OKC Periodontist – Overgrown Gums

added on: March 8, 2013

Gingival Growth Treatment By OKC Periodontist

A patient was referred to me (OKC Periodontist) by his general dentist due to a abnormal growth on his lower left gum tissue.  The patient reported that he had a previous history of overgrown gums in this area.  He had the growth excised approximately 15 year prior.  The tumorlike growth presented as a pedunculated mass on the gingival tissue.  The patient reported no pain associated with the growth.

Differential Diagnosis

Pyogenic Granuloma

Peripheral Giant Cell Granuloma

Peripheral Ossifying Fibroma

Surgical Treatment

As a Periodontist, I performed a complete excision of the tumorlike growth was accomplished with localized osseous re-contouring of abnormal bone growth.  Scaling and root planing was completed to remove any calculus and irritants.  Primary closure was accomplished with three single loop 4-0 chromic gut.  A adequate amount of keratinized gingival tissue was left in order to minimize recession and eliminate the possibility of creation of a mucogingival defect.  Based on the clinical findings of abnormal gingival growth associated with osseous formation, a tentative diagnosis of Peripheral Ossifying Fibroma was determined.  The excised tissue was stored in formalin for further histologic analysis if needed.  A Peripheral Ossifying Fibroma is a relatively common tumorlike growth of the gingiva that may be reactive rather than neoplastic in nature.  It is characterized by a proliferation of fibroma connective tissue arising from the periodontal ligament, associated with the formation of bone, dystrophic calcification, or a cementumlike product.  Treatment consists of surgical excision down to the underlying bone, and the adjacent teeth should be scaled to remove any source of irritation.  Recurrence is seen in 16 to 20% of reported cases, probably because of incomplete removal.

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