Idiopathic Gingival Enlargement: A Report of a Rare Case

TL;DR

This case report describes a rare instance of idiopathic gingival enlargement in a 23-year-old woman and the challenges in its diagnosis and treatment.

Contribution

The paper presents a rare clinical case of idiopathic gingival enlargement with detailed diagnostic and treatment outcomes.

Findings

The patient had generalized diffuse gingival enlargement with no identifiable cause or family history.

Surgical excision did not resolve the condition, and a biopsy confirmed gingival hyperplasia.

Gingivectomy and tooth extraction led to oroantral communication requiring an obturator.

Abstract

Gingival fibromatosis is a heterogeneous group of disorders characterized by the progressive enlargement of the gingiva, caused by an increase in subepithelial connective tissue elements. Idiopathic gingival enlargement (IGE) is a diagnosis by exclusion when no causative agent is identified and there is no family history. This case report presents the diagnosis and treatment of a 23-year-old female patient with IGE. The patient reported a generalized diffuse gingival enlargement for the past seven years, with currently extraoral swelling on the right side and difficulty in chewing with tooth mobility. The patient was apparently healthy seven years ago when she first noticed gingival enlargement with focal areas of involvement, which gradually increased in size to the present extent, with no notable medical history and no family history. The patient reported to the private practitioner 1.5 years ago and had a localized surgical excision of the lesion, but the condition did not resolve. Radiological investigations, including an orthopantomography (OPG) and cone-beam computed tomography (CBCT), blood investigations, and an incisional biopsy of the lesion were performed. The biopsy report confirmed the diagnosis of gingival hyperplasia. Gingivectomy with multiple teeth extraction in a single surgery was performed, resulting in oroantral communication in the maxillary right posterior region. An obturator was given to cover an oroantral communication.

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