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Long term follow up of idiopathic gingival enlargement associated with chronic periodontitis: A case report and review.

Nagarale GP, Ravindra S, Thakur S, Setty S - J Indian Soc Periodontol (2013)

Bottom Line: It may be associated with other diseases/conditions characterizing a syndrome, but rarely associated with periodontitis.Histopathological investigations revealed atrophic epithelium with dense fibrocollagenous tissue.Lesions healed successfully following extraction and surgical excision, and no recurrence was observed after 1 year follow-up but recurrence was observed at 3 and 5-years follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Periodontics, S D M College of Dental Sciences and Hospital, Dharwad, Karnataka, India.

ABSTRACT

Background: Idiopathic gingival enlargement is a rare condition characterized by massive enlargement of the gingiva. It may be associated with other diseases/conditions characterizing a syndrome, but rarely associated with periodontitis.

Case description: This case report describes an unusual clinical form of gingival enlargement associated with chronic periodontitis. Clinical examination revealed diffuse gingival enlargement. The lesion was asymptomatic, firm, and pinkish red. Generalized periodontal pockets were observed. Radiographic evaluation revealed generalized severe alveolar bone loss. Histopathological investigations revealed atrophic epithelium with dense fibrocollagenous tissue. Lesions healed successfully following extraction and surgical excision, and no recurrence was observed after 1 year follow-up but recurrence was observed at 3 and 5-years follow-up.

Clinical implications: Successful treatment of idiopathic gingival enlargement depends on proper identification of etiologic factors and improving esthetics and function through surgical excision of the over growth. However, there may be recurrence.

No MeSH data available.


Related in: MedlinePlus

Histological examination of excised gingival tissue shows dense fibrocollagenous tissue underlying an atrophic epithelium (hematoxylin and eosin stain, original magnification ×100)
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Figure 4: Histological examination of excised gingival tissue shows dense fibrocollagenous tissue underlying an atrophic epithelium (hematoxylin and eosin stain, original magnification ×100)

Mentions: Extraoral examination revealed asymmetry of the face but there were no findings of lymphadenopathy. Intraoral examination revealed massive, generalized diffuse type of gingival enlargement involving both maxillary and mandibular arches, encroaching buccal, palatal, and lingual vestibular spaces [Figure 1a-c]. The lesion extended up to the level of occlusal plane. Gingiva was pale pink and firm in consistency with pebbled surface. No signs of acute inflammation were present. In addition, halitosis was accentuated. Periodontal examination revealed the presence of a thick band of microbial dental plaque and calculus subgingivally, generalized bleeding on probing, generalized mobility of teeth, malpositioning of upper anteriors, and generalized probing pocket depth in the range of 7 and 10 mm [Figure 2a and b]. Consistent with these findings, panoramic radiograph revealed severe generalized alveolar bone loss indicating severe form of periodontal disease [Figure 3]. Examination of immediate family members of the patient revealed that, none of his family members were affected with severe form of periodontal disease suggesting a negative history for aggressive periodontal disease, confirming recorded history. Histopathological investigations of the excised tissue revealed atrophic parakeratinized stratified squamous epithelium with the dense avascular fibrocollagenous tissue [Figure 4].


Long term follow up of idiopathic gingival enlargement associated with chronic periodontitis: A case report and review.

Nagarale GP, Ravindra S, Thakur S, Setty S - J Indian Soc Periodontol (2013)

Histological examination of excised gingival tissue shows dense fibrocollagenous tissue underlying an atrophic epithelium (hematoxylin and eosin stain, original magnification ×100)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3713760&req=5

Figure 4: Histological examination of excised gingival tissue shows dense fibrocollagenous tissue underlying an atrophic epithelium (hematoxylin and eosin stain, original magnification ×100)
Mentions: Extraoral examination revealed asymmetry of the face but there were no findings of lymphadenopathy. Intraoral examination revealed massive, generalized diffuse type of gingival enlargement involving both maxillary and mandibular arches, encroaching buccal, palatal, and lingual vestibular spaces [Figure 1a-c]. The lesion extended up to the level of occlusal plane. Gingiva was pale pink and firm in consistency with pebbled surface. No signs of acute inflammation were present. In addition, halitosis was accentuated. Periodontal examination revealed the presence of a thick band of microbial dental plaque and calculus subgingivally, generalized bleeding on probing, generalized mobility of teeth, malpositioning of upper anteriors, and generalized probing pocket depth in the range of 7 and 10 mm [Figure 2a and b]. Consistent with these findings, panoramic radiograph revealed severe generalized alveolar bone loss indicating severe form of periodontal disease [Figure 3]. Examination of immediate family members of the patient revealed that, none of his family members were affected with severe form of periodontal disease suggesting a negative history for aggressive periodontal disease, confirming recorded history. Histopathological investigations of the excised tissue revealed atrophic parakeratinized stratified squamous epithelium with the dense avascular fibrocollagenous tissue [Figure 4].

Bottom Line: It may be associated with other diseases/conditions characterizing a syndrome, but rarely associated with periodontitis.Histopathological investigations revealed atrophic epithelium with dense fibrocollagenous tissue.Lesions healed successfully following extraction and surgical excision, and no recurrence was observed after 1 year follow-up but recurrence was observed at 3 and 5-years follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Periodontics, S D M College of Dental Sciences and Hospital, Dharwad, Karnataka, India.

ABSTRACT

Background: Idiopathic gingival enlargement is a rare condition characterized by massive enlargement of the gingiva. It may be associated with other diseases/conditions characterizing a syndrome, but rarely associated with periodontitis.

Case description: This case report describes an unusual clinical form of gingival enlargement associated with chronic periodontitis. Clinical examination revealed diffuse gingival enlargement. The lesion was asymptomatic, firm, and pinkish red. Generalized periodontal pockets were observed. Radiographic evaluation revealed generalized severe alveolar bone loss. Histopathological investigations revealed atrophic epithelium with dense fibrocollagenous tissue. Lesions healed successfully following extraction and surgical excision, and no recurrence was observed after 1 year follow-up but recurrence was observed at 3 and 5-years follow-up.

Clinical implications: Successful treatment of idiopathic gingival enlargement depends on proper identification of etiologic factors and improving esthetics and function through surgical excision of the over growth. However, there may be recurrence.

No MeSH data available.


Related in: MedlinePlus