Objective: Hereditary gingival fibromatosis (HGF) is a rare condition characterized by varying degrees of gingival hyperplasia. Gingival fibromatosis usually occurs as an isolated disorder or can be associated with a variety of other syndromes. In some situations, gingival hyperplasia is drug induced or can be manifestation of a genetic disorder. If orthodontic treatment is needed in patients with gingival hyperplasia, both orthodontic and periodontal aspects need to be considered. This case report describes the radiographic and clinical characteristics of two sisters with hereditary gingival fibromatosis who are candidates for orthodontic treatment.
Methods: Intraoral and extraoral photographs and study models were taken and radiologic examination was carried out by using lateral cephalometric, posteroanterior and panoramic radiographs.
Results: The patients presented severely enlarged gingival tissues affecting both arches and covering almost all teeth and surfaces. The arch forms were deformed by the excessive gingival tissue and severe crowding was present due to severe gingival overgrowth. The patients represented hyperdivergent growth pattern and were both skeletally Class II due to retrognathie inferior and both of them had convex profile. Upper and lower incisors were slightly protrusive. Soft tissue analysis revealed extremely protrusive upper and lower lips. The subjects had difficulty in closing their lips due to the severely enlarged gingival tissues and mouth breathing.
Conclusion: The treatment of patients with gingival hyperplasia like hereditary gingival fibromatosis requires multidisciplinary approach and continuous follow up. As a result of orthodontic evaluation, comprehensive periodontal and orthodontic approach would be beneficial for these patients.