Fibromatosis gingival hypertrichosis

Overview

Gingival fibromatosis presents as a generalized but often irregular enlargement of the facial and lingual aspects of the attached and marginal gingiva (Figure 4a). A portion of one quadrant may be involved, or all four quadrants of the gingival tissues may be involved. Enlargement is painless, slowly progressive and dependent to a great extent on the oral hygiene of the individual. While the hyperplastic tissues are usually firm to palpation, inflammation and edema may make some surface areas (facing the teeth) spongy, erythematous and easily bleeding. It is not unusual for the fibromatosis to completely cover the teeth.

Prognosis

Symmetrical fibromatosis of the tuberosity usually requires no treatment. Large lesions or those which interfere with function or denture placement may be removed with conservative surgical excision. Recurrence has not been reported. Granulomatous gingivitis and plasma cell gingivitis are treated by addressing the underlying etiologies.

Treatment

Gingival fibromatosis is removed by gingivectomy, with recurrences being treated in the same fashion or by more conservative removal of local areas of hyperplasia. Improved oral hygiene will greatly diminish the risk of recurrence. Drug-induced gingival hyperplasia may also be treated by gingivectomy and plaque control. Discontinuation of drug use often results in cessation and even regression of the gingival enlargement