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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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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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Hereditary gingival fibromatosis in children: a systematic review of the literature. Clin Oral Investig 2020; 25:3599-3607. [PMID: 33188467 DOI: 10.1007/s00784-020-03682-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/04/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Hereditary gingival fibromatosis (HGF) is an uncommon, inherited condition with slow and progressive fibrous hyperplasia of the gingiva. Due to its association with mastication, speech, and occlusion problems, early diagnosis is important. We sought to summarize the available data regarding the epidemiology, clinical characteristics, and outcomes of children with HGF (< 18 years). METHODS A systematic literature review of the MEDLINE and Cochrane Library databases was conducted with respect to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (end-of-search date: March 1, 2019). RESULTS A total of 99 articles reporting on 146 patients were included. The mean age was 10.82 ± 3.93 years, and generalized gingival enlargement was seen in 97.16% (95% CI 92.69 to 99.14). Jaw, gingival, and teeth abnormalities; poor oral hygiene; eating; or speech difficulties were typical HGF-induced, while 60.90% had extraoral manifestations (95% CI 52.41 to 68.78). The disease was most commonly inherited in an autosomal dominant manner (88.41%, 95% CI 78.5 to 94.26), and about one-third of the patients had syndromic HGF (33.85%, 95% CI 23.50 to 46.00). Gingivectomy was performed in the majority of cases (91.15%, 95% CI 84.31 to 95.29), and recurrence was seen in 33.85% (95% CI 23.50 to 46.00). CONCLUSION HGF should be suspected in children with nodularity and gingival fibrosis, teeth abnormalities, or jaw distortion. Family history can help to establish the diagnosis. CLINICAL RELEVANCE More cases should focus on longer-term follow-up after gingivectomy as disease recurrence is not uncommon.
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Cunha JLS, Ramos MACDC, Regis DM, Sanchéz-Romero C, de Andrade ME, Bezerra BT, de Albuquerque-Júnior RLC. Generalized hereditary gingival fibromatosis in a child: clinical, histopathological and therapeutic aspects. AUTOPSY AND CASE REPORTS 2020; 10:e2020140. [PMID: 32039068 PMCID: PMC6984817 DOI: 10.4322/acr.2020.140] [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: 05/11/2019] [Accepted: 12/03/2019] [Indexed: 11/23/2022] Open
Abstract
Hereditary gingival fibromatosis (HGF) is a rare genetic condition characterized by slow and progressive gingival enlargement. The gingival overgrowth often delays teeth eruption and may cause serious functional and aesthetic problems. We reported a case of a 10-year-old female child presenting a generalized gingival enlargement covering almost all the maxillary and mandibular teeth and resulted in problems for swallowing, speaking, and poor aesthetics. An incisional biopsy was performed and revealed a hypocellular and hypovascular dense collagenous tissue covered by squamous epithelium exhibiting acanthosis and elongated rete ridges. The diagnosis was HGF. The treatment instituted was an association of gingivectomy with a rigorous program of oral hygiene and follow-up. Herein, we describe a rare non-syndromic case of generalized HGF, including clinical and microscopical features, as well as highlighting the importance of correct diagnosis of this genetic condition.
