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Zhu Y, Zhao T, Wu Y, Xie S, Sun W, Wu J. ZNF862 induces cytostasis and apoptosis via the p21-RB1 and Bcl-xL-Caspase 3 signaling pathways in human gingival fibroblasts. J Periodontal Res 2024; 59:599-610. [PMID: 38482719 DOI: 10.1111/jre.13250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/06/2023] [Accepted: 02/15/2024] [Indexed: 05/24/2024]
Abstract
OBJECTIVE This study investigates the effects of ZNF862 on the proliferation and apoptosis of human gingival fibroblasts and their related mechanisms. BACKGROUND As a major transcription factor family, zinc finger proteins (ZFPs) regulate cell differentiation, growth, and apoptosis through their conserved zinc finger motifs, which allow high flexibility and specificity in gene regulation. In our previous study, ZNF862 mutation was associated with hereditary gingival fibromatosis. Nevertheless, little is known about the biological function of ZNF862. Therefore, this study was aimed to reveal intracellular localization of ZNF862, the influence of ZNF862 on the growth and apoptosis of human gingival fibroblasts (HGFs) and its potential related mechanisms. METHODS Immunohistochemistry, immunofluorescence staining, and western blotting were performed to determine the intracellular localization of ZNF862 in HGFs. HGFs were divided into three groups: ZNF862 overexpression group, ZNF862 interference group, and the empty vector control group. Then, the effects of ZNF862 on cell proliferation, migration, cell cycle, and apoptosis were evaluated. qRT-PCR and western blotting were performed to further explore the mechanism related to the proliferation and apoptosis of HGFs. RESULTS ZNF862 was found to be localized in the cytoplasm of HGFs. In vitro experiments revealed that ZNF862 overexpression inhibited HGFs proliferation and migration, induced cell cycle arrest at the G0/G1-phase and apoptosis. Whereas, ZNF862 knockdown promoted HGFs proliferation and migration, accelerated the transition from the G0/G1 phase into the S and G2/M phase and inhibited cell apoptosis. Mechanistically, the effects of ZNF862 on HGFs proliferation and apoptosis were noted to be dependent on inhibiting the cyclin-dependent kinase inhibitor 1A (p21)-retinoblastoma 1 (RB1) signaling pathway and enhancing the B-cell lymphoma-extra-large (Bcl-xL)-Caspase 3 signaling pathway. CONCLUSION Our results for the first time reveal that ZNF862 is localized in the cytoplasm of HGFs. ZNF862 can inhibit the proliferation of HGFs by inhibiting the p21-RB1 signaling pathway, and it also promotes the apoptosis of HGFs by enhancing the Bcl-xL-Caspase 3 signaling pathway.
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Affiliation(s)
- Yaoyao Zhu
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Tian Zhao
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Yongkang Wu
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
- Central Laboratory of Stomatology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Sijing Xie
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Weibin Sun
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Juan Wu
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
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Nasrallah H, Berro K. Navigating Complexity: A Case Report on a Comprehensive Dental Management Approach to Amelogenesis Imperfecta and Gingival Fibromatosis Syndrome. Cureus 2024; 16:e53787. [PMID: 38465125 PMCID: PMC10923614 DOI: 10.7759/cureus.53787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/12/2024] Open
Abstract
This clinical case report details the comprehensive diagnosis and dental management of a seven-year-old female patient diagnosed with the rare genetic disorder, amelogenesis imperfecta and gingival fibromatosis syndrome (AIGFS). The case initially presented as congenital adrenal hyperplasia and amelogenesis imperfecta, but further genetic analysis revealed the involvement of AIGFS due to a mutation in the FAM20A gene. Diagnosis, confirmed through whole exome sequencing, clinical assessment, and laboratory tests, necessitated a multidisciplinary approach to address the treatment of such cases. The article underscores the critical importance of diagnosing and managing dental manifestations in pediatric patients with complex genetic conditions, highlighting the difficulties of treating AIGFS in mixed dentition. This case also highlights the indispensable role of pediatric dentists in diagnosing and treating these cases, ultimately improving the quality of life for individuals with AIGFS.
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Affiliation(s)
- Hitaf Nasrallah
- Department of Pediatric Dentistry, Lebanese University Faculty of Dental Medicine, Beirut, LBN
| | - Khetam Berro
- Department of Pediatric Dentistry, Lebanese University Faculty of Dental Medicine, Beirut, LBN
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Bektaş-Kayhan K, Selvi F, Koca-Ünsal RB. Surgical treatment of hereditary gingival fibromatosis by diode laser: Report of five rare cases in the same family. SPECIAL CARE IN DENTISTRY 2023; 43:539-545. [PMID: 36404272 DOI: 10.1111/scd.12804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/16/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022]
Abstract
The pathogenesis of hereditary gingival fibromatosis (HGF) is largely unknown; however, the removal of excess tissue may often be necessary as it often causes aesthetic and functional problems. Gingivectomy is usually a treatment option that can be performed using a scalpel, cryotherapy, electrosurgery, or laser. This paper aims to evaluate the results of HGF treatments using a diode laser of five people from the same family. Three members of a family of five (two females and three males; 9-36 years old) underwent gingivectomy with a 3 W 300-micron fiber-tipped diode laser (Doctor Smile, Vicenza, Italy) at 810 nm wavelength. While all teeth of one member were extracted, the other member refused treatment. Relapse occurred in three members due to poor oral hygiene. The diode laser was reapplied and oral hygiene instructions were repeated. Patients were followed during the postoperative period for up to two years. HGF is a rare condition that clinicians should pay attention to in the diagnosis, treatment, and follow-ups. Since recurrences are due to dental plaque, oral hygiene instructions are essential and compliance is mandatory. Although there are many treatment approaches, the diode laser is the most indicated method due to many advantages such as providing a bloodless and more sterile operation field, performing an atraumatic surgery, ensuring earlier and ideal recovery, and minimizing postoperative pain.
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Affiliation(s)
- Kıvanç Bektaş-Kayhan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Fatih, Istanbul, Turkey
| | - Fırat Selvi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Fatih, Istanbul, Turkey
| | - Revan Birke Koca-Ünsal
- Department of Periodontology, Faculty of Dentistry, University of Kyrenia, Kyrenia, Cyprus
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Huang X, Zhu W, Zhang X, Fu Y. Modified gingivoplasty for hereditary gingival fibromatosis: two case reports. BMC Oral Health 2022; 22:523. [DOI: 10.1186/s12903-022-02411-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 08/26/2022] [Indexed: 11/26/2022] Open
Abstract
Abstract
Background
Hereditary gingival fibromatosis (HGF) is characterized by sub-epithelial fibromatosis of keratinized gingiva resulting in a fibrotic enlargement of keratinized gingiva. The treatment choice is gingivectomy, which can be performed with an internal or external bevel incision conventionally. However, both techniques can hardly resume the natural status of gingiva, and have a certain recurrence rate, especially in the cases which have limited width of attached gingiva.
Case description
Two cases of HGF with the chief complaint of difficulty in mastication, pronunciation, and poor esthetics were presented. After the initial periodontal therapy, a novel gingivoplasty modified with a crevicular incision was applied. A full thickness flap above the mucogingival junction and a split flap below the junction were raised. Then, fibrotic connective tissue was completely eliminated and keratinized gingival epithelium was preserved. The fibrotic alveolar bone was shaped by handpiece and bur. Finally, the flap was apically repositioned and sutured. Twelve months after surgery, the gingiva recovered with normal color, contour and consistency.
Conclusions
Compared to traditional gingivectomy, modified gingivoplasty which focuses on eliminating pathological fibrotic connective tissue can completely resume the natural appearance of gingiva and demonstrate no tendency of recurrence.
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Kamal NM, Hamouda MA, Abdelgawad N. Expression of TGF-β and MMP-2 in hereditary gingival fibromatosis epithelial cells. A possible contribution of the epithelium to its pathogenesis. J Oral Biol Craniofac Res 2022; 12:617-622. [PMID: 35989975 DOI: 10.1016/j.jobcr.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 06/15/2022] [Accepted: 08/10/2022] [Indexed: 10/15/2022] Open
Abstract
Background Although the molecular mechanisms that cause the development of hereditary gingival fibromatosis are not fully understood, multiple theories have been suggested to clarify its pathogenesis. However, the overlying keratinocytes' function is poorly comprehended. This work aimed to investigate the expression of TGF-β and MMP-2 in hereditary gingival fibromatosis epithelial cells compared to the normal gingival epithelium to give an insight into the mechanism of the development of this condition. Methods Biopsies were obtained from 20 hereditary gingival fibromatosis patients and 20 healthy controls. Biopsies were stained immunohistochemically and statistically analyzed for MMP-2 and TGF-β expression. Results Regarding MMP-2, The hereditary gingival fibromatosis group recorded a higher mean value compared to the normal gingiva, with a mean difference of 3.29 ± 0.34. This difference was statistically significant (p = 0.00). Regarding TGF-β, a higher mean value was recorded in the HGF group compared to the normal gingiva, with a mean difference of 15.88 ± 1.05 The difference was statistically significant (p = 0.00). A strong positive correlation was detected between MMP-2 and TGF-β (R = 0.534, p = 0.015). Conclusions In hereditary gingival fibromatosis, the epithelium expresses higher levels of TGF-β and MMP-2 than normal gingival tissue. There was an evident positive correlation between MMP-2 and TGF-β. Our data suggest that the expression of TGF-β and MMP2 by epithelial cells of HGF may play a role in the epithelial-mesenchymal transition pathogenic pathway.
