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American Journal of Health Research2015; 3(1-2): 16-19Published online January 19, 2015 (http:!!!"s#ien#epublishin$$roup"#o%&a&hr)doi: 10"116'&"a&hr"s"2015030102"1'

**+: 2330- (Print); **+: 2330-96 (nline) 

Idiopathic gingival fibromatosis – case report

Abdullah G. Amran1, *

, Ahmed A. Madfa2 

1.epart%ent o/ Periodontolo$y, a#ulty o/ .entistry, niersity o/ ha%ar, .ha%ar, 4e%en 2.epart%ent o/ onseratie .entistry, a#ulty o/ .entistry, niersity o/ ha%ar, .ha%ar, 4e%en

Email address:dri%ran2006yahoo"#o% (7" 8" 7%ran)

To cite this article:7bdullah 8" 7%ran, 7h%ed 7" ad/a" diopathi# 8in$ial ibro%atosis ase eport" American Journal of Health Research" *pe#ial ssue:

ral ed by pro$ressie oer$ro!th o/ the$in$ial tissues"his #ase report presented the #lini#al /eatures o/ a typi#al idiopathi# $in$ial enlar$e%ent !hi#h !as treated

!ith e?ternal beel $in$ia#to%y. he patient presented !ith $enerali>ed di//use $in$ial enlar$e%ent inolin$ the %a?illary

and %andibular ar#hes e?tendin$ on bu##al and lin$ualpalatal sur/a#es and #oerin$ in#isalo##lusal third o/ the tooth

resultin$ in di//i#ulty in spee#h and %asti#ation sin#e last three years" 8in$ie#to%y !as #arried out to i%proe patient@s

Auality o/ li/e" *in#e re%oal o/ hyperplasti# $in$ial tissue eli%inates di//i#ulties in eatin$ and speaBin$" here/ore, this

sur$i#al interention i%proes a##ess /or plaAue #ontrol, and leads to psy#holo$i#al bene/its due to estheti# i%proe%ent" n

this #ase, een a/ter one year /ro% /ollo!in$-up, no re#urren#e o/ $in$ial oer$ro!th !as obsered"

Keyword: 8in$ial er$ro!th, diopathi# 8in$ial ibro%atosis, 8in$ia#to%y, Ciopsy, 4e%en 

1. ntroduction

8in$ial /ibro%atosis is a rare #ondition resultin$ /ro% the

 proli/eratie /ibrous oer$ro!tho/ the $in$ial tissue" t also

des#ribed as a hetero$eneous $roup o/ disorders

#hara#teri>ed by pro$ressie enlar$e%ent o/ the $in$ia

#aused by an in#rease in sub%u#osal #onne#tie tissue

ele%ents D1E"

any #ases are iatro$eni#; so%e are inherited !hile others

are idiopathi#"

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  7%eri#an Journal o/ e any Bind o/ toothpaste

andor other types o/ oral health #are /or her li/e as she stated"

Panora%i# radio$raphi# e?a%ination sho!ed %ild bone

resorption around so%e anterior and posterior teeth"

Fig. 1. Pre-operative progressive gingival fibromatosis.

2.2. Histopathological Evaluation

Ciopsy !as #arried outand sent /orhistopatholo$i#al study"

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1 7bdullah 8" 7%ran and 7h%ed 7" ad/a: diopathi# 8in$ial ibro%atosis ase eport

 pro#edure (i$" 5)" urther, the sa%e sur$i#al pro#edure !as

also per/or%ed /or lo!er ar#h !ith inter/ere bet!een both

sur$i#al pro#edures !as 9 days" 7/ter!ards, s#alin$ and root

 plannin$ !ere a##o%plished a/ter re%oal o/ enlar$ed

$in$ial tissues sur$i#ally (i$s" 5 and 6)" *ubseAuently,

 periodontal dressin$ !as then applied into sur$i#al area /or

 prote#tion and he%ostasis purpose (i$" )" 7ntibioti#s and

anti-in/la%%atory a$ents !ere then pres#ribed /or one !eeB"

Fastly, the re%oed tissue !as sent /or histopatholo$i#al

study"

he patient !as hi$hly %otiated to Beep up $ood oral

hy$iene" his pro#edure o/ the treat%ent is #alled

%aintenan#e phase (Phase )" inally, the patient !as

in/or%ed to retain /or /ollo!in$ up re#ord" +o re#urren#e

!as noti#ed a/ter one year /ollo!in$-up (i$" )"

Fig. 4. Quadrant wisetechnique.

Fig. 5. nlarged gingival tissues that removed surgically.

Fig. 6.  Postoperative image after nine days from e!ternal bevel

 gingivectomy procedure.

Fig. 7. Periodontal dressing applied into surgical area.

