A Case Report on Idiopathic Gingival Fibromatosis

Abstract

Idiopathic gingival fibromatosis (IGF) is an uncommon condition characterized by diffuse gingival enlargement, independent of bacterial plaque, which may present as an isolated finding or in association with syndromes. Clinically, it manifests as a progressive, firm, and nodular gingival overgrowth that, in severe cases, may cover dental crowns, causing diastemas, esthetic and functional alterations, as well as difficulties in mastication and phonation. Its etiology is heterogeneous, with a possible genetic association on chromosome 2. Histologically, dense connective tissue, abundant collagen, and thickened epithelium are observed, warranting a comprehensive clinico-histopathological diagnosis. Treatment ranges from plaque control to gingivectomy in advanced cases. We report the case of a 12-year-old female presenting with generalized gingival enlargement, multiple diastemas, and deep bite, along with facial features such as midfacial hypoplasia and broad nasal bridge. Hematologic and imaging studies were unremarkable. Surgical management included quadrant-wise gingivectomy and gingivoplasty. Histopathological analysis confirmed dense collagenized fibrous tissue with inflammatory infiltrate, consistent with idiopathic gingival fibromatosis. Genetic studies ruled out clinically significant variants, and family evaluation revealed no similar cases. Twelve-month follow-up showed no recurrence and a notable improvement in function, esthetics, and self-esteem. IGF is a rare condition with significant psychological and functional impact. Surgical treatment, combined with strict oral hygiene and long-term follow-up, is effective in preventing recurrence. Interdisciplinary collaboration, particularly with genetics, is essential for comprehensive management.