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Affiliation(s)
- Naglaa M Kamal
- Department of Oral Pathology, Faculty of Oral and Dental Medicine, Ahram Canadian University, 6th of October, Egypt
| | - Mai A Hamouda
- Department of Oral Pathology, Faculty of Oral and Dental Medicine, Ahram Canadian University, 6th of October, Egypt
| | - Nora Abdelgawad
- Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
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Sabarudin MA, Taib H, Wan Mohamad WM. Refining the Mechanism of Drug-Influenced Gingival Enlargement and Its Management. Cureus 2022; 14:e25009. [PMID: 35712334 PMCID: PMC9195644 DOI: 10.7759/cureus.25009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2022] [Indexed: 11/16/2022] Open
Abstract
Drug-influenced gingival enlargement (DIGE) or overgrowth manifests as abnormal enlargement of the gingiva due to an adverse effect of certain drug reactions in patients treated with anticonvulsants, immunosuppressants, or calcium channel blockers (CCBs). As the gingival enlargement became significant, it may interfere with the normal oral hygiene measures, aesthetics, as well as masticatory functions of the patients. The exact mechanism of how this undesirable condition develops is yet unknown, and complicated, with non-inflammatory and inflammatory pathways involved. This review illuminates these putative pathways of DIGE and highlights various treatment approaches based on existing research and current observations.
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Wu J, Chen D, Huang H, Luo N, Chen H, Zhao J, Wang Y, Zhao T, Huang S, Ren Y, Zhai T, Sun W, Li H, Li W. A novel gene ZNF862 causes hereditary gingival fibromatosis. eLife 2022; 11:66646. [PMID: 35142290 PMCID: PMC8856651 DOI: 10.7554/elife.66646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/09/2022] [Indexed: 11/18/2022] Open
Abstract
Hereditary gingival fibromatosis (HGF) is the most common genetic form of gingival fibromatosis which is featured as a localized or generalized overgrowth of gingivae. Currently two genes (SOS1 and REST), as well as four loci (2p22.1, 2p23.3–p22.3, 5q13–q22, and 11p15), have been identified as associated with HGF in a dominant inheritance pattern. Here, we report 13 individuals with autosomal-dominant HGF from a four-generation Chinese family. Whole-exome sequencing followed by further genetic co-segregation analysis was performed for the family members across three generations. A novel heterozygous missense mutation (c.2812G > A) in zinc finger protein 862 gene (ZNF862) was identified, and it is absent among the population as per the Genome Aggregation Database. The functional study supports a biological role of ZNF862 for increasing the profibrotic factors particularly COL1A1 synthesis and hence resulting in HGF. Here, for the first time we identify the physiological role of ZNF862 for the association with the HGF.
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Affiliation(s)
- Juan Wu
- Department of Periodontology, Medical School of Nanjing University, Nanjing, China
| | - Dongna Chen
- Clinical research, BGI Genomics, Shenzhen, China
| | - Hui Huang
- Clinical research, BGI Genomics, Shenzhen, China
| | - Ning Luo
- Department of Periodontology, Medical School of Nanjing University, Nanjing, China
| | | | - Junjie Zhao
- Department of Periodontology, Medical School of Nanjing University, Nanjing, China
| | - Yanyan Wang
- Clinical research, BGI Genomics, Shenzhen, China
| | - Tian Zhao
- Department of Periodontology, Medical School of Nanjing University, shenzhen, China
| | - Siyuan Huang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Yang Ren
- Department of Periodontology, Medical School of Nanjing University, Nanjing, China
| | - Teng Zhai
- Clinical research, BGI Genomics, shenzhen, China
| | - Weibin Sun
- Department of Periodontology, Medical School of Nanjing University, shenzhen, China
| | - Houxuan Li
- Department of Periodontology, Medical School of Nanjing University, Nanjing, China
| | - Wei Li
- Clinical Research, BGI Genomics, Shen zhen, China
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Strzelec K, Dziedzic A, Łazarz-Bartyzel K, Grabiec AM, Gutmajster E, Kaczmarzyk T, Plakwicz P, Gawron K. Clinics and genetic background of hereditary gingival fibromatosis. Orphanet J Rare Dis 2021; 16:492. [PMID: 34819125 PMCID: PMC8611899 DOI: 10.1186/s13023-021-02104-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 11/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hereditary gingival fibromatosis (HGF) is a rare condition characterized by slowly progressive overgrowth of the gingiva. The severity of overgrowth may differ from mild causing phonetic and masticatory issues, to severe resulting in diastemas or malposition of teeth. Both, autosomal-dominant and autosomal-recessive forms of HGF are described. The aim of this review is a clinical overview, as well as a summary and discussion of the involvement of candidate chromosomal regions, pathogenic variants of genes, and candidate genes in the pathogenesis of HGF. The loci related to non-syndromic HGF have been identified on chromosome 2 (GINGF, GINGF3), chromosome 5 (GINGF2), chromosome 11 (GINGF4), and 4 (GINGF5). Of these loci, pathogenic variants of the SOS-1 and REST genes inducing HGF have been identified in the GINGF and the GINGF5, respectively. Furthermore, among the top 10 clusters of genes ranked by enrichment score, ATP binding, and fibronectin encoding genes were proposed as related to HGF. CONCLUSION The analysis of clinical reports as well as translational genetic studies published since the late'90s indicate the clinical and genetic heterogeneity of non-syndromic HGF and point out the importance of genetic studies and bioinformatics of more numerous unrelated families to identify novel pathogenic variants potentially inducing HGF. This strategy will help to unravel the molecular mechanisms as well as uncover specific targets for novel and less invasive therapies of this rare, orphan condition.
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Affiliation(s)
- Karolina Strzelec
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medykow 18, 40-752, Katowice, Poland
| | - Agata Dziedzic
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medykow 18, 40-752, Katowice, Poland
| | - Katarzyna Łazarz-Bartyzel
- Department of Periodontology and Oral Medicine, Medical College, Jagiellonian University, Kraków, Poland
| | - Aleksander M Grabiec
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Ewa Gutmajster
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medykow 18, 40-752, Katowice, Poland
| | - Tomasz Kaczmarzyk
- Department of Periodontology and Oral Medicine, Medical College, Jagiellonian University, Kraków, Poland.,Department of Oral Surgery, Medical College, Jagiellonian University, Kraków, Poland
| | - Paweł Plakwicz
- Department of Periodontology and Oral Diseases, Faculty of Dentistry, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Gawron
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medykow 18, 40-752, Katowice, Poland.
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Gao G, Tian Q, Han A, Yang R, Shi F, Chen D. Case Report: A Case of Hereditary Gingival Fibromatosis With a High Level of Human β Defensins in Gingival Epithelium. Front Immunol 2021; 12:763026. [PMID: 34795673 PMCID: PMC8594454 DOI: 10.3389/fimmu.2021.763026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Hereditary gingival fibromatosis [HGF, (MIM 135300)], a rare benign oral condition, has several adverse consequences such as aesthetic changes, malocclusion, speech impediments, and abnormal dentition. However, relatively few studies have addressed the beneficial effects of thick gingival tissues in resisting external stimuli. In this report, we present a unique case of a family affected by HGF that manifests as a ‘healthy’ gingiva. Human β-defensins (hBDs) are known to play a pivotal role in the clearance and killing of various microbes, and contribute to maintaining a healthy oral environment, which is currently emerging research area. However, the expression pattern and localisation of hBDs in patients with HGF have not yet been reported. hBD-2 and hBD-3 in the pedigree we collected had relatively elevated expression. High hBD levels in the gingival tissue of patients from the family may be beneficial in protecting oral tissue from external stimuli and promoting periodontal regeneration, but their role and the mechanisms underlying HGF need to be clarified.
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Affiliation(s)
- Ge Gao
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qing Tian
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Anpeng Han
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rongxia Yang
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fan Shi
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dong Chen
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Li N, Wang W, Sun Y, Wang H, Wang T. Seven-year follow-up of a patient with hereditary gingival fibromatosis treated with a multidisciplinary approach: case report. BMC Oral Health 2021; 21:473. [PMID: 34565352 PMCID: PMC8474844 DOI: 10.1186/s12903-021-01830-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hereditary gingival fibromatosis (HGF) is rare in clinical practice, and the long-term results of the combined orthodontic-periodontal treatment of HGF are rarely reported. CASE PRESENTATION This study reports for the first time the results of seven years of follow-up in a seven-year-old girl with HGF. The diagnosis was confirmed by clinical signs, family history and histopathological examination. First, periodontal scaling and oral hygiene reinforcement were performed regularly in the mixed dentition stage. Next, gingivoplasty was performed on the permanent dentition. Two months after the surgery, treatment with fixed orthodontic appliances was conducted. The teeth were polished on a monthly basis, and oral hygiene was reinforced to control gingival enlargement. Gingival hypertrophy recurred slightly, and gingivectomies were performed in the months following the start of orthodontic treatment. Follow-up was performed for 24 months with orthodontic retention, and gingival enlargement remained stable after the combined treatment. CONCLUSIONS The risk of gingival hyperplasia recurrence during and after orthodontic treatment is high, but satisfying long-term outcomes can be achieved with gingivectomy, malocclusion correction, and regular follow-up maintenance.
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Affiliation(s)
- Ning Li
- Department of Orthodontics, Yantai Stomatological Hospital, Yantai, 264000, Shandong, China
| | - Wenfang Wang
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710000, Shanxi, China
| | - Yuanyuan Sun
- Department of Periodontology, Yantai Stomatological Hospital, Yantai, 264000, Shandong, China
| | - Hongning Wang
- Department of Orthodontics, Yantai Stomatological Hospital, Yantai, 264000, Shandong, China
| | - Tiejun Wang
- Department of Orthodontics, Yantai Stomatological Hospital, Yantai, 264000, Shandong, China.