Fig. 8. "mage for gingiva of the patient after one year#ollowing-up. 

he analysis /or re%oed tissue reealed

hyperparaBeratinised strati/ied sAua%ous epitheliu% and a

reti#ular a#anthosis !ith elon$ated rete red$es !ith

underlyin$ /ibrous #onne#tie tissue (i$" ')" onne#tie

tissue e?hibited bundles o/ #olla$en /ibers asso#iated !ith

/e! /ibroblasts (i$"5)" Giden#e o/ dysplasia !as not

noti#ed"

%. &iscussion

his #ase report des#ribes $in$ial enlar$e%ent in a

4e%eni patient that also had %oderate plaAue and #al#ulus

a##u%ulation" he $in$ial enlar$e%ent %ay be either

hereditary or idiopathi#, ariations in the inheritan#e pattern

and its /reAuent asso#iation !ith syste%i# de/e#ts or

ano%alies %aBe it ery #o%ple? to study D1E"he $in$ial enlar$e%ent is usually asso#iated !ith

#ontinuous in#rease in %ass o/ tissues, %aintenan#e o/ oral

hy$iene be#o%e #hallen$in$ durin$ all phases o/ therapy"

##asionally, $in$ial enlar$e%ent does not o##ur until the

eruption o/ the per%anent dentition" urther enlar$e%ent

does not o##ur on#e the $ro!th o/ &a! is #o%pleted" *o%e

studies reported that $in$ial enlar$e%ent %ay be due to

nutritional and hor%onal /a#tors; ho!eer, these hae not

 been #o%pletely alidated D1, 2E"

he present #ase o/ idiopathi# $in$ial oer$ro!th %ay a

typi#al #ondition, #hara#teri>ed by pro$ressie, lar$e %asses

o/ /ir%, dense, resilient insensitie $ro!th that #oers thealeolar rid$es and e?tends oer the teeth" / this #ase doesnHt

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  7%eri#an Journal o/ ed durin$ %asti#ation, !hi#h

!as obsered in the present #ase" 7ttributable to %assie

$in$ial enlar$e%ent, the a//e#ted patient usually deelops

abnor%al s!allo!in$ pattern and e?perien#es di//i#ulty in

spee#h and %asti#ation" 7lon$ !ith these /eatures, there %ay

 be so%e inter/eren#e !ith the oral hy$iene %easures and

nor%al %asti#ation" 7ll these !ill /aour a##u%ulation o/

alba and plaAue, !hi#h /urther #o%pli#ates the e?istin$

hyperplasti# tissue"

=arious %odalities o/ treat%ent had been proposed

in#ludin$ radi#al treat%ent !ith e?tra#tion o/ the inoled

teeth, !hi#h !as reported not to /aour a re#urren#e o/ the

$ro!thD6E" he treat%ent o/ #hoi#e in this #ondition !as

$in$ia#to%y to satis/y the patient@s aestheti#s DE" his !as

#oin#ided !ith the #urrent study in !hi#h $in$ia#to%y !asused /or restorin$ the patientHs happiness"

ed the $in$ial enlar$e%ent as

reported by perious studies D1, 6, E"

n the #urrent study, thou$h $in$ial oer$ro! tissue

appeared to be pale and /ir%, the sur$i#al pro#edure !as

#o%pli#ated !ith e?#essie hae%orrha$e" *in#e re#urren#e#ould be e?pe#ted !ithin a /e! %onths a/ter sur$ery and %ay

return to the ori$inal #ondition !ithin /e! years, the patient

%ay hae to under$o repeated $in$ia#to%y pro#edures" his

o/ten #auses /urther in#rease in the patientsI psy#holo$i#al

and e%otional stress" hus, psy#holo$i#al therapy is a

#o%%it%ent /or patients"

aintenan#e o/ $ood oral hy$iene is ery i%portant D1E" t

is not Bno!n i/ plaAue #ontrol %easures are e//e#tie in this

#ondition; ho!eer, it is a $ood pra#ti#e to %aintain the

 plaAue #ontrol /ollo!in$ $in$ia#to%y pro#edure" he

 patientsH %aintenan#e o/ oral hy$iene had to be e%phasi>ed

as hi$h re#urren#e rates hae been asso#iated !ith poor oral

hy$iene" n this study, on /ollo!-up a/ter a year, the patient

sho!ed not re#urren#e o/ the $in$ial oer$ro!th"

'. !onclusionshis #ase report presented the #lini#al /eatures o/ a typi#al

idiopathi# $in$ial enlar$e%ent !hi#h !as treated !ith

e?ternal beel $in$ia#to%y" Cene/its o/ sur$i#al interention

are re#o$ni>ed to i%proe patient@s Auality o/ li/e" *in#e

re%oal o/ hyperplasti# $in$ial tissue eli%inates di//i#ulties

in eatin$ and speaBin$" here/ore, this sur$i#al interention

i%proes a##ess /or plaAue #ontrol, and leads to

 psy#holo$i#al bene/its due to estheti# i%proe%ent" n this

#ase, een a/ter one year /ro% /ollo!in$-up, no re#urren#e o/

$in$ial oer$ro!th !as obsered"

"eferences

D1E   +e!%an 8, aBei