Extensive Gingival Enlargement in Siblings : A Case Report = ضخامة اللثة الشاملة عند الأشقاء : تقرير حال

Abstract

Gingival hyperplasia is an unusual condition which interferes with speech, mastication, occlusion, lip continence, and facial appearance of the affected individual, causing aesthetic, functional, psychological, and masticatory disturbances. Drug-induced gingival enlargements are the commonest form. The inherited condition in which the gingival tissue spontaneously and progressively enlarges is identified as hereditary gingival fibromatosis (HGF).1 It is a rare condition, affecting only one in 750,000 people, with males and females being equally affected.2 HGF is characterised by a slowly progressive, non-haemmorhagic fibrous enlargement of gingival tissue, occurring peripheral to the alveolar bone, which does not involve the periodontal ligament. The hyperplastic gingival tissue usually presents with a normal colour and has a firm consistency with abundant stippling. 3,4 Furthermore, HGF usually develops as an isolated disorder but can be one feature of a syndrome or a chromosomal abnormality. Accordingly, it has been divided into two forms: non-syndromic and syndromic. 5The gingival enlargement usually begins with the eruption of the permanent or deciduous dentition. 1The growth may worsen throughout adolescence, suggesting an influence of growth hormones. 6 The clinical presentation of HGF is highly variable, both in the number of teeth involved and degree of Sultan Qaboos University Med J, November 2012, Vol. 12, Iss. 4, pp. 517-521, Epub. 20 th Nov 12 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.

Hereditary Gingivo-Alveolar Hyperplasia: A Report of Two Siblings

“…Although a longer follow-up is needed to detect any recurrence, it does not seem to be a serious problem as it is reported in the literature that the risk of recurrence is higher if the surgery was done before eruption of all permanent dentition. 1 Besides, the mother also did not have recurrence 20 years after her surgery. The patients showed significant improvement of mastication function and aesthetics.…”

“…This is in line with previous publications where hereditary gingival hyperplasia is characterized by slow, progressive enlargement of the gingiva, which usually begins with the eruption of deciduous or permanent teeth. 1,4,5,8 The gingiva is usually pink, firm, and does not bleed easily. 1,4,5,8 The cases presented in this report could be categorized as severe since almost all of the crowns of the teeth were buried in.…”

“…1,4,5,8 The gingiva is usually pink, firm, and does not bleed easily. 1,4,5,8 The cases presented in this report could be categorized as severe since almost all of the crowns of the teeth were buried in. However, it did not bleed profusely during the surgery although it was not easy to inject vasoconstrictor.…”

“…1 It is characterized by localized or generalized enlargement of the gingiva 1 and causes impairment of speech function, mastication, occlusion, and aesthetics. 1À4 Gap between two teeth, malposition of the teeth, prolonged retention of primary dentition, and delayed eruption of permanent dentition have also been reported.…”

“…1À4 Gap between two teeth, malposition of the teeth, prolonged retention of primary dentition, and delayed eruption of permanent dentition have also been reported. 1,5 We conducted a literature search in PubMed on March 15, 2013, using Boolean operator OR, the field of title, under the keywords ''gingival hyperplasia,'' ''drug induced gingival hyperplasia,'' ''gingival overgrowth,'' ''gingival fibromatosis,'' ''hereditary gingival fibromatosis,'' and ''idiopathic gingival fibromatosis.'' Only publications in English were retrieved to have the number of cases that have been reported.…”