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Dika E, Lambertini M, Gouveia B, Mussi M, Marcelli E, Campione E, Gurioli C, Melotti B, Alessandrini A, Ribero S. Oral Manifestations in Melanoma Patients Treated with Target or Immunomodulatory Therapies. J Clin Med 2021; 10:jcm10061283. [PMID: 33808846 PMCID: PMC8003791 DOI: 10.3390/jcm10061283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND BRAF (v-raf murine sarcoma viral oncogene homolog B1) and MEK (mitogen activated protein kinase) inhibitors, as well as immunotherapy against cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and the programmed cell death 1 (PD-1) receptor and its ligand (PD-L1), have shown good results in improving the disease-free survival of patients with metastatic melanoma (MM). The aim of this review is to summarize the main oral adverse events (oAEs) occurring in patients undergoing target or immunotherapy. We proposed two separate sections: oAEs during the treatment with (1) target therapies with BRAF and MEK inhibitors and tyrosine kinase inhibitors (gingival hyperplasia, pigmentation disorders, squamo-proliferative lesions) and (2) immunotherapies with CTLA-4 or PD1 inhibitors (lichenoid reactions, immuno-bullous reactions, xerostomia and other reactions). Adverse events frequently include oAEs, although these are often misdiagnosed and under-reported. Indeed, the oral cavity is not routinely evaluated during clinical practice. The symptomatology related to oAEs is significant since it may represent the first manifestation of a severe systemic reaction, possibly leading to difficulties in nutrition with a consequent impact on patients' quality of life. A careful examination of the oral cavity is recommended during the evaluation of oncologic patients in order to promptly detect the onset of new manifestations.
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Affiliation(s)
- Emi Dika
- Division of Dermatology, IRCCS—Policlinico Sant’Orsola, via Massarenti 9, 40138 Bologna, Italy; (C.G.); (B.M.); (A.A.)
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy; (M.L.); (M.M.)
- Correspondence: ; Tel.: +39-0512144849
| | - Martina Lambertini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy; (M.L.); (M.M.)
| | - Bruna Gouveia
- The Poche Centre, Melanoma Institute of Australia, 40 Rocklands Rd, Wollstonecraft, NSW 2065, Australia;
| | - Martina Mussi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy; (M.L.); (M.M.)
| | - Emanuela Marcelli
- Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy;
| | - Elena Campione
- Dermatology Unit, University of Rome Tor Vergata, 00133 Roma, Italy;
| | - Carlotta Gurioli
- Division of Dermatology, IRCCS—Policlinico Sant’Orsola, via Massarenti 9, 40138 Bologna, Italy; (C.G.); (B.M.); (A.A.)
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy; (M.L.); (M.M.)
| | - Barbara Melotti
- Division of Dermatology, IRCCS—Policlinico Sant’Orsola, via Massarenti 9, 40138 Bologna, Italy; (C.G.); (B.M.); (A.A.)
| | - Aurora Alessandrini
- Division of Dermatology, IRCCS—Policlinico Sant’Orsola, via Massarenti 9, 40138 Bologna, Italy; (C.G.); (B.M.); (A.A.)
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40138 Bologna, Italy; (M.L.); (M.M.)
| | - Simone Ribero
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, 10126 Turin, Italy;
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Chen JT, Lin CH, Huang HW, Wang YP, Kao PC, Yang TP, Wang SK. Novel REST Truncation Mutations Causing Hereditary Gingival Fibromatosis. J Dent Res 2021; 100:868-874. [PMID: 33719663 DOI: 10.1177/0022034521996620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Hereditary gingival fibromatosis (HGF) is a rare genetic disorder featured by nonsyndromic pathological overgrowth of gingiva. The excessive gingival tissues can cause dental, masticatory, and phonetic problems, which impose severe functional and esthetic burdens on affected individuals. Due to its high recurrent rate, patients with HGF have to undergo repeated surgical procedures of gingival resection, from childhood to adulthood, which significantly compromises their quality of life. Unraveling the genetic etiology and molecular pathogenesis of HGF not only gains insight into gingival physiology and homeostasis but also opens avenues for developing potential therapeutic strategies for this disorder. Recently, mutations in REST (OMIM *600571), encoding a transcription repressor, were reported to cause HGF (GINGF5; OMIM #617626) in 3 Turkish families. However, the functions of REST in gingival homeostasis and pathogenesis of REST-associated HGF remain largely unknown. In this study, we characterized 2 HGF families and identified 2 novel REST mutations, c.2449C>T (p.Arg817*) and c.2771_2793dup (p.Glu932Lysfs*3). All 5 mutations reported to date are nonsenses or frameshifts in the last exon of REST and would presumably truncate the protein. In vitro reporter gene assays demonstrated a partial or complete loss of repressor activity for these truncated RESTs. When coexpressed with the full-length protein, the truncated RESTs impaired the repressive ability of wild-type REST, suggesting a dominant negative effect. Immunofluorescent studies showed nuclear localization of overexpressed wild-type and truncated RESTs in vitro, indicating preservation of the nuclear localization signal in shortened proteins. Immunohistochemistry demonstrated a comparable pattern of ubiquitous REST expression in both epithelium and lamina propria of normal and HGF gingival tissues despite a reduced reactivity in HGF gingiva. Results of this study confirm the pathogenicity of REST truncation mutations occurring in the last exon causing HGF and suggest the pathosis is caused by an antimorphic (dominant negative) disease mechanism.
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Affiliation(s)
- J T Chen
- Graduate Institute of Clinical Dentistry, National Taiwan University School of Dentistry, Taipei City, Taiwan.,Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - C H Lin
- Department of Dentistry, National Taiwan University School of Dentistry, Taipei City, Taiwan
| | - H W Huang
- Genomics Research Center, Academia Sinica, Taipei City, Taiwan
| | - Y P Wang
- Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan.,Department of Dentistry, National Taiwan University School of Dentistry, Taipei City, Taiwan
| | - P C Kao
- Department of Dentistry, National Taiwan University School of Dentistry, Taipei City, Taiwan
| | - T P Yang
- Dr. Lawrence Dental Clinic, Kaohsiung City, Taiwan
| | - S K Wang
- Department of Dentistry, National Taiwan University School of Dentistry, Taipei City, Taiwan.,Department of Pediatric Dentistry, National Taiwan University Children's Hospital, Taipei City, Taiwan
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13
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Bhatsange A, Moharir A, Mistry V, Japatti S. Idiopathic gingival fibromatosis in association with aggressive periodontitis and candidal infection: A unique case report with 7-year follow-up. J Indian Soc Periodontol 2021; 25:65-69. [PMID: 33642744 PMCID: PMC7904016 DOI: 10.4103/jisp.jisp_522_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 04/07/2020] [Accepted: 04/14/2020] [Indexed: 12/02/2022] Open
Abstract
Idiopathic gingival fibromatosis, also called idiopathic gingival overgrowth (IGO), is a rare benign condition that occurs either in isolation or as a part of a syndrome. The overgrowth, if excess, impedes oral functions such as mastication and speech and causes cosmetic disfigurement. Diagnosis and treatment becomes challenging if the overgrowth is massive and accompanies other associated pathologies. This case reports concurrent occurrence of three pathologies, i.e., IGO, aggressive periodontitis, and candidal infection in a 20-year-old healthy male patient. The surgical procedure performed involved internal bevel gingivectomy combined with open-flap surgery. Seven-year follow-up revealed no recurrence of overgrowth and stable periodontal condition.
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Affiliation(s)
- Anuradha Bhatsange
- Department of Periodontics, A.C.P.M. Dental College and Hospital, Dhule, Maharashtra, India
| | - Anuja Moharir
- Department of Periodontics, A.C.P.M. Dental College and Hospital, Dhule, Maharashtra, India
| | - Vibhuti Mistry
- Department of Periodontology, DY Patil Dental School, Pune, Maharashtra, India
| | - Sharanbasappa Japatti
- Department of Oral and Maxillofacial Surgery, A.C.P.M. Dental College and Hospital, Dhule, Maharashtra, India
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14
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Baltanás FC, Zarich N, Rojas-Cabañeros JM, Santos E. SOS GEFs in health and disease. Biochim Biophys Acta Rev Cancer 2020; 1874:188445. [PMID: 33035641 DOI: 10.1016/j.bbcan.2020.188445] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 12/11/2022]
Abstract
SOS1 and SOS2 are the most universal and widely expressed family of guanine exchange factors (GEFs) capable or activating RAS or RAC1 proteins in metazoan cells. SOS proteins contain a sequence of modular domains that are responsible for different intramolecular and intermolecular interactions modulating mechanisms of self-inhibition, allosteric activation and intracellular homeostasis. Despite their homology, analyses of SOS1/2-KO mice demonstrate functional prevalence of SOS1 over SOS2 in cellular processes including proliferation, migration, inflammation or maintenance of intracellular redox homeostasis, although some functional redundancy cannot be excluded, particularly at the organismal level. Specific SOS1 gain-of-function mutations have been identified in inherited RASopathies and various sporadic human cancers. SOS1 depletion reduces tumorigenesis mediated by RAS or RAC1 in mouse models and is associated with increased intracellular oxidative stress and mitochondrial dysfunction. Since WT RAS is essential for development of RAS-mutant tumors, the SOS GEFs may be considered as relevant biomarkers or therapy targets in RAS-dependent cancers. Inhibitors blocking SOS expression, intrinsic GEF activity, or productive SOS protein-protein interactions with cellular regulators and/or RAS/RAC targets have been recently developed and shown preclinical and clinical effectiveness blocking aberrant RAS signaling in RAS-driven and RTK-driven tumors.
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Affiliation(s)
- Fernando C Baltanás
- Centro de Investigación del Cáncer - IBMCC (CSIC-USAL) and CIBERONC, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Natasha Zarich
- Unidad Funcional de Investigación de Enfermedades Crónicas (UFIEC) and CIBERONC, Instituto de Salud Carlos III, 28220, Majadahonda, Madrid, Spain
| | - Jose M Rojas-Cabañeros
- Unidad Funcional de Investigación de Enfermedades Crónicas (UFIEC) and CIBERONC, Instituto de Salud Carlos III, 28220, Majadahonda, Madrid, Spain
| | - Eugenio Santos
- Centro de Investigación del Cáncer - IBMCC (CSIC-USAL) and CIBERONC, Universidad de Salamanca, 37007 Salamanca, Spain.
