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Case Reports
. 2020:77:62-66.
doi: 10.1016/j.ijscr.2020.10.084. Epub 2020 Oct 22.

Long standing Idiopathic gingival hyperplasia of oral cavity with invasion of maxillary sinus: A rare case report

Kanchan Shah  1 , Kainat Khan  2 , P K Pandilwar  1 , Anoop Unnikrishnan K S  1 , Mahesh Sanap  1 , Trupti Nikalje  1
Affiliations
Case Reports

Long standing Idiopathic gingival hyperplasia of oral cavity with invasion of maxillary sinus: A rare case report

Kanchan Shah et al. Int J Surg Case Rep. 2020.

Abstract

Introduction: Idiopathic gingival hyperplasia is a rare entity (about one in 1,75,000 individuals). It is characterized by a slow progressive benign enlargement, affecting the attached gingiva, marginal gingiva, and interdental papilla.

Presentation of case: This case report highlights the management of an unusual case of long standing idiopathic gingival hyperplasia involving the right maxillary sinus.

Discussion: Management of gingival hyperplasia depends on the severity of the condition. In this case, surgical excision was performed in both the arches, that resulted in the creation of an oroantral communication, which was protected with a prefabricated custom-made acrylic stent. Despite having a visible raw area of epithelialization evident on the 2nd post operative day, there were no significant signs of recurrence even at a follow-up of 2 years post surgery. Many authors advocate extraction of involved teeth, in addition to the gingival excision, in the presumption of a permanent cure.

Conclusion: The patient was satisfied with the resultant esthetic and functional outcome of the treatment. But, the possibility of recurrence cannot be ruled out, so the patient should be kept under close observation. She may also require subsequent surgeries, thus making psychological counseling mandatory.

Keywords: Case report; Idiopathic gingival hyperplasia; Maxillary sinus; Oroantral fistula.

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Figures

Fig. 1
Fig. 1
Frontal (a) and lateral view of patient (b and c).
Fig. 2
Fig. 2
(a–e) preoperative photographs showing severe generalized diffused nodular gingival hyperplasia.
Fig. 3
Fig. 3
(a) OPG showing excessive osseous destruction. (b–d) CBCT scan reveals involvement of right maxillary sinus.
Fig. 4
Fig. 4
Excised hyperplastic gingival tissue.
Fig. 5
Fig. 5
H & E stained section showing parakeratinized epithelium, arcading pattern of rete ridges, fibrous Connective tissue with collagen fiber bundles, chronic inflammatory cell infiltrate and mild degree of vascularity.
Fig. 6
Fig. 6
Progressive healing of oroantral fistula at 6 month post operation.
Fig. 7
Fig. 7
Postoperative photograph of patient at 2 year followup.
See this image and copyright information in PMC

References

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