Idiopathic Gingival Fibromatosis: Case Report and Review of the Literature

Idiopathic gingival fibromatosis and primary analysis of dominant bacteria in subgingival biofilm: a case report

Idiopathic gingival fibromatosis (IGF), a rare fibroproliferative disease of unknown etiology, affects gingival tissue and has substantial adverse effects on patients. Therefore, the pathogenesis of IGF requires more extensive and in-depth research. In this case, a patient with confirmed IGF underwent initial nonsurgical periodontal therapy and gingivectomy, and the prognosis was good. The patient had no loss of periodontal attachment but had a history of swelling and bleeding of the gingiva prior to fibrous enlargement, which prompted further investigation. We explored the patient's subgingival microbiome and found a high abundance of periodontal pathogens. Gingival tissue biopsy revealed abundant fibrous tissue containing multiple inflammatory cell infiltrates. These results suggest that gingival inflammation secondary to periodontal pathogens can contribute to IGF onset.

Hereditary Gingival Fibromatosis and Developmental Anomalies: A Case Report

Hereditary gingival fibromatosis is the most common genetic form of gingival fibromatosis that develops as a slow, progressive, benign, localized, or generalized enlargement of the keratinized gingiva. It is a genetically heterogeneous disorder transmitted as an autosomal dominant or autosomal recessive trait or appears sporadically. Here, we report a case of a male patient with generalized gingival hyperplasia with great tissue extension to the palatal region, bilateral mandibular torus, bilateral exostosis in the maxillary posterior region, anterior open bite, and diastema in anterior maxilla and mandible teeth. The mucous membranes were healthy and normal colored, with pale pink gums and firm teeth upon palpation. Computed tomography also revealed images suggestive of supernumerary teeth. The patient reported that his mother and a maternal aunt have the same gingival condition. Considering the gingival characteristic, the patient's family history, and the absence of other possible etiological factors of gingival hyperplasia, the diagnostic hypothesis was hereditary gingival fibromatosis. The surgical removal of the enlarged tissue through gingivectomy with internal bevel, osteoplasty, and removal of supernumerary teeth with a subsequent filling of the surgical sites with platelet and leukocyte-rich fibrin membranes in the same surgical time presented good functional and aesthetic results for the young patient with hereditary gingival fibromatosis. It is a viable possibility for clinical management of similar cases.

Exosomes derived from idiopathic gingival fibroma fibroblasts regulate gingival fibroblast proliferation and apoptosis

OBJECTIVE

Exosomes have been proved to play an essential role in intercellular information transmission. However, few researches focused on exosomes derived from gingival fibroblasts (GFs) of IGF. The aim of this study is to investigate the effect of exosomes derived from GFs of IGF (IGF-GFs) on the proliferation and apoptosis of normal gingival fibroblasts (N-GFs).

METHODS

Gingival fibroblasts were cultured and identified using immunocytochemistry. Exosomes were isolated with exosomes extraction kit and characterized by transmission electron microscopy (TEM) and flow cytometry. PKH67 labeling was further used to trace the intracellular distribution of the exosomes. And MTS assay was used to test the effective concentration and time course of IGF-GFs-derived exosomes. Furthermore, the expression of PCNA, Ki67, Bcl-2, and Bax in N-GFs was analyzed by qRT-PCR and Western blot.

RESULTS

Exosomes were isolated from IGF-GFs; the identification of exosomes and gingival fibroblasts was successfully finished. Moreover, we found that N-GFs co-cultured with exosomes showed a great increase in PCNA and Bcl-2 levels, and a moderate increase in Ki67 levels. By contrast, the levels of Bax were significantly reduced.

CONCLUSION

These results suggest that exosomes derived from idiopathic gingival fibroma fibroblasts are involved in the regulation of gingival fibroblast proliferation and apoptosis.

Rare case report of idiopathic gingival fibromatosis in childhood and its management

Idiopathic gingival fibromatosis (GF), also known as gingivomatosis, is a rare condition in childhood, with an unknown aetiology. The oral manifestations of the condition are varied and depend on the severity and age of involvement. This paper describe the case of a 5-year-old male child with extensive gingival enlargement covering almost all the maxillary and mandibular teeth resulted in difficulty with speech, mastication and poor aesthetics. Clinical and radiographic examination along with haematological investigations ruled out any systemic association. The case was managed with conventional scalpel blade surgery along with electrocautery under general anaesthesia yielding good results without any recurrence after a 12-month follow-up. The results revealed that the oral manifestations of GF depend on its severity and the age of onset. Timely intervention can help to prevent associated complications in a growing child.