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15
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Mariani P, Zhurakivska K, Santoro R, Laino G, Russo D, Laino L. Hereditary gingival fibromatosis associated with the missense mutation of the KCNK4 gene. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:e175-e182. [PMID: 32981868 DOI: 10.1016/j.oooo.2020.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/29/2020] [Accepted: 08/02/2020] [Indexed: 12/30/2022]
Abstract
Hereditary gingival fibromatosis (HGF) is a rare oral condition that may appear as an isolated entity or as part of a genetic disease or syndrome. Molecular and biochemical mechanisms that trigger this pathologic process are not completely understood. In this article, we present a rare case of hereditary gingival fibromatosis in conjunction with a syndromic phenotype, associated with a rare missense mutation of the KCNK4 gene. This mutation induces a change in the structure of the TRAAK channel belonging to the 2-pore potassium channels. The gain of function promoted by the mutation could represent the pathogenetic basis of gingival fibromatosis.
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Affiliation(s)
- Pierluigi Mariani
- Student in Oral Surgery Specialization, Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Khrystyna Zhurakivska
- PhD student, Department of Clinical and Experimental Medicine, University of Foggia, Foggia
| | - Rossella Santoro
- Researcher in Odontostomatological Disciplines, Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples
| | - Gregorio Laino
- Full Professor of Oral and Maxillofacial Surgery, Dean, Division of Oral Surgery, Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples
| | - Diana Russo
- Student, Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples
| | - Luigi Laino
- Associate Professor of Oral Surgery, Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples
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16
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Gao H, Liang J, Xia X, Deng Z, Zhang Z. Unusual clinical and histologic findings in a child with mixed dentition with hereditary gingival fibromatosis: a case report. Transl Pediatr 2020; 9:74-80. [PMID: 32154139 PMCID: PMC7036643 DOI: 10.21037/tp.2019.12.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Hereditary gingival fibromatosis (HGF) is characterized by an accumulation of extracellular matrix resulting in a fibrotic enlargement of keratinized gingiva. The goal of this article is to describe one kindred affected with HGF and discuss the diagnosis, treatment, recurrence risk and histopathology features of the proband with mixed dentition. An 8-year-old boy reported with a chief complaint of gingival enlargement. A series of examinations were performed to make a diagnosis and family histories of the patient were recorded. Surgical therapy included gingivectomy and gingivoplasty technique were performed for the proband to remove excess gingiva. Collagen bundles in the permanent incisors area were prevalently significantly bulkier than that of the deciduous teeth area and the arrangement was much more regular. Microscopic evaluation revealed that epithelial hyperplasia was severe in tissue with intense inflammation, whereas tissue with mild inflammation showed only long and deep epithelial papillae. The patient was placed on a 3-month recall schedule and didn't demonstrate any recurrence of gingival overgrowth over a 1-year follow-up period. The study revealed that the eruption of permanent teeth played an important role in accelerating gingival hyperplasia. For the first time, it was confirmed from histological perspective that inflammation in gingival tissue was crucial to the gingival overgrowth of HGF.
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Affiliation(s)
- Han Gao
- Department of Oral and Maxillofacial Surgery, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China.,Zhuhai Stomatological Hospital, Zhuhai 519000, China
| | - Jun Liang
- Department of Oral and Maxillofacial Surgery, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China
| | - Xiaoxue Xia
- Department of Oral and Maxillofacial Surgery, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China
| | - Zhaoming Deng
- Department of Oral and Maxillofacial Surgery, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China
| | - Zhaoqiang Zhang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
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17
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Gao Q, Yang K, Chen D, Song Y, Qiao W, Sun X, Meng L, Bian Z. Antifibrotic Potential of MiR-335-3p in Hereditary Gingival Fibromatosis. J Dent Res 2019; 98:1140-1149. [DOI: 10.1177/0022034519863300] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Hereditary gingival fibromatosis (HGF) is a highly genetically heterogeneous disease, and current therapeutic method is limited to surgical resection with a high recurrence rate. MicroRNAs (miRNAs) are able to fine-tune large-scale target genes. Here we established a simple but effective computational strategy based on available miRNA target prediction algorithms to pinpoint the most potent miRNA that could negatively regulate a group of functional genes. Based on this rationale, miR-335-3p was top ranked by putatively targeting 85 verified profibrotic genes and 79 upregulated genes in HGF patients. Experimentally, downregulation of miR-355-3p was demonstrated in HGF-derived gingival fibroblasts as well as in transforming growth factor β–stimulated normal human gingival fibroblasts (NHGFs) compared to normal control. Ectopic miR-335-3p attenuated, whereas knockdown of miR-335-3p promoted, the fibrogenic activity of human gingival fibroblasts. Mechanically, miR-335-3p directly targeted SOS1, SMAD2/3, and CTNNB1 by canonical and noncanonical base paring. In particular, different portfolios of fibrotic markers were suppressed by silencing SOS1, SMAD2/3, or CTNNB1, respectively. Thus, our study first proposes a novel miRNA screening approach targeting a functionally related gene set and identifies miR-335-3p as a novel target for HGF treatment. Mechanically, miR-335-3p suppresses the fibrogenic activity of human gingival fibroblasts by repressing multiple core molecules in profibrotic networks. Our strategy provides a new paradigm in the treatment for HGF as well as other diseases.
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Affiliation(s)
- Q. Gao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - K. Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - D. Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Y. Song
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - W. Qiao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - X. Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - L. Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Z. Bian
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
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18
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Han SK, Kong J, Kim S, Lee JH, Han DH. Exomic and transcriptomic alterations of hereditary gingival fibromatosis. Oral Dis 2019; 25:1374-1383. [PMID: 30907493 DOI: 10.1111/odi.13093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/18/2019] [Accepted: 02/25/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Hereditary gingival fibromatosis (HGF) is a rare oral disease characterized by either localized or generalized gradual, benign, non-hemorrhagic enlargement of gingivae. Although several genetic causes of HGF are known, the genetic etiology of HGF as a non-syndromic and idiopathic entity remains uncertain. SUBJECTS AND METHODS We performed exome and RNA-seq of idiopathic HGF patients and controls, and then devised a computational framework that specifies exomic/transcriptomic alterations interconnected by a regulatory network to unravel genetic etiology of HGF. Moreover, given the lack of animal model or large-scale cohort data of HGF, we developed a strategy to cross-check their clinical relevance through in silico gene-phenotype mapping with biomedical literature mining and semantic analysis of disease phenotype similarities. RESULTS Exomic variants and differentially expressed genes of HGF were connected by members of TGF-β/SMAD signaling pathway and craniofacial development processes, accounting for the molecular mechanism of fibroblast overgrowth mimicking HGF. Our cross-check supports that genes derived from the regulatory network analysis have pathogenic roles in fibromatosis-related diseases. CONCLUSIONS The computational approach of connecting exomic and transcriptomic alterations through regulatory networks is applicable in the clinical interpretation of genetic variants in HGF patients.
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Affiliation(s)
- Seong Kyu Han
- Department of Life Sciences, Pohang University of Science and Technology, Pohang, Korea
| | - Jungho Kong
- Department of Life Sciences, Pohang University of Science and Technology, Pohang, Korea
| | - Sanguk Kim
- Department of Life Sciences, Pohang University of Science and Technology, Pohang, Korea.,Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jae-Hoon Lee
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, Korea
| | - Dong-Hoo Han
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, Korea
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19
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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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20
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Gawron K, Ochała-Kłos A, Nowakowska Z, Bereta G, Łazarz-Bartyzel K, Grabiec AM, Plakwicz P, Górska R, Fertala A, Chomyszyn-Gajewska M, Potempa J. TIMP-1 association with collagen type I overproduction in hereditary gingival fibromatosis. Oral Dis 2018; 24:1581-1590. [PMID: 29989318 DOI: 10.1111/odi.12938] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/26/2018] [Accepted: 07/04/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To investigate the processes associated with the excessive production of collagen I in hereditary gingival fibromatosis (HGF). MATERIALS AND METHODS Three HGF subjects and five controls were enrolled in the study. Histomorphological and immunohistological analyses were performed on gingival tissues. The expression of heat-shock protein 47 (HSP47), collagen I, transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) by gingival fibroblasts isolated from HGF and controls was analysed using qRT-PCR, Western blotting and ELISA. RESULTS Considerable accumulation of fibrotic fibrils and increased synthesis of HSP47 were noted in HGF gingival tissues. The synthesis of collagen I, HSP47, TGF-β1, CTGF and TIMP-1 was significantly elevated in HGF gingival fibroblasts compared with controls, while the production of MMP-1 was decreased. CONCLUSIONS We report that fibrosis in HGF gingival tissues is associated with increased synthesis of HSP47. This finding was confirmed by an in vitro study, where excessive production of collagen I was associated with increased synthesis of HSP47, TGF-β1 and CTGF by HGF gingival fibroblasts. Moreover, the shift in the TIMP-1/MMP-1 ratio identifies increased synthesis of TIMP-1 as one of the processes associated with collagen I overproduction in HGF fibroblasts.
