ammaji AD. Ipsilateral idiopathic gingival enlargement and it's management using conventional gingivectomy and diode laser: A recurrent case after 15 years. J Indian Soc Periodontol 2013; 17:387-90. [PMID: 24049343 PMCID: PMC3768193 DOI: 10.4103/0972-124x.115649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 05/24/2013] [Indexed: 11/04/2022] Open
Abstract
Idiopathic gingival fibromatosis is a relatively rare condition characterized by the proliferation of the gingival tissues resulting in masticatory, esthetics, phonetics and psychological disturbances. The severity of the overgrowth can range from a solitary isolated mass to a more generalized and diffused enlargement. The etiopathogenesis of this bizarre condition is poorly understood and has been attributed to various factors. It can present as a single disorder or may manifest as part of a syndrome. This case reports an ipsilateral diffused idiopathic gingival enlargement in a middle aged adult recurring after a gap of 15 years. External bevel gingivectomy on the buccal aspects of maxillary and mandibular gingiva and diode laser for excision of the enlarged tissue on the lingual/palatal aspect was carried out to eliminate the excessive tissue. Periodic recalls showed maintenance of good oral hygiene and 1 year follow-up revealed no recurrence.
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Affiliation(s)
- Potharaju Kamala Devi
- Department of Periodontics, Government Dental College and Hospital, Hyderabad, Andhra Pradesh, India
| | - Gudi Pavan Kumar
- Department of Periodontics, Government Dental College and Hospital, Hyderabad, Andhra Pradesh, India
| | - Yendluri Durga Bai
- Department of Periodontics, Government Dental College and Hospital, Hyderabad, Andhra Pradesh, India
| | - Annamdevula Durga Ammaji
- Department of Periodontics, Government Dental College and Hospital, Hyderabad, Andhra Pradesh, India
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Idiopathic gingival fibromatosis rehabilitation: a case report with two-year followup. Case Rep Dent 2013; 2013:513153. [PMID: 23606991 PMCID: PMC3623108 DOI: 10.1155/2013/513153] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 03/03/2013] [Indexed: 11/17/2022] Open
Abstract
Gingival enlargements are quite common and may be either inflammatory, noninflammatory, or a combination of both. Gingival hyperplasia is a bizarre condition causing esthetic, functional, psychological, and masticatory disturbances of the oral cavity. Causes of gingival enlargement can be due to plaque accumulation, due to poor oral hygiene, inadequate nutrition, or systemic hormonal stimulation (Bakaeen and Scully, 1998). It can occur as an isolated disease or as part of a syndrome or chromosomal abnormality. A progressive fibrous enlargement of the gingiva is a facet of idiopathic fibrous hyperplasia of the gingiva (Carranza and Hogan, 2002; Gorlin et al., 1976). It is described variously as fibromatosis gingivae, gingivostomatitis, hereditary gingival fibromatosis, idiopathic fibromatosis, familial elephantiasis, and diffuse fibroma. We present a case of idiopathic gingival fibromatosis with its multidisciplinary approach of management.
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Millet C, Rodier P, Farges JC, Labert N, Duprez JP. Surgical and prosthetic treatment in an elderly patient affected by unilateral idiopathic gingival fibromatosis: a case report. Gerodontology 2012; 29:e1185-9. [PMID: 22612835 DOI: 10.1111/j.1741-2358.2011.00564.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim was to present the diagnosis and treatment of a case of unilateral idiopathic gingival fibromatosis (IGF) in a geriatric patient. BACKGROUND IGF is a rare condition characterised by an enlargement of the attached and marginal gingivae with no obvious association to any causative factor. Gingival overgrowth causes inaesthetic changes and clinical symptoms such as speech disturbances, tooth movement, and occlusal problems. MATERIALS AND METHODS A 65-year-old female presented localised enlargement of mandibular gingiva, malpositioning of anterior mandibular teeth, and difficulty in speech and mastication. IGF also causes numerous aesthetic and psychological problems. Treatment consisted of multiple extractions, surgical therapy, and early prosthetic rehabilitation to restore function and appearance and to prevent recurrence. RESULTS Excellent aesthetic result and psychological benefit were achieved, and no fibromatosis recurrence was detected after 1 year following surgery. CONCLUSION Gingival resection of the tissue excess and early oral rehabilitation with removable dentures have so far greatly improved patient's quality of life.
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Affiliation(s)
- Catherine Millet
- Service d'Odontologie, Hospices Civils de Lyon, Faculté d'Odontologie, Université Lyon 1, Lyon, France
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Abstract
Hereditary gingival fibromatosis is a rare condition that can occur as an isolated disease or as part of a syndrome or chromosomal abnormality. In severe cases, the gingival enlargement may cover the crowns of teeth and cause severe functional and aesthetic concerns. Here, we present a case of an 8-year-old girl with severe enlargement of gums in maxilla and mandible. Both deciduous and permanent teeth were not erupted in the oral cavity at all. Mutation in the Son-of-Sevenless (SOS-1) gene has been associated with the disease. The diagnosis was made based on clinical examination and family history. Surgical removal of the hyperplastic tissue was performed under general anesthesia.
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Affiliation(s)
- Shweta Sharma
- Department of Oral Surgery, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India
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Idiopathic gingival fibromatosis: case report and its management. Int J Dent 2009; 2009:153603. [PMID: 20339448 PMCID: PMC2836736 DOI: 10.1155/2009/153603] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Accepted: 12/18/2009] [Indexed: 11/29/2022] Open
Abstract
Idiopathic gingival fibromatosis is a rare condition. We present a case of idiopathic gingival fibromatosis with its multidisciplinary approach of management. The clinical, radiographic, and histopathological features have been described in detail.
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Building on the Proceedings of the McGill Conference: Implant-Retained Overdentures in an Area of South America. IMPLANT DENT 2008; 17:288-98. [DOI: 10.1097/id.0b013e318182ed65] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bibliography. Current world literature. Head and neck reconstruction. Curr Opin Otolaryngol Head Neck Surg 2006; 14:289-91. [PMID: 16832188 DOI: 10.1097/01.moo.0000233602.37541.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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