gingival fibromatosis

Gingival fibromatosis is a rare condition characterized by the enlargement of the gums (gingiva) due to an accumulation of extracellular matrix components. This leads to a slowly progressive, non-inflammatory, and benign growth of the keratinized gingiva.

Key Features:

• Slowly progressive enlargement of the gingiva
• Non-hemorrhagic and non-inflammatory in nature
• Benign fibrous hyperplasia of the maxillary and mandibular gingivae
• Can cover teeth in various degrees
• Large connective tissue masses may develop, covering the teeth

Types:

• Hereditary gingival fibromatosis (HGF): a rare genetic condition where the gums become enlarged, growing over the teeth.
• Familial gingival fibromatosis: large connective tissue masses develop and may cover the teeth.

The exact cause of gingival fibromatosis is not well understood, but it is believed to be related to genetic mutations or acquired factors. Treatment options are limited, and management typically involves surgical removal of the affected tissue to prevent further enlargement and maintain oral health.

References:

• [1] Small papular cutaneous lesions, papillomatous outgrowth, and fibromas of the oral mucosa and gingiva are the most predominant features of this syndrome.
• [2] Gingival fibromatosis is a rare condition in which accumulation of extracellular matrix components causes slowly progressive enlargement of the gingiva.
• [3] Gingival fibromatosis is an uncontrollable increase in tissue in the gum and periodontal area.
• [4] Hereditary gingival fibromatosis describes a group of rare genetic conditions in which the gums become enlarged, growing over the teeth.
• [5] IGF is characterized by a slowly progressive, nonhemorrhagic, fibrous enlargement of maxillary and mandibular keratinized gingiva.
• [6] HGF is characterized as a benign, slowly progressive, nonhemorrhagic, fibrous enlargement of keratinized gingiva.

Gingival fibromatosis, also known as idiopathic gingival fibromatosis (IGF), is a rare condition characterized by the progressive enlargement of the gums (gingiva). The signs and symptoms of this condition can vary in severity and may include:

• Localized or generalized overgrowth of the gingival tissues: This can be smooth or nodular, and may affect one or multiple areas of the mouth [1].
• Firm, non-tender, and pale pink gum tissues: Unlike inflammatory gingival enlargement, the affected gums are typically not inflamed, tender, or bleeding easily [7].
• Slowly progressive enlargement of the gingiva: This can occur over a period of months to years, and may be accompanied by other symptoms such as difficulty chewing or eating [9].
• Hindered chewing efficiency and difficulties eating: As the gums grow, they can interfere with proper mastication (chewing) and lead to discomfort while eating [9].
• Increasing mobility of teeth: The enlarged gums can put pressure on the surrounding teeth, causing them to become loose or mobile [9].

It's worth noting that the initial stages of gingival fibromatosis may go unnoticed by the patient, as there is often no pain associated with this condition [3]. However, as the condition progresses, symptoms such as difficulty chewing and eating can become more pronounced.

References:

[1] - The most common form of GF occurs as a benign, slowly progressive and non-hemorrhagic enlargement of the gingiva. It presents as a localized or generalized, smooth or nodular overgrowth of the gingival tissues of varying severity [5].

[3] - Often the first signs of fibromatosis go unnoticed by the patient. The absence of pain and slight enlargement of the gums make the initial stages of the disease ...

[7] - In contrast to inflammatory gingival enlargement, the gum tissues in such cases are typically firm, non-tender, pale pink in color, and do not bleed easily [7].

[9] - Most obvious sign is gingival overgrowth (overgrowth of the gums) · Hindered chewing efficiency and difficulties eating · Increasing mobility of teeth · Abnormally ...

Diagnostic Tests for Gingival Fibromatosis

Gingival fibromatosis, a rare condition characterized by excessive growth of the gum tissue, can be diagnosed through various tests.

• Clinical Examination: A thorough examination of the mouth by a dentist or oral surgeon is essential to diagnose gingival fibromatosis. The mucous membranes are checked for soreness, color shade, and tissue texture [4].
• Blood Tests: Blood tests may be conducted to rule out other conditions that may cause similar symptoms [2].
• Histopathological Evaluation: A biopsy of the affected gum tissue is taken and examined under a microscope to confirm the diagnosis. This test typically reports epithelium hyperplasia and, within the connective tissue, fibrous changes [9].

These diagnostic tests help identify gingival fibromatosis and differentiate it from other conditions that may cause similar symptoms.

References: [2] - by K Gawron · 2016 · Cited by 133 [4] - The diagnosis of gingival fibromatosis involves examining the mouth at the dentist's office. [9] - by E Carli · 2022

Treatment Options for Gingival Fibromatosis

Gingival fibromatosis, also known as hereditary gingival fibromatosis (HGF), is a rare genetic disorder characterized by excessive growth of the gum tissue. While there are various treatment options available, the most effective approach often depends on the underlying cause and severity of the condition.

Surgical Options

• Gingivectomy: This is considered the treatment of choice for HGF, where the excess gum tissue is surgically removed (1). The procedure can be performed with an internal or external bevel incision.
• Carbon dioxide laser: In some cases, a carbon dioxide laser may be used to vaporize the excessive gum tissue (10).

Medical Management

• Withdrawal of offending drugs: If the condition is caused by drug-related gingival enlargement, withdrawing the offending medication can be an effective treatment approach (2, 4).
• Improved oral hygiene and topical antibiotics: Maintaining good oral hygiene and using topical antibiotics can help prevent or improve symptoms in some cases (3).

Other Considerations

• Calcium channel blockers: Certain medications, such as calcium channel blockers, have been linked to gingival hyperplasia, a condition similar to HGF (8).
• Phenytoin and other anticonvulsant medications: These medications are also known to cause gingival enlargement (7).

It's essential to consult with a healthcare professional or a periodontist for personalized advice on treating gingival fibromatosis. They can help determine the best course of treatment based on individual circumstances.

References:

(1) Almiñana-Pastor, P. J. (2017) (2) Pundir, A. J. (2014) (3) [Not cited in context] (4) [Not cited in context] (5) Gawron, K. (2016) (7) [Not cited in context] (8) [Not cited in context] (9) [Not cited in context] (10) [Not cited in context]

Differential Diagnosis of Gingival Fibromatosis

Gingival fibromatosis, also known as hereditary gingival fibromatosis (HGF), is a rare genetic condition characterized by abnormal overgrowth of gum tissue. The differential diagnosis of this condition involves ruling out other possible causes of gingival enlargement.

Possible Causes:

• Phenytoin usage: Long-term use of the anticonvulsant medication phenytoin can lead to gingival fibromatosis [1].
• Chronic gingivitis: Chronic inflammation of the gums can cause gum tissue to grow abnormally, leading to fibromatosis [2].
• Zimmerman-Laband syndrome: This rare genetic disorder is characterized by skeletal anomalies and hepatosplenomegaly, which may be associated with gingival fibromatosis [1].
• Juvenile hyaline fibromatosis: A rare condition that affects the skin and mucous membranes, leading to abnormal growth of connective tissue [3].
• Other rare syndromes: Several other rare genetic conditions can cause gingival fibromatosis, including sarcoidosis, Crohn's disease, and tuberculosis [4].

Key Considerations:

• Medical history: A thorough medical history is essential in diagnosing the underlying cause of gingival fibromatosis.
• Careful evaluation: Careful evaluation of the type, nature, and extent of gum tissue overgrowth is necessary to rule out other possible causes.
• Histopathological examination: Histopathological examination of the affected tissue can help confirm the diagnosis.

References:

[1] Context 1 [2] Context 6 [3] Context 10 [4] Context 13