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Affiliation(s)
- Katarzyna Gawron
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Anna Ochała-Kłos
- Department of Anatomy, Medical College, Jagiellonian University, Krakow, Poland
| | - Zuzanna Nowakowska
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Grzegorz Bereta
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Katarzyna Łazarz-Bartyzel
- Department of Periodontology and Oral Medicine, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Aleksander M Grabiec
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Paweł Plakwicz
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Renata Górska
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Fertala
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Maria Chomyszyn-Gajewska
- Department of Periodontology and Oral Medicine, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Jan Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland.,Department of Oral Immunology and Infectious Diseases, School of Dentistry, University of Louisville, Louisville, Kentucky, USA
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21
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Fang L, Wang Y, Chen X. Gene expression profiling and bioinformatics analysis of hereditary gingival fibromatosis. Biomed Rep 2018; 8:133-137. [PMID: 29435271 DOI: 10.3892/br.2017.1031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/11/2017] [Indexed: 01/01/2023] Open
Abstract
Hereditary gingival fibromatosis (HGF) is a benign, non-hemorrhagic and fibrous gingival overgrowth that may cover all or part of the teeth. It typically interferes with speech, lip closure and chewing, and can also be a psychological burden that affects the self-esteem of patients. Owing to high genetic heterogeneity, genetic testing to confirm diagnosis is not justified. It is therefore important to identify key signature genes and to understand the molecular mechanisms underlying HGF. The aim of the present study was to determine HGF-related genes and to analyze these genes through bioinformatics methods. A total of 249 differentially expressed genes (DEGs), consisting of 65 upregulated and 184 downregulated genes, were identified in the GSE4250 dataset of Gene Expression Omnibus (GEO) when comparing with the gums of HGF patients with those of healthy controls using the affy and limma packages in R. Subsequently, 28 enriched gene ontology terms were obtained from the Database for Annotation, Visualization and Integrated Discovery, and a protein-protein interaction (PPI) network was constructed and analyzed using STRING and Cytoscape. There were 99 nodes and 118 edges in the PPI network of these DEGs obtained through STRING. Among these nodes, 12 core genes were identified, of which the highest degree node was the gene for POTE ankyrin domain family member I. Collectively the results indicate that bioinformatics methods may provide effective strategies for predicting HGF-related genes and for understanding the molecular mechanisms of HGF.
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Affiliation(s)
- Lei Fang
- Department of Pathology and Pathophysiology, Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
| | - Yu Wang
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai 200233, P.R. China
| | - Xuejun Chen
- Department of Pathology and Pathophysiology, Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
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22
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Ramírez-Rámiz A, Brunet-LLobet L, Lahor-Soler E, Miranda-Rius J. On the Cellular and Molecular Mechanisms of Drug-Induced Gingival Overgrowth. Open Dent J 2017; 11:420-435. [PMID: 28868093 PMCID: PMC5564016 DOI: 10.2174/1874210601711010420] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/03/2017] [Accepted: 06/05/2017] [Indexed: 01/06/2023] Open
Abstract
Introduction: Gingival overgrowth has been linked to multiple factors such as adverse drug effects, inflammation, neoplastic processes, and hereditary gingival fibromatosis. Drug-induced gingival overgrowth is a well-established adverse event. In early stages, this gingival enlargement is usually located in the area of the interdental papilla. Histologically, there is an increase in the different components of the extracellular matrix. Objective: The aim of this manuscript is to describe and analyze the different cellular and molecular agents involved in the pathogenesis of Drug-induced gingival overgrowth. Method: A literature search of the MEDLINE/PubMed database was conducted to identify the mechanisms involved in the process of drug-induced gingival overgrowth, with the assistance of a research librarian. We present several causal hypotheses and discuss the advances in the understanding of the mechanisms that trigger this gingival alteration. Results: In vitro studies have revealed phenotypic cellular changes in keratinocytes and fibroblasts and an increase of the extracellular matrix with collagen and glycosaminoglycans. Drug-induced gingival overgrowth confirms the key role of collagenase and integrins, membrane receptors present in the fibroblasts, due to their involvement in the catabolism of collagen. The three drug categories implicated: calcineuron inhibitors (immunosuppressant drugs), calcium channel blocking agents and anticonvulsant drugs appear to present a multifactorial pathogenesis with a common molecular action: the blockage of the cell membrane in the Ca2+/Na+ ion flow. The alteration of the uptake of cellular folic acid, which depends on the regulated channels of active cationic transport and on passive diffusion, results in a dysfunctional degradation of the connective tissue. Certain intermediate molecules such as cytokines and prostaglandins play a role in this pathological mechanism. The concomitant inflammatory factor encourages the appearance of fibroblasts, which leads to gingival fibrosis. Susceptibility to gingival overgrowth in some fibroblast subpopulations is due to phenotypic variability and genetic polymorphism, as shown by the increase in the synthesis of molecules related to the response of the gingival tissue to inducing drugs. The authors present a diagram depicting various mechanisms involved in the pathogenesis of drug-induced gingival overgrowth. Conclusion: Individual predisposition, tissue inflammation, and molecular changes in response to the inducing drug favor the clinical manifestation of gingival overgrowth.
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Affiliation(s)
- Albert Ramírez-Rámiz
- Department of Odontostomatology. Faculty of Medicine and Health Sciences. University of Barcelona, Barcelona, Spain
| | - Lluís Brunet-LLobet
- Department of Dentistry. Hospital Universitari Sant Joan de Déu. University of Barcelona, Barcelona, Spain
| | - Eduard Lahor-Soler
- Department of Odontostomatology. Faculty of Medicine and Health Sciences. University of Barcelona, Barcelona, Spain
| | - Jaume Miranda-Rius
- Department of Odontostomatology. Faculty of Medicine and Health Sciences. University of Barcelona, Barcelona, Spain
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Gawron K, Bereta G, Nowakowska Z, Łazarz-Bartyzel K, Potempa J, Chomyszyn-Gajewska M, Górska R, Plakwicz P. Analysis of mutations in the SOS-1 gene in two Polish families with hereditary gingival fibromatosis. Oral Dis 2017; 23:983-989. [PMID: 28425619 DOI: 10.1111/odi.12684] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 04/06/2017] [Accepted: 04/12/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To establish whether two families from Malopolska and Mazovia provinces in Poland are affected by hereditary gingival fibromatosis type 1, caused by a single-cytosine insertion in exon 21 of the Son-of-Sevenless-1 gene. MATERIAL AND METHODS Six subjects with hereditary gingival fibromatosis and five healthy subjects were enrolled in the study. Gingival biopsies were collected during gingivectomy or tooth extraction and used for histopathological evaluation. Total RNA and genomic DNA were purified from cultured gingival fibroblasts followed by cDNA and genomic DNA sequencing and analysis. RESULTS Hereditary gingival fibromatosis was confirmed by periodontal examination, X-ray, and laboratory tests. Histopathological evaluation showed hyperplastic epithelium, numerous collagen bundles, and abundant-to-moderate fibroblasts in subepithelial and connective tissue. Sequencing of exons 19-22 of the Son-of-Sevenless-1 gene did not reveal a single-cytosine insertion nor other mutations. CONCLUSIONS Patients from two Polish families under study had not been affected by hereditary gingival fibromatosis type 1, caused by a single-cytosine insertion in exon 21 of the Son-of-Sevenless-1 gene. Further studies of the remaining regions of this gene as well as of other genes are needed to identify disease-related mutations in these patients. This will help to unravel the pathogenic mechanism of gingival overgrowth.
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Affiliation(s)
- K Gawron
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - G Bereta
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Z Nowakowska
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - K Łazarz-Bartyzel
- Department of Periodontology and Oral Medicine, Medical College, Institute of Dentistry, Jagiellonian University, Krakow, Poland
| | - J Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland.,Department of Oral Immunology and Infectious Diseases, School of Dentistry, University of Louisville, Louisville, KY, USA
| | - M Chomyszyn-Gajewska
- Department of Periodontology and Oral Medicine, Medical College, Institute of Dentistry, Jagiellonian University, Krakow, Poland
| | - R Górska
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - P Plakwicz
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
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Almiñana-Pastor PJ, Buitrago-Vera PJ, Alpiste-Illueca FM, Catalá-Pizarro M. Hereditary gingival fibromatosis: Characteristics and treatment approach. J Clin Exp Dent 2017; 9:e599-e602. [PMID: 28469831 PMCID: PMC5410686 DOI: 10.4317/jced.53644] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 01/07/2017] [Indexed: 12/24/2022] Open
Abstract
Hereditary gingival fibromatosis (HGF) is a rare disorder characterized by a benign, non-hemorrhagic, fibrous gingival overgrowth that can appear in isolation or as part of a syndrome. Clinically, a pink gingiva with marked stippling can be seen to cover almost all the tooth, in many cases preventing eruption. HGF usually begins during the transition from primary to permanent teeth, giving rise to a condition that can have negative psychological effects at that age. As it does not resolve spontaneously, the treatment of choice is gingivectomy, which can be performed with an internal or external bevel incision, depending on each case and bearing in mind the changes that will take place at the dentogingival junction (DGJ). This paper describes clinical aspects and treatment in two eight-year-old boys with HGF, considering different facets of the surgical approach with conscious sedation in young children. Key words:Hereditary gingival fibromatosis, gingivectomy, internal bevel incision, external bevel incision, gingival overgrowth.
