Hereditary Gingival Fibromatosis Associated with Aggressive Periodontitis and Rheumatoid Arthritis: Report of A Rare Case
Authors: Yashoda Prakash and A.R. Pradeep
Abstract: Background: Hereditary gingival fibromatosis is a rare, genetically inherited overgrowth, clinically characterized by a fibrous enlargement of maxillary and mandibular keratinized gingiva. This condition may occur alone or in conjunction with a wide variety of other genetically inherited disorders as a part of more extensive syndrome. Nevertheless its co-existence with rheumatoid arthritis and aggressive periodontitis has not been reported. Hence this paper reports an unusual mélange of HGF, GAgP and RA in the patient for the first time and confabulates the shared mechanisms involved in the pathogenesis of these three entities.
Case report: A 20-year-old Indian male patient reported with a chief complaint of tooth mobility and gingival enlargement. On Intraoral examination, a diffuse overgrowth of the gingivae in both the arches was seen. Generalized attachment loss and mobility of the teeth were observed. Radiographic evaluation demonstrated severe alveolar bone loss. Family history showed that his 13 year old sister also exhibited clinically significant gingival overgrowth. The patient was diagnosed with gingival fibromatosis and aggressive periodontitis based on the clinical, radiographic findings and family history. Medical history revealed that he is known arthritic patient. Conclusions: This is the first report of hereditary gingival fibromatosis associated with aggressive periodontitis and rheumatoid arthritis. Such coexistence opens opportunity for research into the existence of a predictable association between the three entities. On the other hand such coexistence may be challenging to the dental professional, necessitating the implementation of different therapeutic approaches concomitantly and because of the rarity of such unusual mélange, information through case reports may form the basis for future hypothesis and further study.