The use of CO2 laser in the treatment of gingival fibromatosis: a case report

Hereditary gingival fibromatosis in children: a systematic review of the literature

OBJECTIVES

Hereditary gingival fibromatosis (HGF) is an uncommon, inherited condition with slow and progressive fibrous hyperplasia of the gingiva. Due to its association with mastication, speech, and occlusion problems, early diagnosis is important. We sought to summarize the available data regarding the epidemiology, clinical characteristics, and outcomes of children with HGF (< 18 years).

METHODS

A systematic literature review of the MEDLINE and Cochrane Library databases was conducted with respect to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (end-of-search date: March 1, 2019).

RESULTS

A total of 99 articles reporting on 146 patients were included. The mean age was 10.82 ± 3.93 years, and generalized gingival enlargement was seen in 97.16% (95% CI 92.69 to 99.14). Jaw, gingival, and teeth abnormalities; poor oral hygiene; eating; or speech difficulties were typical HGF-induced, while 60.90% had extraoral manifestations (95% CI 52.41 to 68.78). The disease was most commonly inherited in an autosomal dominant manner (88.41%, 95% CI 78.5 to 94.26), and about one-third of the patients had syndromic HGF (33.85%, 95% CI 23.50 to 46.00). Gingivectomy was performed in the majority of cases (91.15%, 95% CI 84.31 to 95.29), and recurrence was seen in 33.85% (95% CI 23.50 to 46.00).

CONCLUSION

HGF should be suspected in children with nodularity and gingival fibrosis, teeth abnormalities, or jaw distortion. Family history can help to establish the diagnosis.

CLINICAL RELEVANCE

More cases should focus on longer-term follow-up after gingivectomy as disease recurrence is not uncommon.

Technology of Lasers and Their Applications in Oral Surgery: Literature Review

The word “Laser” is an acronym for “Light Amplification by Stimulated Emission of Radiation”. Recent advances in laser technology have brought a kind of revolution in dentistry. The purpose of this article is to provide an overview of clinical application of lasers in oral medicine and especially in oral surgery, including their advantages, disadvantages and safety.

Idiopathic gingival fibromatosis

Idiopathic gingival fibromatosis (IGF) is a rare hereditary condition characterized by slowly progressive, nonhemorrhagic, fibrous enlargement of maxillary and mandibular keratinized gingiva caused by increase in submucosal connective tissue elements, mostly associated with some syndrome. This case report describes a case of nonsyndromic generalized IGF in an 18-year-old male patient who presented with generalized gingival enlargement. The enlarged tissue was surgically removed by internal bevel gingivectomy and ledge and wedge procedure. The patient was regularly monitored clinically for improvement in his periodontal condition as well as for any recurrence of gingival overgrowth.

Use of the CO(2) laser on orthodontic patients suffering from gingival hyperplasia

OBJECTIVE

The present study aimed to assess the effect of the use of the CO(2) laser on the treatment of gingival hyperplasia in orthodontic patients wearing fixed appliances.

BACKGROUND DATA

Gingival hyperplasia is a condition very frequent in patients undergoing fixed orthodontic treatment. Amongst the treatments available for this is the use of surgical lasers.

METHODS

Ten patients entered this study and signed an informed consent. Seventy-five anterior teeth with gingival hyperplasia were selected for laser surgery. Prior to surgery, the length of the crowns were measured using a digital caliper, and depth of the pocket was probed. The hyperplasic gingival was removed with a CO(2) laser under local anesthesia. Immediately after surgery, measurement of the length of the crowns and probing were carried out and were repeated.

RESULTS

The results were statistically analyzed and significant differences were detected regarding the length of the crown (p = 0.000) and depth of the gingival sulcus (p = 0.000).

CONCLUSION

It is concluded that the use of the CO(2) laser was effective in the treatment of gingival hyperplasia.

Hereditary Gingival Fibromatosis: A Systematic Review

Generalized gingival enlargement can be caused by a variety of etiological factors. It can be inherited (hereditary gingival fibromatosis [HGF]); associated with other diseases characterizing a syndrome; or induced as a side effect of systemic drugs, such as phenytoin, cyclosporin, or nifedipine. HGF, previously known as elephantiasis gingivae, hereditary gingival hyperplasia, and hypertrophic gingiva, is a genetic disorder characterized by a progressive enlargement of the gingiva. This review will focus on diagnosis, treatment, and control of HGF. The pattern of inheritance, the histopathologic characteristics, and the known biologic and genetic features associated with HGF are also emphasized.