A 13-year-old female patient came to the Oral Surgery Service of the Dental Clinic of Rafael Núñez due to generalized gingival enlargement.
As family history, the mother and a brother described a generalized increase in gingival tissue volume.
In her personal history she manifested that at 4 years of age, she underwent gingivectomy due to an increase in the size of the gingivitis with satisfactory results, at 8 years she had two pharmacological episodes with phenytoin such as days.
In the intraoral clinical examination it was observed generalized gingival enlargement compromising maxilla and mandible, covering more than 85% of the dental crown in the posterior teeth and 90% in the previous ones bacterial consistency, of approximately one year of evolution, asymptomatic plaque.
Radiographic examination showed teeth in good general condition and presence of tooth number 73.
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Because it is a large spontaneous fibrous gingival growth without association with syndromes and family history in which the mother and a brother had the same pathology, a diagnosis of hereditary gingival fibromatosis was established.
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Procedure
The treatment consisted of a gingivectomy and gingivoplasty in two surgical phases initially in the mandible and later in the maxilla under local anesthesia.
A primary incision was made using an internal bevel at an angle of 45o towards the apex of the teeth. Previous localization of the same ones with the periodontal probe of Williams. A periodontal curettage was performed with an oral paste.
The same procedure was performed on the maxilla 20 days later.
Histopathological examination microscopically describes fragments of oral mucosa lined by epithelium parakeratosis, hyperplastic, over stroma with abundant thick collagen bundles arranged at random, compatible with gingival fibromatosis.
In the post-surgical control that was carried out at 20 days of each procedure (maxillary and mandible), it was evidenced decrease in the volume of gingival tissue, good healing process, the dental crowns more frequently showed improvement in the patient.
He also presented alterations in dental occlusion, such as diastemas, deep bite, poor dental position, among others, reason why he was referred to the orthodontic service for his therapy.
