Hereditary Gingival Fibromatosis

Hereditary Gingival Fibromatosis

Article
Dental Health
Diseases & Conditions
+2
Contributed byMaulik P. Purohit MD MPHSep 26, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • HGF (Hereditary Gingival Fibromatosis)

What is Hereditary Gingival Fibromatosis? (Definition/Background Information)

  • Hereditary Gingival Fibromatosis (HGF) is a common, slowly-progressing, benign condition of the gums. This condition has been noted to be present from birth (it has a congenital presentation)
  • The cause of HGF is believed to be genetic factors. A common risk factor for the condition is the presence of various genetic syndromes and a family history of the disease
  • The most common treatment for Hereditary Gingival Fibromatosis is surgery. After surgery, post-surgical therapy and monitoring is required to help the patient return to normal function, ensuring that complications do not arise
  • With prompt and appropriate treatment, the prognosis of Hereditary Gingival Fibromatosis is good. In some cases, the gum tissue growth may recur on an incomplete surgical removal

Who gets Hereditary Gingival Fibromatosis? (Age and Sex Distribution)

  • Infants and young children are usually affected as Heredity Gingival Fibromatosis can be seen at birth
  • Both males and females may be affected by this condition; the incidence rate is almost equal between males and females
  • The condition can occur worldwide. Also, there is no ethnic or racial preference for HGF; hence, it can occur in any race or ethnic group

What are the Risk Factors for Hereditary Gingival Fibromatosis? (Predisposing Factors)

The primary risk factor for Hereditary Gingival Fibromatosis is a family history of the condition.

  • HGF has been found to be inherited in both autosomal dominant (only one mutated allele) and autosomal recessive (two mutated alleles) pattern
  • Other genetic defects and genetic syndromes have also been found to predispose individuals to the condition

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

It is also important to remember that not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Hereditary Gingival Fibromatosis? (Etiology)

The cause of Hereditary Gingival Fibromatosis may include:

  • The presence of genetic defects/other genetic syndromes
  • A positive family history of Hereditary Gingival Fibromatosis

What are the Signs and Symptoms of Hereditary Gingival Fibromatosis?

 The signs and symptoms of Hereditary Gingival Fibromatosis may include:

  • Growth of tissue on the gums:
    • This condition typically results in tissue growth on the gums, which is less than 1 cm in size (along the larger dimension)
    • Gums of both the upper and lower jaw can be affected
    • HGF on the gums is normally painless and slow-growing
  • The tissue masses are usually firm to the touch and well-defined
  • Masses may be present as single or multiple, well-defined nodules, at various locations on the gums
  • In some cases, Hereditary Gingival Fibromatosis may cause bleeding from the gums, or gum ulcerations

How is Hereditary Gingival Fibromatosis Diagnosed?

The following are some diagnostic tools used to identify Hereditary Gingival Fibromatosis:

  • A thorough physical examination and a complete medical history: A physical examination will allow the physician to determine, if there is a growth on the gums; while a complete medical history will identify, if any risk factors are present that may make an individual more susceptible to developing Heredity Gingival Fibromatosis
  • A tissue biopsy of the tumor: A tissue biopsy is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together the clinical findings, conducting special studies on tissues (if needed) and organizing the microscopic findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be the gold standard, in arriving at a conclusive diagnosis
  • Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, histochemical stains, molecular testing, and very rarely, electron microscopic studies
  • Differential diagnosis, to eliminate other tumor types, is also often conducted, before arriving at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions before arriving at a definitive diagnosis.

What are the possible Complications of Hereditary Gingival Fibromatosis?

No significant complications due to Hereditary Gingival Fibromatosis have been reported. However, in rare cases:

  • The tumor may become large in size, resulting in a cosmetic issue
  • Gum infections due to ulceration of large tumors may be seen
  • The condition may recur after surgical excision, if the tumor is incompletely removed

How is Hereditary Gingival Fibromatosis Treated?

The following are some of the treatment methods outlined for Hereditary Gingival Fibromatosis:

  • Usually no treatment is required, due to the benign nature of HGF
  • Some growths caused by HGF are self-limiting and asymptomatic, requiring no treatment at all; these growths may even regress completely
  • If the growths are too large, a gingivectomy (complete surgical removal) may be performed
  • If HGF is causing cosmetic issues, a surgical removal may be necessary and is recommended
  • Follow-up care with regular screening and check-ups are important

The healthcare provider will determine the best course of treatment depending on each specific case.

How can Hereditary Gingival Fibromatosis be Prevented?

Currently, there are no specific methods or guidelines to prevent Hereditary Gingival Fibromatosis, since it is a genetic condition. However, the following information is useful with respect to HGF:

  • Early diagnosis, with close monitoring and treatment of the tumor is important
  • Prompt treatment and early tumor recognition will help in having an optimal outcome
  • Genetic testing of the expecting parents (and related family members) and prenatal diagnosis (molecular testing of the fetus during pregnancy) may help in understanding the risks better during pregnancy
  • If there is a family history of the condition, then genetic counseling will help assess risks before planning for a child

What is the Prognosis of Hereditary Gingival Fibromatosis? (Outcomes/Resolutions)

  • The prognosis of Hereditary Gingival Fibromatosis is very good with suitable treatment
  • A complete excision usually results in low tumor recurrence
  • However, the prognosis of this condition also depends on the severity of any underlying associated syndromes. The more severe these conditions, the more difficult HGFs are to treat and control

Additional and Relevant Useful Information for Hereditary Gingival Fibromatosis:

Drug-induced gingival fibromatosis is a common benign condition of the gums. It is a slow-growing tumor that is caused as a side effect of certain drugs; hence, it is a drug-induced condition.

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Maulik P. Purohit MD MPH

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