Hereditary Gingival Fibromatosis Associated With Generalized Aggressive Periodontitis: A Case Report

Abstract

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.

Idiopathic Gingival Fibromatosis with Generalized Aggressive Periodontitis: A Rare Case Report and Its Management

“…The diagnosis of Idiopathic gingival fibromatosis with generalized aggressive periodontitis was made based on patient's medical and family history, clinical presentation, radiographic findings and histopathological examination. Similar cases of Idiopathic gingival fibromatosis associated with aggressive periodontitis have been reported by Chaturvedi R.(2009), [11] , Sanadi RM (2010) [18] , Fatema S. , Preeti M. (2012) [19] and Casavechia P,Uzel ml , Kantari A, Hasturkh , Dibots, Hart (2004) [20]. The patient in the present case was troubled by esthetics and chewing function hence gingivectomy was carried out in all four Quadrants.…”

Alteraciones gingivales no relacionadas con placa

“…La forma localizada afecta a la zona de molares superiores y tuberosidad del maxilar, especialmente en la zona palatina 25 ( fig.9). Puede aparecer como una entidad aislada o asociada a otras alteraciones sistémicas formando parte de algún síndrome hereditario como el querubismo, el síndrome de Laband, el sín-drome de Klippel-Trenaunay-Weber o el síndrome de Ehlers-Danlos 26 . El mecanismo celular por el que se produce no está del todo claro aunque se ha demostrado que los fibroblastos sintetizan niveles más elevados de lo habitual de componentes de la matriz extracelular.…”

“…El mecanismo celular por el que se produce no está del todo claro aunque se ha demostrado que los fibroblastos sintetizan niveles más elevados de lo habitual de componentes de la matriz extracelular. Además la degradación de la matriz extracelular disminuye en estos pacientes ya que las metaloproteinasas están disminuidas, mientras que el factor de crecimiento ß1 aparece aumentado 26 . Todo esto provoca un desequilibrio en el mecanismo normal de síntesis y degradación de las moléculas dando, como resultado final, un aumento de fibras que provoca el aumento del volumen gingival.…”

Apoptosis in Gingival Overgrowth Tissues

“…The balance between cell proliferation and apoptosis may be characteristic of different forms of gingival overgrowth, and variations in this balance may provide insights into different etiologies in different forms of gingival overgrowth. For example, phenytoin-induced gingival overgrowth and inherited gingival fibromatosis appear to be more fibrotic than other forms of gingival overgrowth (Uzel et al, 2001;Casavecchia et al, 2004;Trackman and Kantarci, 2004;Kantarci et al, 2006). A working hypothesis is that, in hypercellular and fibrotic lesions, fibroblast proliferation may be stimulated, whereas in lesions containing high levels of extracellular matrix and fewer cells, fibroblast apoptosis may be stimulated.…”