Hereditary gingival fibromatosis (HGF) is a rare genetic disorder characterized by fibrous proliferation of the gingiva. Gingival overgrowth in cases of HGF usually begins in early childhood. In regard to the pathogenesis, while the genetic background is known to be the predominant factor in the development of HGF, dental plaque is also known to induce the onset and recurrence of gingival overgrowth after surgical intervention. Surgical interventions, such as conventional gingivectomy, after initial periodontal therapy is the most commonly used treatment strategy for HGF.
It is essential to maintain good oral hygiene and perform resection of the excess gingival tissue in cases with recurrent HGF after surgical treatment. According to reports published in the literature, patients with HGF have a tendency towards malocclusion. It is conceivable that malocclusion in HGF patients would result not only in functional and aesthetic problems, but also affect the rate of progression and risk of recurrence of gingival hyperplasia as a plaque retention factor along with the growth of the gingiva at the site of recrudescence.
We present the case of an 18-year-old female patient who presented with severe gingival overgrowth and was diagnosed as having HGF. Her three-generation Japanese family had at least four individuals with gingival hyperplasia. Comprehensive dental treatment, including initial periodontal therapy, periodontal surgical intervention and orthodontic treatment yielded a favorable response. Therefore, through our treatment experience over the last 10 years, we have observed the efficacy of periodontal surgery in cases of severe HGF and verified the effectiveness of managing the plaque retention factor by comprehensive dental treatment.
