Hereditary Nonsyndromic Gingival Fibromatosis: Report of Family Case Series

Hereditary gingival fibromatosis (HGF) is a rare, benign disorder with slowly progressive enlargement of maxillary and mandibular gingiva. Herewith, we report the first case series of HGF presenting among mother and all of her 3 children. Their complaints included unaesthetic appearance due to gingival growth, malocclusion, and difficulty in mastication. Conventional gingivectomy with oral hygiene measures and regular followup is the treatment of choice for such presentation. 1. Introduction Hereditary gingival fibromatosis (HGF) is a rare type of gingival enlargement. HGF can present in two forms, a nodular form affecting the dental papillae or a symmetric uniform gingival enlargement. HGF is seen as pale-pink enlargements, firm and leathery in consistency [1]. The literature search in PubMed revealed only two case series on HGF [2, 3]. Herewith, we report the first case series to the best of our knowledge, comprising 4 patients with HGF involving the mother and all of her three children including 2 daughters and 1 son. 2. Case Presentation A 14-year-old female was reported with her father to the Outpatient Department, Faculty of Dentistry, Sebha University, Sebha, Libya. Her chief complaint was gingival swellings in the posterior region of upper and lower jaws since her childhood. Previous medical and surgical histories were noncontributory. Family history revealed that similar presentations were seen in her elder sister, elder brother, and her mother. Her father was unaffected. Clinical examination revealed diffuse, firm gingival enlargements symmetrically involving the maxillary and mandibular gingiva bilaterally (Figure 1). The enlargements were more severe in the molar region (Figure 2) and crowns were covered by soft tissue (Figure 3). Her family members were requested to report for clinical examination. Her elder sister was 25 years of age. She also had bilateral, symmetrical, and gingival enlargements in the posterior region of maxillary and mandibular gingiva (Figure 4). The teeth were displaced from their normal position. She also had retained deciduous teeth and multiple grossly decayed teeth (Figure 5). Her elder brother was 35 years of age. He also had bilateral, symmetrical enlargements, more prominent in the molar region (Figure 6). He also had severe malocclusion with arch collapse (Figures 7 and 8). Her mother was 62 years of age. She gave a history of similar enlargements in her gingiva and underwent multiple gingival surgeries for the same reason. Clinical examination revealed multiple missing teeth and remaining roots (Figure 9),