Cargando…

Gingival fibromatosis: clinical, molecular and therapeutic issues

Gingival fibromatosis is a rare and heterogeneous group of disorders that develop as slowly progressive, local or diffuse enlargements within marginal and attached gingiva or interdental papilla. In severe cases, the excess tissue may cover the crowns of the teeth, thus causing functional, esthetic,...

Descripción completa

Detalles Bibliográficos
Autores principales: Gawron, Katarzyna, Łazarz-Bartyzel, Katarzyna, Potempa, Jan, Chomyszyn-Gajewska, Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4729029/
https://www.ncbi.nlm.nih.gov/pubmed/26818898
http://dx.doi.org/10.1186/s13023-016-0395-1
_version_ 1782412214737567744
author Gawron, Katarzyna
Łazarz-Bartyzel, Katarzyna
Potempa, Jan
Chomyszyn-Gajewska, Maria
author_facet Gawron, Katarzyna
Łazarz-Bartyzel, Katarzyna
Potempa, Jan
Chomyszyn-Gajewska, Maria
author_sort Gawron, Katarzyna
collection PubMed
description Gingival fibromatosis is a rare and heterogeneous group of disorders that develop as slowly progressive, local or diffuse enlargements within marginal and attached gingiva or interdental papilla. In severe cases, the excess tissue may cover the crowns of the teeth, thus causing functional, esthetic, and periodontal problems, such as bone loss and bleeding, due to the presence of pseudopockets and plaque accumulation. It affects both genders equally. Hereditary, drug-induced, and idiopathic gingival overgrowth have been reported. Hereditary gingival fibromatosis can occur as an isolated condition or as part of a genetic syndrome. The pathologic manifestation of gingival fibromatosis comprises excessive accumulation of extracellular matrix proteins, of which collagen type I is the most prominent example. Mutation in the Son-of-Sevenless-1 gene has been suggested as one possible etiological cause of isolated (non-syndromic) hereditary gingival fibromatosis, but mutations in other genes are also likely to be involved, given the heterogeneity of this condition. The most attractive concept of mechanism for drug-induced gingival overgrowth is epithelial-to-mesenchymal transition, a process in which interactions between gingival cells and the extracellular matrix are weakened as epithelial cells transdifferentiate into fibrogenic fibroblast-like cells. The diagnosis is mainly made on the basis of the patient’s history and clinical features, and on histopathological evaluation of affected gingiva. Early diagnosis is important, mostly to exclude oral malignancy. Differential diagnosis comprises all pathologies in the mouth with excessive gingival overgrowth. Hereditary gingival fibromatosis may present as an autosomal-dominant or less commonly autosomal-recessive mode of inheritance. If a systemic disease or syndrome is suspected, the patient is directed to a geneticist for additional clinical examination and specialized diagnostic tests. Treatments vary according to the type of overgrowth and the extent of disease progression, thus, scaling of teeth is sufficient in mild cases, while in severe cases surgical intervention is required. Prognosis is precarious and the risk of recurrence exists.
format Online
Article
Text
id pubmed-4729029
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-47290292016-01-28 Gingival fibromatosis: clinical, molecular and therapeutic issues Gawron, Katarzyna Łazarz-Bartyzel, Katarzyna Potempa, Jan Chomyszyn-Gajewska, Maria Orphanet J Rare Dis Review Gingival fibromatosis is a rare and heterogeneous group of disorders that develop as slowly progressive, local or diffuse enlargements within marginal and attached gingiva or interdental papilla. In severe cases, the excess tissue may cover the crowns of the teeth, thus causing functional, esthetic, and periodontal problems, such as bone loss and bleeding, due to the presence of pseudopockets and plaque accumulation. It affects both genders equally. Hereditary, drug-induced, and idiopathic gingival overgrowth have been reported. Hereditary gingival fibromatosis can occur as an isolated condition or as part of a genetic syndrome. The pathologic manifestation of gingival fibromatosis comprises excessive accumulation of extracellular matrix proteins, of which collagen type I is the most prominent example. Mutation in the Son-of-Sevenless-1 gene has been suggested as one possible etiological cause of isolated (non-syndromic) hereditary gingival fibromatosis, but mutations in other genes are also likely to be involved, given the heterogeneity of this condition. The most attractive concept of mechanism for drug-induced gingival overgrowth is epithelial-to-mesenchymal transition, a process in which interactions between gingival cells and the extracellular matrix are weakened as epithelial cells transdifferentiate into fibrogenic fibroblast-like cells. The diagnosis is mainly made on the basis of the patient’s history and clinical features, and on histopathological evaluation of affected gingiva. Early diagnosis is important, mostly to exclude oral malignancy. Differential diagnosis comprises all pathologies in the mouth with excessive gingival overgrowth. Hereditary gingival fibromatosis may present as an autosomal-dominant or less commonly autosomal-recessive mode of inheritance. If a systemic disease or syndrome is suspected, the patient is directed to a geneticist for additional clinical examination and specialized diagnostic tests. Treatments vary according to the type of overgrowth and the extent of disease progression, thus, scaling of teeth is sufficient in mild cases, while in severe cases surgical intervention is required. Prognosis is precarious and the risk of recurrence exists. BioMed Central 2016-01-27 /pmc/articles/PMC4729029/ /pubmed/26818898 http://dx.doi.org/10.1186/s13023-016-0395-1 Text en © Gawron et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Gawron, Katarzyna
Łazarz-Bartyzel, Katarzyna
Potempa, Jan
Chomyszyn-Gajewska, Maria
Gingival fibromatosis: clinical, molecular and therapeutic issues
title Gingival fibromatosis: clinical, molecular and therapeutic issues
title_full Gingival fibromatosis: clinical, molecular and therapeutic issues
title_fullStr Gingival fibromatosis: clinical, molecular and therapeutic issues
title_full_unstemmed Gingival fibromatosis: clinical, molecular and therapeutic issues
title_short Gingival fibromatosis: clinical, molecular and therapeutic issues
title_sort gingival fibromatosis: clinical, molecular and therapeutic issues
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4729029/
https://www.ncbi.nlm.nih.gov/pubmed/26818898
http://dx.doi.org/10.1186/s13023-016-0395-1
work_keys_str_mv AT gawronkatarzyna gingivalfibromatosisclinicalmolecularandtherapeuticissues
AT łazarzbartyzelkatarzyna gingivalfibromatosisclinicalmolecularandtherapeuticissues
AT potempajan gingivalfibromatosisclinicalmolecularandtherapeuticissues
AT chomyszyngajewskamaria gingivalfibromatosisclinicalmolecularandtherapeuticissues