特发性牙龈纤维瘤病病例报道及文献回顾

目的探讨特发性牙龈纤维瘤病的病因、临床表现、诊断、鉴别诊断及治疗方法,为临床诊疗提供参考。方法对1例发生于口腔的特发性牙龈纤维瘤病病例的临床资料及相关文献进行回顾性分析。结果该病例行全口牙周基础治疗,前牙区牙周手术治疗后,牙龈形态得到改善。特发性牙龈纤维瘤病是一种罕见的以牙龈组织增生为主要特征的疾病,病因及发病机制不明。该病可在幼儿时就发病,一般发生在恒牙萌出后,表现为牙龈广泛地逐渐增生,可累及全口的牙龈缘、龈乳头和附着龈,甚至达膜龈联合处,病理变化的特点是牙龈上皮的棘层增厚,上皮钉突明显增长,结缔组织体积增大,充满粗大的胶原纤维束和大量成纤维细胞,血管相对较少,炎症不明显。在临床上需与药物性牙龈增生、以增生为主要表现的慢性龈炎等疾病相鉴别。目前特发性牙龈纤维瘤病的治疗以牙龈切除术为主。该病手术后易复发,复发率与口腔卫生维护有关,复发后可再次手术治疗。结论特发性牙龈纤维瘤病较为罕见,诊断主要依靠病史询问、临床表现和病理检查,治疗方法主要为手术切除,今后的研究方向应致力于寻找更有效的治疗方法。

Idiopathic gingival fibromatosis:a case report and literature review

Objective To explore the etiology,clinical manifestations,diagnosis,differential diagnosis and treat⁃ment of idiopathic gingival fibromatosis,and to provide references for clinical diagnosis and treatment.Methods The clinical data and related literatures of a case of idiopathicgingival fibroma that occurred in the oral cavity were retro⁃spectively analyzed.Results Total periodontal treatment was performed for the patient,and the gingival morphology was improved after periodontal surgery in the anterior region.Idiopathic gingival fibromatosis is a rare disease character⁃ized by gingival tissue hyperplasia.The etiology and pathogenesis are unknown.The disease can occur in young chil⁃dren.Generally,it occurs after the permanent teeth erupt,and it manifests as extensive gingival hyperplasia,which can affect the entire gingival margin,gingival papilla and attached gingival,and can even reach the membrane-gingival junction.The pathological changes include thickening of the spinous layer of the gingival epithelium,significant increas⁃es in the epithelial styloid process,increases in the connective tissue volume,and filling with large collagen fiber bun⁃dles and a large number of fibroblasts.The blood vessels are relatively small,and inflammation is not obvious.Clinical⁃ly,this disease needs to be distinguished from drug-induced gingival hyperplasia and chronic gingivitis with hyperpla⁃sia as the main manifestation.At present,the treatment of idiopathic gingival fibromatosis is mainly gingival angioplas⁃ty.The disease easily relapses after surgery.The recurrence rate is related to the quality of oral hygiene.After recur⁃rence,it can be treated again.Conclusion Idiopathic gingival fibromatosis is relatively rare,and the diagnosis mainly depends on the history of inquiry,clinical manifestations and pathological examination.The treatment is mainly surgical resection,and future research should focus on finding a more effective treatment.