Long-term Management of a Gingival Fibromatosis Patient with the Primary Dentition

Abstract

Gingival fibromatosis is a rare oral condition that is characterized by proliferative fibrous overgrowth of the attached gingiva, the marginal gingiva, and the interdental papilla, typically presenting in the growth period. A case of a 27-month-old girl with a generalized severe gingival overgrowth is described herein. The patient had no known systemic disease, but enlarged gingival tissue had gradually covered her teeth. The excess gingival tissue was removed by conventional gingivectomy, which involved extraction of the retentive primary teeth under general anesthesia when she was 5 years old. Post surgical follow-up at 18 months after the surgery demonstrated no recurrence. Resectional surgery of the enlarged gingival tissue is the treatment choice for gingival fibromatosis, although there is a high risk of recurrence. More frequent professional follow-ups and oral hygiene instruction might be required. A delay in the surgical treatment may have significant consequences for the patient, such as primary dentition retention and consequent delay in the eruption of the permanent teeth, difficulties in mastication and phonation, malpositioning of the teeth, and psychological problems. Early surgical treatment should be performed according to the severity of enlargement.