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Fibromatosis gingivaeQ38.6

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

elephantiasis gingivae; Gingival fibromatosis

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DefinitionThis section has been translated automatically.

Term for a heterogeneous group of clinical pictures which have in common an idiopathic, diffuse, non-neoplastic, connective tissue proliferation of the gingiva ( gingival hyperplasia) and hard palate. Some of the diseases are exclusively intraoral (see below gingivitis hyperplastica), some cases are combined with malformations of other organ systems (see below fibromatoses).

ClassificationThis section has been translated automatically.

On the one hand, the disease occurs spontaneously; furthermore, various hereditary, autosomal-dominant (less frequently recessive) inherited forms are known:

  • GINGF1 with mutations in the SOS1 gene at gene locus 2p22.1
  • GINGF2 with mutations at the gene locus 5q13-q22
  • GINGF3 with mutations at gene locus 2p23.3-p22.3
  • GINGF4 with mutations at gene locus 11p15

Gingival fibromatosis is a partial symptom of various types of fibromatosis. syndromes (Balaji P et al. 2017):

EtiopathogenesisThis section has been translated automatically.

Discussed are idiopathic genesis as well as autosomal dominant inheritance, combined with local irritant factors. A mutation in the Son-of-Sevenless-1 gene is assumed to be a possible etiological cause of non-syndromal hereditary gingival fibromatosis
(Gawron K et al. 2016).

ManifestationThis section has been translated automatically.

Start with eruption of the milk teeth, continuation after the 2nd dentition. In rare cases gingival hyperplasia can be combined with hypertrichosis ( Hypertrichosis lanuginosa) (so-called hair people).

LocalizationThis section has been translated automatically.

The upper jaw is affected more than the lower jaw. The frontal area is more excessively affected than the lateral area.

Clinical featuresThis section has been translated automatically.

Mostly symmetrically appearing gum growths of both jaws with smooth or papillomatous surface and blurred transition to the surroundings. Starting point are interdental papillae. Fibromatosis can completely overgrow the local teeth (pseudo-anodontics). Malocclusion, articulation and chewing difficulties are the consequences of gingival hyperplasia.

HistologyThis section has been translated automatically.

Fibre-rich tissue, fuzzy boundary, myxoid degeneration of connective tissue; multinucleated giant cells.

Differential diagnosisThis section has been translated automatically.

Reactive gingival hyperplasia due to ingestion of various Drugs(calcium channel blocker, phenytoin, Ciclosporin).

TherapyThis section has been translated automatically.

The therapy of choice is excision of fibromatous tissue (gingivectomy), if necessary extraction of teeth in places. The excision must be performed by skilled speialists (Almiñana Pastor PJ et al. 2017).

LiteratureThis section has been translated automatically.

  1. Almiñana Pastor PJ et al (2017) Hereditary gingival fibromatosis: Characteristics and treatment approach. J Clin Exp Dent 9:e599-e602.
  2. Balaji P et al (2017) Gingival fibromatosis with hypertrichosis syndrome: Case series of rare syndrome. Indian J Dent Res 28:457-460.
  3. Gawron K et al (2017) Analysis of mutations in the SOS-1 gene in two Polish families with hereditary gingival fibromatosis. Oral Dis 23:983-989.
  4. Gawron K et al (2016) Gingival fibromatosis: clinical, molecular and therapeutic issues. Orphanet J Rare Dis. 11:9.
  5. Ko YC et al (2016) Idiopathic Gingival Fibromatosis: Case Report and Review of the Literature. At J Dermatopathol 38:e68-71.

Authors

Last updated on: 29.10.2020

Author: Prof. Dr. med. Peter Altmeyer