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Hereditary gingival fibromatosis associated with generalized aggressive periodontitis: a case report.
J Periodontol. 2004 May; 75(5):770-8.JP

Abstract

BACKGROUND

Hereditary gingival fibromatosis is a rare, genetically inherited overgrowth condition that is clinically characterized by a benign fibrous enlargement of maxillary and mandibular keratinized gingiva. A syndromic association between gingival fibromatosis and a wide variety of other genetically inherited disorders has been described. However, its coexistence with aggressive periodontitis has not been reported.

METHODS

A 24-year-old African-American female, patient (proband X, [Px]) reported with a chief complaint of tooth mobility and gingival enlargement. Clinical examination revealed moderate to severe gingival overgrowth on both mandible and maxilla. Generalized attachment loss and mobility of the teeth were observed. Radiographic evaluation demonstrated severe alveolar bone loss. The patient was diagnosed with gingival fibromatosis and aggressive periodontitis based on the clinical and radiographic findings. Her brother (Bx) and her mother (Mx) were evaluated and diagnosed with gingival fibromatosis suggesting that this is a dominant trait in the family and gingival fibromatosis might be of hereditary origin. In addition, the brother also exhibited localized aggressive periodontitis. Medical history revealed no other systemic or local contributory factors associated with the oral findings in any of the subjects.

RESULTS

Surgical therapy included internal bevel gingivectomy combined with open flap debridement procedures for Px and Bx. Only internal bevel gingivectomy was performed for Mx since there was mild bone resorption and no intrabony defects. At the time of surgery, gingival biopsies were obtained and fixed in 4% paraformaldehyde. Multiple serial sections were stained with hematoxylin and eosin. Microscopic evaluation of the gingival specimens revealed large parallel collagen bundles associated with scarce fibroblasts in the connective tissue. The collagen bundles reached into the subepithelial connective tissue where elongated rete-pegs were also observed. Following the completion of the treatment, no signs of recurrence or bone resorption were observed over 2-year follow-up.

CONCLUSIONS

This is the first report of hereditary gingival fibromatosis associated with aggressive periodontitis. Combined treatment comprising removal of fibrotic gingival tissue and traditional flap surgery for the elimination of intrabony defects represents a unique treatment approach in periodontal therapy. Two-year follow-up revealed that both the gingival overgrowth and the destructive lesions were successfully treated.

Authors+Show Affiliations

Department of Periodontology and Oral Biology, Boston University, Goldman School of Dental Medicine, Boston, MA 02118, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15212361

Citation

Casavecchia, Piero, et al. "Hereditary Gingival Fibromatosis Associated With Generalized Aggressive Periodontitis: a Case Report." Journal of Periodontology, vol. 75, no. 5, 2004, pp. 770-8.
Casavecchia P, Uzel MI, Kantarci A, et al. Hereditary gingival fibromatosis associated with generalized aggressive periodontitis: a case report. J Periodontol. 2004;75(5):770-8.
Casavecchia, P., Uzel, M. I., Kantarci, A., Hasturk, H., Dibart, S., Hart, T. C., Trackman, P. C., & Van Dyke, T. E. (2004). Hereditary gingival fibromatosis associated with generalized aggressive periodontitis: a case report. Journal of Periodontology, 75(5), 770-8.
Casavecchia P, et al. Hereditary Gingival Fibromatosis Associated With Generalized Aggressive Periodontitis: a Case Report. J Periodontol. 2004;75(5):770-8. PubMed PMID: 15212361.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hereditary gingival fibromatosis associated with generalized aggressive periodontitis: a case report. AU - Casavecchia,Piero, AU - Uzel,M Ilhan, AU - Kantarci,Alpdogan, AU - Hasturk,Hatice, AU - Dibart,Serge, AU - Hart,Thomas C, AU - Trackman,Philip C, AU - Van Dyke,Thomas E, PY - 2004/6/24/pubmed PY - 2004/8/27/medline PY - 2004/6/24/entrez SP - 770 EP - 8 JF - Journal of periodontology JO - J Periodontol VL - 75 IS - 5 N2 - BACKGROUND: Hereditary gingival fibromatosis is a rare, genetically inherited overgrowth condition that is clinically characterized by a benign fibrous enlargement of maxillary and mandibular keratinized gingiva. A syndromic association between gingival fibromatosis and a wide variety of other genetically inherited disorders has been described. However, its coexistence with aggressive periodontitis has not been reported. METHODS: A 24-year-old African-American female, patient (proband X, [Px]) reported with a chief complaint of tooth mobility and gingival enlargement. Clinical examination revealed moderate to severe gingival overgrowth on both mandible and maxilla. Generalized attachment loss and mobility of the teeth were observed. Radiographic evaluation demonstrated severe alveolar bone loss. The patient was diagnosed with gingival fibromatosis and aggressive periodontitis based on the clinical and radiographic findings. Her brother (Bx) and her mother (Mx) were evaluated and diagnosed with gingival fibromatosis suggesting that this is a dominant trait in the family and gingival fibromatosis might be of hereditary origin. In addition, the brother also exhibited localized aggressive periodontitis. Medical history revealed no other systemic or local contributory factors associated with the oral findings in any of the subjects. RESULTS: Surgical therapy included internal bevel gingivectomy combined with open flap debridement procedures for Px and Bx. Only internal bevel gingivectomy was performed for Mx since there was mild bone resorption and no intrabony defects. At the time of surgery, gingival biopsies were obtained and fixed in 4% paraformaldehyde. Multiple serial sections were stained with hematoxylin and eosin. Microscopic evaluation of the gingival specimens revealed large parallel collagen bundles associated with scarce fibroblasts in the connective tissue. The collagen bundles reached into the subepithelial connective tissue where elongated rete-pegs were also observed. Following the completion of the treatment, no signs of recurrence or bone resorption were observed over 2-year follow-up. CONCLUSIONS: This is the first report of hereditary gingival fibromatosis associated with aggressive periodontitis. Combined treatment comprising removal of fibrotic gingival tissue and traditional flap surgery for the elimination of intrabony defects represents a unique treatment approach in periodontal therapy. Two-year follow-up revealed that both the gingival overgrowth and the destructive lesions were successfully treated. SN - 0022-3492 UR - https://wwww.unboundmedicine.com/medline/citation/15212361/Hereditary_gingival_fibromatosis_associated_with_generalized_aggressive_periodontitis:_a_case_report_ L2 - https://doi.org/10.1902/jop.2004.75.5.770 DB - PRIME DP - Unbound Medicine ER -