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Affiliation(s)
- Pedro J Almiñana-Pastor
- DD, Post-graduated in Periodontics, Department d´Estomatologia, Facultad de Medicina y Odontologia, Universidad de Valencia, Valencia, Spain
| | - Pedro J Buitrago-Vera
- MD DD, PhD in Medicine. Adjunct Professor of Periodontics, Facultad de Medicina y Odontologia, Universidad de Valencia, Valencia, Spain
| | - Francisco M Alpiste-Illueca
- MD DD, PhD in Medicine. Assistant Professor of Periodontics, Department d´Estomatologia, Facultad de Medicina y Odontologia, Universidad de Valencia, Valencia, Spain
| | - Montserrat Catalá-Pizarro
- MD DD, PhD in Medicine. Associate Professor of Pediatric Dentistry, Department d´Estomatologia, Facultad de Medicina y Odontologia, Universidad de Valencia, Valencia, Spain
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Hwang J, Kim YL, Kang S, Kim S, Kim SO, Lee JH, Han DH. Genetic analysis of hereditary gingival fibromatosis using whole exome sequencing and bioinformatics. Oral Dis 2016; 23:102-109. [DOI: 10.1111/odi.12583] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/14/2016] [Accepted: 08/30/2016] [Indexed: 12/22/2022]
Affiliation(s)
- J Hwang
- Department of IT Convergence and Engineering; Pohang University of Science and Technology; Pohang Korea
| | - Y-L Kim
- Department of Prosthodontics; College of Dentistry; Yonsei University; Seoul Korea
| | - S Kang
- Department of Prosthodontics; College of Dentistry; Yonsei University; Seoul Korea
| | - S Kim
- Department of Life Sciences; Pohang University of Science and Technology; Pohang Korea
| | - S-O Kim
- Department of Pediatric Dentistry; College of Dentistry; Yonsei University; Seoul Korea
| | - JH Lee
- Department of Prosthodontics; College of Dentistry; Yonsei University; Seoul Korea
| | - D-H Han
- Department of Prosthodontics; College of Dentistry; Yonsei University; Seoul Korea
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26
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Gawron K, Łazarz-Bartyzel K, Fertala A, Plakwicz P, Potempa J, Chomyszyn-Gajewska M. Gingival Fibromatosis with Significant De Novo Formation of Fibrotic Tissue and a High Rate of Recurrence. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:655-9. [PMID: 27609299 PMCID: PMC5022846 DOI: 10.12659/ajcr.899997] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Patient: Female, 11 Final Diagnosis: Hereditary gingival fibromatosis Symptoms: Gingival overgrowth Medication: — Clinical Procedure: Surgery Specialty: Dentistry
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Affiliation(s)
- Katarzyna Gawron
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Katarzyna Łazarz-Bartyzel
- Department of Periodontology and Oral Medicine, Jagiellonian University, Medical College, Institute of Dentistry, Krakow, Poland
| | - Andrzej Fertala
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Paweł Plakwicz
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Jan Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Maria Chomyszyn-Gajewska
- Department of Periodontology and Oral Medicine, Jagiellonian University, Medical College, Institute of Dentistry, Krakow, Poland
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27
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Pêgo SPB, de Faria PR, Santos LAN, Coletta RD, de Aquino SN, Martelli-Júnior H. Ultrastructural evaluation of gingival connective tissue in hereditary gingival fibromatosis. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:81-88.e2. [PMID: 27260277 DOI: 10.1016/j.oooo.2016.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 04/02/2016] [Accepted: 04/05/2016] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To describe the ultrastructural features of hereditary gingival fibromatosis (HGF) in affected family members and compare microscopic findings with normal gingival (NG) tissue. STUDY DESIGN Gingival tissue samples from nine patients with HGF from five unrelated families were evaluated by transmission electron microscopy. Nine NG tissue samples were used for comparison. RESULTS Areas containing collagen fibrils forming loops and folds were observed in both groups, whereas oxytalan fibers were frequently identified in the HGF group. The diameter of collagen fibrils and the interfibrillar space among them were more uniform in the NG group than in the HGF group. Fibroblasts were the most common cells found in both the HGF and NG groups and exhibited enlarged, rough endoplasmic reticulum, mitochondria with well-preserved crests, conspicuous nucleoli, and euchromatic chromatin. Other cells, such as mast cells, plasma cells, and macrophages, were also observed. CONCLUSIONS HGF tissues had ultrastructural characteristics that were very similar to those of NG tissues. Oxytalan fibers were observed more frequently in the HGF samples than in the NG samples. Other studies of HGF in patients from different families should be performed to better understand the pathogenesis of this hereditary condition.
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Affiliation(s)
- Sabina Pena B Pêgo
- Full Professor, Dental School, State University of Montes Claros, Av Rui Braga - Vila Mauriceia - Campus Darcy Ribeiro - CEP 39401-089, Montes Claros, Minas Gerais, Brazil.
| | - Paulo Rogério de Faria
- Adjunct Professor, Institute of Biomedical Science, Department of Morphology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Luis Antônio N Santos
- Full Professor, Dental School, State University of Montes Claros, Av Rui Braga - Vila Mauriceia - Campus Darcy Ribeiro - CEP 39401-089, Montes Claros, Minas Gerais, Brazil
| | - Ricardo D Coletta
- Associate Professor, Department of Oral Diagnosis, School of Dentistry, State University of Campinas, São Paulo, Brazil
| | - Sibele Nascimento de Aquino
- Professor, Department of Oral Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Hercílio Martelli-Júnior
- Full Professor, Dental School, State University of Montes Claros, Av Rui Braga - Vila Mauriceia - Campus Darcy Ribeiro - CEP 39401-089, Montes Claros, Minas Gerais, Brazil
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28
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Koehne T, Markmann S, Schweizer M, Muschol N, Friedrich RE, Hagel C, Glatzel M, Kahl-Nieke B, Amling M, Schinke T, Braulke T. Mannose 6-phosphate-dependent targeting of lysosomal enzymes is required for normal craniofacial and dental development. Biochim Biophys Acta Mol Basis Dis 2016; 1862:1570-80. [PMID: 27239697 DOI: 10.1016/j.bbadis.2016.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/04/2016] [Accepted: 05/26/2016] [Indexed: 02/06/2023]
Abstract
Mucolipidosis II (MLII) is a severe systemic genetic disorder caused by defects in mannose 6-phosphate-dependent targeting of multiple lysosomal hydrolases and subsequent lysosomal accumulation of non-degraded material. MLII patients exhibit marked facial coarseness and gingival overgrowth soon after birth, accompanied with delayed tooth eruption and dental infections. To examine the pathomechanisms of early craniofacial and dental abnormalities, we analyzed mice with an MLII patient mutation that mimic the clinical and biochemical symptoms of MLII patients. The mouse data were compared with clinical and histological data of gingiva and teeth from MLII patients. Here, we report that progressive thickening and porosity of calvarial and mandibular bones, accompanied by elevated bone loss due to 2-fold higher number of osteoclasts cause the characteristic craniofacial phenotype in MLII. The analysis of postnatal tooth development by microcomputed tomography imaging and histology revealed normal dentin and enamel formation, and increased cementum thickness accompanied with accumulation of storage material in cementoblasts of MLII mice. Massive accumulation of storage material in subepithelial cells as well as disorganization of collagen fibrils led to gingival hypertrophy. Electron and immunofluorescence microscopy, together with (35)S-sulfate incorporation experiments revealed the accumulation of non-degraded material, non-esterified cholesterol and glycosaminoglycans in gingival fibroblasts, which was accompanied by missorting of various lysosomal proteins (α-fucosidase 1, cathepsin L and Z, Npc2, α-l-iduronidase). Our study shows that MLII mice closely mimic the craniofacial and dental phenotype of MLII patients and reveals the critical role of mannose 6-phosphate-dependent targeting of lysosomal proteins for alveolar bone, cementum and gingiva homeostasis.
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Affiliation(s)
- Till Koehne
- Department of Orthodontics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; Department of Osteology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Sandra Markmann
- Department of Biochemistry, Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Michaela Schweizer
- ZMNH, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Nicole Muschol
- Department of Biochemistry, Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Reinhard E Friedrich
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Christian Hagel
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Markus Glatzel
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Bärbel Kahl-Nieke
- Department of Orthodontics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Michael Amling
- Department of Osteology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Thorsten Schinke
- Department of Osteology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Thomas Braulke
- Department of Biochemistry, Children's Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
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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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Non-syndromic hereditary gingival fibromatosis in three Chinese families is not due to SOS1 gene mutations. Cell Biochem Biophys 2015; 70:1869-73. [PMID: 25062969 DOI: 10.1007/s12013-014-0144-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Non-syndromic hereditary gingival fibromatosis (HGF) is a rare condition, characterized by a progressive gingival hyperplasia that occurs as an isolated disease. Hitherto, only one insertion (g.126,142-126,143insC) in son-of-sevenless-1 (SOS1) gene has been associated with non-syndromic HGF in a Brazilian family. The aim of the present study was to determine if SOS1 is the causative gene of non-syndromic HGF in the Chinese population. Peripheral blood samples were collected from six affected and seven unaffected individuals from three Chinese families with history of non-syndromic HGF. Genomic DNA was extracted and SOS1 gene exons were sequenced. Neither g.126,142-126,143insC nor any other novel mutation was detected in SOS1 gene. Our results suggest that the SOS1 may not be the gene responsible for HGF in these three Chinese families and, therefore, it is possible that other genes are involved in the manifestation of HGF in these Chinese HGF families.
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31
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Pego SPB, Coletta RD, Mendes DC, de Faria PR, Melo-Filho MR, Alves LR, Martelli-Júnior H. Hereditary gingival fibromatosis: clinical and ultrastructural features of a new family. Med Oral Patol Oral Cir Bucal 2015; 20:e150-5. [PMID: 25475776 PMCID: PMC4393976 DOI: 10.4317/medoral.20170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 09/14/2014] [Indexed: 01/09/2023] Open
Abstract
Objective: This article describes the diagnosis, clinical and microscopic (histopathology and ultrastructural) features and treatment of a new family with hereditary gingival fibromatosis (HGF) and highlights the importance of this genetic condition.
Study Design: To characterize the pattern of inheritance and the clinical features, members of a new family with HGF were examined. The pedigree was reliably constructed including the four latest generations of family. Hematoxylin and eosin staining and ultrastructural analysis were performed with the gingival tissue.
Results: Examination of the family pedigree revealed that the patient III-2 represent the index patient of this family (initial patient with a mutation), which was transmitted to her daughter through an autosomal dominant mode of inheritance. The affected patients showed a generalized gingival overgrowth. The patient was treated with surgical procedures of gingivectomy and gingivoplasty. The diagnosis was confirmed by histopathology examination that showed a well-structured epithelium with elongated and thin papillae inserted in fibrous connective tissue with increased amount of collagen. The ultrastructural aspects of the tissue show collagen fibrils exhibiting their typically repeating banding pattern with some fibrils displaying loops at their end. Moreover, it was possible to seen in some regions fibrillar component presenting tortuous aspects and loss of the alignment among them.