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Affiliation(s)
- John Lennon Silva Cunha
- University of Campinas (UNICAMP), Piracicaba Dental School, Department of Oral Diagnosis. Piracicaba, SP, Brazil
| | | | | | - Celeste Sanchéz-Romero
- University of Campinas (UNICAMP), Piracicaba Dental School, Department of Oral Diagnosis. Piracicaba, SP, Brazil
| | - Maria Eliane de Andrade
- Tiradentes University, Institute of Technology and Research, Laboratory of Morphology and Experimental Pathology. Aracaju, SE, Brazil
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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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Gluckman H, Du Toit J, Pontes CC, Hille J. Hyperplastic Response Following Soft Tissue Augmentation in the Esthetic Zone. Clin Adv Periodontics 2018; 9:50-54. [DOI: 10.1002/cap.10047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/12/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Howard Gluckman
- Private practice of periodontics and oral medicine – The Implant ClinicThe Implant & Aesthetic Academy Cape Town South Africa
| | - Jonathan Du Toit
- ResidentDepartment of Periodontics and Oral MedicineUniversity of Pretoria Pretoria South Africa
- The Implant & Aesthetic Academy Cape Town South Africa
| | | | - Jos Hille
- Department of Oral and Maxillofacial PathologyUniversity of the Western Cape Cape Town South Africa
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Ferreira Gonçalves C, Mundim AP, Martins RFS, Gagliardi RM, Santos PSS, Ayrton de Toledo O. Hereditary Gingival Fibromatosis: a Case Report with Seven-Year Follow-up. Acta Stomatol Croat 2018; 52:254-258. [PMID: 30510301 PMCID: PMC6238873 DOI: 10.15644/asc52/3/9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Introduction Hereditary gingival fibromatosis (HGF) is a rare disease characterized by gingival enlargement, normal color with benign and firm consistency. This growth may be exacerbated by use of drugs and plaque build-up. The treatment for this clinical condition is surgical excision of the enlarged gingival tissue or the extraction of all teeth. Case Report A 20-year-old Brazilian female handicapped patient with a chief complaint of exaggerated gingival enlargement who had been prescribed Carbamazepine and Gardenal was referred to our center. According to the clinical presentation and family history, the final diagnosis of gingival enlargement was HGF. Full dental treatment was performed, including basic periodontal treatment, restorations, sealants, and gingivoplasty with internal bevel. Special care was taken to ensure that there was no change in patient’s anticonvulsant medication. The patient has been monitored for seven years without signs of recurrence of gingival hyperplasia due to constant professional and home control of plaque.
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Affiliation(s)
- Cíntia Ferreira Gonçalves
- Department of Pediatric Dentistry, School of Dentistry, Instituto Tocantinense Presidente Antônio Carlos - Porto Nacional, Porto Nacional, TO, Brazil
| | - Ana Paula Mundim
- Department of Pediatric Dentistry, School of Dentistry, Instituto Tocantinense Presidente Antônio Carlos - Porto Nacional, Porto Nacional, TO, Brazil
| | | | | | | | - Orlando Ayrton de Toledo
- Department of Pediatric Dentistry, School of Dentistry, University of Brasília, Brasília, DF, Brazil
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Liu C, Tao T, Zhao L, Ding Y. Decreased Alpha 2 integrin gene expression in non-familial gingival fibromatosis: a report of two cases. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:7492-7497. [PMID: 31966593 PMCID: PMC6965286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 04/20/2017] [Indexed: 06/10/2023]
Abstract
BACKGROUND Generalized gingival fibromatosis is characterized by a progressive overgrowth of the gingiva, which can be caused by a variety of factors. According to these factors, it can be defined as hereditary gingival fibromatosis, non-familial gingival fibromatosis or drug-induced gingival fibromatosis. Non-familial gingival fibromatosis is a rare entity that needs to be documented. CASE PRESENTATION Here, we describe two cases of Chinese non-familial gingival fibromatosis. A six-year-old girl and a five-year-old boy presented with generalized gingival overgrowth. Clinical appearance, histological examination, and family history lead to the diagnosis of non-familial gingival fibromatosis. Real time PCR was performed to examine the expression of the α2-integrin gene, ITGA2, and identified decreased expression of ITGA2 in the gingiva of patients compared to both their parents and healthy volunteers. This is the first evidence that suggests a role for ITGA2 in non-familial gingival fibromatosis. CONCLUSION Our findings provide evidence that altered cell-matrix interactions via collagen receptors, such as α2-integrin, may play a role in non-familial gingival fibromatosis. Thus, targeting collagen receptors might be an attractive target for the treatment of gingival fibromatosis.
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Affiliation(s)
- Chengcheng Liu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan UniversityChengdu, PR China
- Department of Periodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, PR China
| | - Tingting Tao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan UniversityChengdu, PR China
- Department of Periodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, PR China
- Chengfei HospitalChengdu, PR China
| | - Lei Zhao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan UniversityChengdu, PR China
- Department of Periodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, PR China
| | - Yi Ding
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan UniversityChengdu, PR China
- Department of Periodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, PR China
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