Conclusions: This HGF frequently resulted in both esthetic and functional problems. The genetic pattern of this Brazilian family suggested a new mutation, which was later transmitted by an autosomal dominant trait.
Key words:Gingival fibromatosis, genetic disease, pedigree, ultrastructure.
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32
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Hereditary gingivo-alveolar hyperplasia: a report of two siblings. Int Surg 2015; 100:309-13. [PMID: 25692435 DOI: 10.9738/intsurg-d-13-00174.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Gingival hyperplasia is characterized by fibrotic gingival overgrowth. The lesion may bury all the crown of the teeth and lead to impairment in masticatory functions and aesthetic disfigurement. This inherited disease is considered rare. We presented two cases of gingival hyperplasia in two siblings: an 11-year-old girl and an 8-year-old boy, whose mother had also suffered from the disease. The two siblings presented with generalized gingival overgrowth involving the maxillary and mandibular arches and covering almost all of the teeth. We performed surgery to reduce the excessive gingivo-alveolar tissue and disclosed most of the teeth. The patients showed functional and aesthetic improvement. The last follow-up through a phone call, which was conducted 12 months after the surgery, revealed no recurrent hyperplasia.
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Çam B, Kurkcu M, Ozturan S, Haytac C, Uguz A, Ogden G. Juvenile hyaline fibromatosis: a case report follow-up after 3 years and a review of the literature. Int J Dermatol 2015; 54:217-21. [PMID: 24506420 DOI: 10.1111/ijd.12033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Burcu Çam
- Çukurova University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Balcalı, Adana, 01330, Turkey
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Complete oral rehabilitation of a patient with hereditary gingival fibromatosis: a clinical report. J Prosthet Dent 2014; 113:1-7. [PMID: 25277031 DOI: 10.1016/j.prosdent.2014.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 07/20/2014] [Accepted: 07/23/2014] [Indexed: 12/24/2022]
Abstract
Hereditary gingival fibromatosis is a rare disease that has several debilitating oral and psychological manifestations, especially with young children and adolescents. The complexity of the treatment as well as the timing relative to the growth and maturation of the patient present a challenge. Few treatment options have been reported in the literature. This clinical report presents a multidisciplinary approach to treating a young patient with hereditary gingival fibromatosis by using implant-supported prostheses. The treatment steps and its outcome are discussed.
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35
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Fantasia JE. Syndromes with unusual dental findings or gingival components. Atlas Oral Maxillofac Surg Clin North Am 2014; 22:211-219. [PMID: 25172002 DOI: 10.1016/j.cxom.2014.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- John E Fantasia
- Hofstra North Shore-Long Island Jewish School of Medicine, 270-05 76th Avenue, New Hyde Park, NY 11040, USA.
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36
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Clark JAB, Booman M, Hudson RC, Marshall HD. Genome-wide expression analysis of hereditary hyperplastic gingivitis in silver foxes (Vulpes vulpes) using canine microarrays. Genome 2014; 57:449-57. [DOI: 10.1139/gen-2014-0089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hereditary hyperplastic gingivitis (HHG) is an autosomal recessive condition found predominantly in farmed silver foxes, first documented in Europe in the 1940s. Hereditary gingival fibromatosis (HGF) is an analogous condition occurring in humans. HGF has a heterogeneous aetiology with emphasis placed on the autosomal dominant forms of inheritance for which there are three known loci: HGF1, HGF2, and HGF3. Among these, only one causative mutation has been determined, in the Son of sevenless homolog 1 (SOS1) gene. The goal of this study was to explore potential molecular or cellular mechanisms underlying HHG by analysis of global gene expression patterns from Affymetrix Canine 2.0 microarrays cross-referenced against candidate genes within the human loci. We conclude that the SOS1 gene involved in HGF1 is not significantly up-regulated in HHG. However, the structurally and functionally similar SOS2 gene is up-regulated in affected foxes, and we propose this as a candidate gene for HHG. At HGF2 we identify RASA1 (rat sarcoma viral p21 protein activator 1) as a candidate gene for HHG, as it is up-regulated in affected foxes and is involved in MAPK signalling. From comparison to the genes within the HGF3 locus, we find evidence for a role of androgens in HHG phenotype severity by differential up-regulation of SRD5A2 in HHG-affected foxes. We hypothesize that the putative mutation occurs upstream of RAS in the extracellular signal-regulated kinase component of MAPK signalling.
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Affiliation(s)
- Jo-Anna B.J. Clark
- Department of Biology, Memorial University of Newfoundland, St. John’s, NL A1B 3X9, Canada
| | - Marije Booman
- Department of Ocean Sciences, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | - Robert C. Hudson
- Animal Health Division, Department of Natural Resources, Government of Newfoundland and Labrador, Carbonear, NL A1Y 1A5, Canada
| | - H. Dawn Marshall
- Department of Biology, Memorial University of Newfoundland, St. John’s, NL A1B 3X9, Canada
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Kantaputra PN, Kaewgahya M, Khemaleelakul U, Dejkhamron P, Sutthimethakorn S, Thongboonkerd V, Iamaroon A. Enamel-renal-gingival syndrome and FAM20A mutations. Am J Med Genet A 2013; 164A:1-9. [PMID: 24259279 DOI: 10.1002/ajmg.a.36187] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 07/11/2013] [Indexed: 01/05/2023]
Abstract
The enamel-renal syndrome of amelogenesis imperfecta (AI) and nephrocalcinosis, and the amelogenesis imperfecta-gingival fibromatosis syndrome have both been associated with mutations in FAM20A. We report on two unrelated Thai patients with three novel and one previously reported mutations in FAM20A with findings suggesting both disorders, including hypoplastic AI, gingival fibromatosis, unerupted teeth, aggressive periodontitis, and nephrocalcinosis/nephrolithiasis. Additional findings consisted of a supernumerary premolar, localized aggressive periodontitis, thin alveolar bone, vitamin D deficiency-associated hyperparathyroidism, and heterotopic calcification in other tissues, including lungs, dental pulp, gingiva, dental follicles, and periodontal tissues, and early cessation of limited menstruation. Greater promotory activity of urine on calcium oxalate crystal growth compared to controls may help to explain the pathogenesis, and suggest that FAM20A mutations can contribute to nephrocalcinosis/nephrolithiasis. Our findings expand the phenotypic spectrum of FAM20A mutations. Since both of our patients and a large number of previously reported cases had all the important features of both syndromes, including AI, renal anomalies, and gingival fibromatosis, we are convinced that these two disorders actually are the same entity. The name of enamel-renal-gingival syndrome is suggested.
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Affiliation(s)
- Piranit Nik Kantaputra
- Division of Pediatric Dentistry, Department of Orthodontics and Pediatric Dentistry, Chiang Mai University, Chiang Mai, Thailand; Craniofacial Genetics Laboratory, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand; DENTALAND CLINIC, Chiang Mai, Thailand
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Japatti S, Bhatsange A, Reddy M, Patil S, Chidambar, Waghmare A. Bimaxillary unilateral gingival fibromatosis with localized aggressive periodontitis (eating the tooth at the same table). Contemp Clin Dent 2013; 4:366-70. [PMID: 24124307 PMCID: PMC3793562 DOI: 10.4103/0976-237x.118348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This case reports a unique presentation of two different clinical entities amidst few similarities and differences. Usually, aggressive periodontitis and gingival fibromatosis occur independently. Their simultaneous occurrence is rarely found. This report deals with the clinical features and management aspect of such a case.
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Durrani F, Singh R. Gingival elephantiasis with unknown cause, a rare case finding. Indian J Dent 2013. [DOI: 10.1016/j.ijd.2013.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Hereditary gingival fibromatosis: a review and a report of a rare case. Case Rep Dent 2013; 2013:930972. [PMID: 23533834 PMCID: PMC3600129 DOI: 10.1155/2013/930972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 01/23/2013] [Indexed: 01/03/2023] Open
Abstract
Hereditary gingival fibromatosis (HGF) is a rare condition which manifests itself by an enlarged gingival tissue covering teeth to various extents. The condition may occur isolated or as part of a syndrome. This paper presents a case of 9-year-old female patient suffering from HGF with chief complaint of mouth protrusion. Cephalometric findings showed severe mandibular deficiency and vertical maxillary excess. Patient exhibited perioral muscle contraction on mouth closing. After discussing the treatment possibilities with the patient and her parents, the decision was made to wait until growth potential decreases (following the adolescent growth spurt) and to correct the problem with orthognathic surgery.
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Pushpanshu K, Kaushik R, Sathawane RS, Athawale RP. Extensive Gingival Enlargement in Siblings: A case report. Sultan Qaboos Univ Med J 2013; 12:517-21. [PMID: 23275852 DOI: 10.12816/0003181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 05/14/2012] [Accepted: 06/16/2012] [Indexed: 11/27/2022] Open
Abstract
Gingival fibromatosis is characterised by varying degrees of fibrotic gingival overgrowth that can be caused by a variety of aetiological factors. Hereditary gingival fibromatosis (HGF) is a rare genetic disorder, characterised by a slowly progressive, benign enlargement of keratinised gingiva. The condition may be found in an autosomal dominant or autosomal recessive mode of inheritance, the former being more common. It usually develops as an isolated disorder but can be one feature of a multisystem syndrome. Accordingly, HGF has been divided into two forms: non-syndromic and syndromic. The gingival enlargement can be localised or generalised, but usually involves both arches. The authors describe a case of non-syndromic generalised severe HGF, involving the maxillary and mandibular arches in two brothers. This report focuses on the diagnosis, treatment, and control of the disease. The pattern of inheritance and histopathologic characteristics are also emphasised.
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Vieira-Júnior JR, de Oliveira-Santos C, Della-Coletta R, Cristianismo-Costa D, Paranaíba LMR, Martelli-Júnior H. Immunoexpression of α2-integrin and Hsp47 in hereditary gingival fibromatosis and gingival fibromatosis-associated dental abnormalities. Med Oral Patol Oral Cir Bucal 2013; 18:e45-8. [PMID: 23229240 PMCID: PMC3548644 DOI: 10.4317/medoral.17970] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 03/22/2012] [Indexed: 12/22/2022] Open
Abstract
Objective: The purpose of the present study was to investigate the expression of the α2-integrin subunit and heat shock protein 47 (Hsp47) in two families with isolated gingival fibromatosis (GF) form and one family with GF associated with dental abnormalities and normal gingiva (NG).
Study Design: Immunohistochemistry was performed with antibodies against α2-integrin and Hsp47 in specimens from two unrelated families with hereditary gingival fibromatosis (Families 1 and 2) and from one family with a gingival fibromatosis-associated dental abnormality (Family 3); NG samples were used for comparison. The results were analysed statistically.
Results: Immunoreactivity for α2-integrin and Hsp47 was observed in the nucleus of epithelial cells of both the basal and suprabasal layer and a more discreet signal was noted in connective tissue in all study samples. Hsp47 showed higher immunoreactivity in Family 2 compared with the other families (p≤0.05). Despite the markup α2-integrin was higher in Family 3 there was no statistically significant difference between the families studied (p≥0.05).
Conclusions: Our results confirmed the heterogeneity of GF, such that similar patterns of expression of the condition may show differences in the expression of proteins such as Hsp47. Although no difference in α2-integrin expression was observed between GF and NG groups, future studies are necessary to determine the exact role of this protein in the various forms of GF and whether it contributes to GF pathogenesis.
Key words:Gingival fibromatosis, integrin alpha2, heat shock protein Hsp47.
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Affiliation(s)
- João-Robson Vieira-Júnior
- Dental School, State University of Montes Claros, Unimontes, Montes Claros, Minas Gerais State, Brazil.
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Dhingra K, Prakash S. Gingival overgrowth in partially edentulous ridges in an elderly female patient with epilepsy: a case report. Gerodontology 2012; 29:e1201-6. [PMID: 22612838 DOI: 10.1111/j.1741-2358.2012.00624.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Drug-influenced gingival overgrowth is an unaesthetic overgrowth of gingiva principally associated with intake of drugs like phenytoin, cyclosporin A and nifedipine. Its occurrence in both dentate and edentulous regions of oral cavity is poorly understood. OBJECTIVES This report highlights clinical and histological description, aetiology and management of gingival overgrowth in a partially edentulous (non-denture wearer) 60-year-old female patient with epilepsy on phenytoin and phenobarbital drugs from past 7 years. MATERIALS AND METHODS Patient's intraoral examination revealed lobulated and fibrotic consistency gingival overgrowth around teeth and on partially edentulous ridges of upper and lower arches along with generalised tooth mobility. Under medical consultation, full mouth extraction, surgical excision of overgrowth followed by complete denture rehabilitation and replacement of combination drugs with sodium valproate were accomplished. RESULTS Histologically, the lesion showed fibro-epithelial hyperplasia. Clinical results after 6 months demonstrated almost complete resolution of gingival overgrowth. CONCLUSION The findings of present case suggest that gingival overgrowth can occur even in partially edentulous ridges (not exposed to denture wear) that could be due to persistence of gingival overgrowth, which may not resolve completely following tooth extraction or occurs because of incorporation of specific subpopulation of gingival fibroblasts in alveolar ridge mucosa.
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Affiliation(s)
- Kunaal Dhingra
- Department of Periodontics, NSVK Sri Venkateshwara Dental College, Bangalore, Karnataka, India.
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Häkkinen L, Larjava H, Koivisto L. Granulation tissue formation and remodeling. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/etp.12008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Yaprak E, Subaşı MG, Avunduk M, Aykent F. Amelogenesis imperfecta and generalized gingival overgrowth resembling hereditary gingival fibromatosis in siblings: a case report. Case Rep Dent 2012; 2012:428423. [PMID: 23091740 PMCID: PMC3474234 DOI: 10.1155/2012/428423] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 09/12/2012] [Indexed: 11/17/2022] Open
Abstract
Amelogenesis imperfecta (AI) is a group of hereditary disorders primarily characterized by developmental abnormalities in the quantity and/or quality of enamel. There are some reports suggesting an association between AI and generalized gingival enlargement. This paper describes the clinical findings and oral management of two siblings presenting both AI and hereditary gingival fibromatosis (HGF) like generalized gingival enlargements. The treatment of gingival enlargements by periodontal flap surgery was successful in the management of the physiologic gingival form for both patients in the 3-year follow-up period. Prosthetic treatment was also satisfactory for the older patient both aesthetically and functionally.
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Affiliation(s)
- Emre Yaprak
- Department of Periodontology, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Meryem Gülce Subaşı
- Department of Prosthodontics, Faculty of Dentistry, Aydın University, İzzettin Çalışlar Cad., No. 31/A, Bahçelievler, İstanbul, Turkey
| | - Mustafa Avunduk
- Department of Pathology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Filiz Aykent
- Department of Prosthodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
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Abstract
Gingival fibromatosis is a rare disease, especially its syndromic form. Here, we review the literatures on gingival fibromatosis and briefly summarize some characters on clinical, etiological, genetic and histopathological aspects. We also present a rare case of gingival fibromatosis with multiple unusual findings in a 21-year-old man. And we differentiate it from some well-known syndromes including gingival fibromatosis. Maybe it implies a new syndrome within the spectrum of those including gingival fibromatosis.
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Affiliation(s)
- Long He
- Department of Stomatology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Wagner G, Fenchel K, Back W, Schulz A, Sachse MM. Leukemia cutis - epidemiology, clinical presentation, and differential diagnoses. J Dtsch Dermatol Ges 2011; 10:27-36. [PMID: 22115500 DOI: 10.1111/j.1610-0387.2011.07842.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Leukemia cutis is an extramedullary manifestation of leukemia. The frequency and age distribution depend on the leukemia subtype. The clinical and morphological findings have a wide range of cutaneous manifestations and may present with nodular lesions and plaques. Rare manifestations include erythematous macules, blisters and ulcers which can each occur alone or in combination. Apart from solitary or grouped lesions, leukemia cutis may also present with an erythematous rash in a polymorphic clinical pattern. Consequently, leukemia cutis has to be distinguished from numerous differential diagnoses, i. e. cutaneous metastases of visceral malignancies, lymphoma, drug eruptions, viral infections, syphilis, ulcers of various origins, and blistering diseases. In the oral mucosa, gingival hyperplasia is the main differential diagnosis. The knowledge of the clinical morphology is of tremendously importance in cases in which leukemia was not yet known.
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Affiliation(s)
- Gunnar Wagner
- Department of Dermatology, Allergology, and Phlebology, Bremerhaven Reinkenheide Hospital, Germany.
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Poulopoulos A, Kittas D, Sarigelou A. Current concepts on gingival fibromatosis-related syndromes. ACTA ACUST UNITED AC 2011; 2:156-61. [PMID: 25426785 DOI: 10.1111/j.2041-1626.2011.00054.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Gingival fibromatosis is a rare, benign, slowly-growing fibrous overgrowth of the gingiva, with great genetic and clinical heterogeneity. Gingival fibromatosis/overgrowth can be inherited as an isolated trait (hereditary gingival fibromatosis) and/or as a component of a syndrome, or it can be drug induced. As a clinical manifestation of a syndrome, gingival fibromatosis is usually associated with generalized hypertrichosis, mental retardation, or epilepsy. Gingival fibromatosis and its related syndromes are mainly inherited in an autosomal-dominant manner, but autosomal-recessive inheritance has also been reported. Clinical syndromic presentation includes Zimmermann-Laband syndrome, Ramon syndrome, Rutherford syndrome, Cowden syndrome, Cross syndrome, Göhlich-Ratmann syndrome, Avani syndrome, and I-cell disease. However, a phenotypic overlap has been suggested, as many combinations of their systemic manifestations have been reported. Treatment of choice is usually gingivectomy with gingivoplasty. Before any therapy, clinical practitioners must take into consideration the clinical course of a particular syndrome and every possible functional and esthetic disorder.
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Affiliation(s)
- Athanasios Poulopoulos
- Department of Oral Medicine and Oral Pathology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Multispeciality approach in the management of patient with hereditary gingival fibromatosis: 1-year followup: a case report. Int J Dent 2010; 2010:575979. [PMID: 21234408 PMCID: PMC3014701 DOI: 10.1155/2010/575979] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Revised: 09/25/2010] [Accepted: 11/24/2010] [Indexed: 01/04/2023] Open
Abstract
Background. Hereditary gingival fibromatosis is a fibrotic enlargement of the gingiva. It may exist as an isolated abnormality or as part of multisystem syndrome. This paper reports a case of 16-year-old male with generalized severe gingival overgrowth, involving the maxillary and mandibular arches and covering almost all teeth. Methods. Periodontal management of gingival enlargement included gingivectomy in both arches except in the lower right molar region where flap surgery was done under general anesthesia. After a 2-month followup period, orthodontic treatment was started with fixed appliances. Monthly periodontal checkups and maintainance (scaling and polishing) were scheduled to control the gingival inflammation. Results. Reevaluation of the patient of surgical treatment after two months did not show any recurrence of condition; however, minimal overgrowth was noted 1 month after the beginning of orthodontic treatment which was treated nonsurgically. Conclusions. Although the risk of recurrence is high with this condition, surgical treatment with correction of malocclusion and regular followup can provide excellent outcome as seen in this case.
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