Gingival Enlargement as a Manifestation of Tuberous Sclerosis: Case Report and Periodontal Management

Department of Periodontics and Implant Dentistry, New York University College of Dentistry, New York, NY, USA.
Journal of Periodontology (Impact Factor: 2.71). 05/2008; 79(4):759-63. DOI: 10.1902/jop.2008.070407
Source: PubMed


Tuberous sclerosis is an autosomal-dominant inherited disease involving many organs of the body. Oral manifestations include gingival enlargement, fibromas, and dental enamel pitting. The report presents a case of tuberous sclerosis with gingival enlargement histologically consistent with angiofibroma, describes its successful periodontal management, and reviews the literature associated with oral manifestations of tuberous sclerosis.
A 26-year-old white male presented to the Department of Periodontics and Implant Dentistry, New York University College of Dentistry, with a diagnosis of tuberous sclerosis and a chief complaint of gingival enlargement affecting mastication and esthetics. Following a complete medical history review, consultation with the patient's medical team at New York University Medical Center, and a thorough oral and periodontal examination, a treatment plan was developed that included oral hygiene instructions, mechanical debridement, and periodontal reevaluation. This was followed by gingivectomy, which provided improved function and esthetics. Excised tissue was submitted for histologic examination. The patient was followed every 2 months for assessment of the outcome of the surgical treatment. An extensive search of the dental and dermatologic literature was performed on MEDLINE.
Histologic examination of the gingival tissue revealed features consistent with angiofibroma. Fifteen months following gingivectomy, the contours and gingival surface appearance remained normal.
The gingival enlargement was histologically consistent with the characteristic angiofibromas of tuberous sclerosis. The gingival enlargement responded very well to gingivectomy and periodontal maintenance.

19 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Tuberous sclerosis is an inherited neurocutaneous disorder that occurs in approximately 1 in 7,500 live births. It is characterized by benign neoplasms of the skin, heart, kidneys, lungs, central nervous system, and mucosa. Oral lesions are usually fibrous in nature and most commonly occur on the anterior gingivae. Patients may suffer with epilepsy and learning difficulties, which may complicate dental management. When a 10-year-old girl with a history of tuberous sclerosis was brought in for a routine dental check-up, a leafy growth on the anterior gingiva was detected. An excisional biopsy was carried out. Histologically, the appearance was described as nonspecific, but was consistent with a diagnosis of tuberous sclerosis. Tuberous sclerosis is a rare condition that may exhibit oral manifestations. The patients may also exhibit epilepsy and learning difficulties. Dental management of affected patients may therefore be more complicated and complex.
    No preview · Article · Jan 1954 · Special Care in Dentistry
  • [Show abstract] [Hide abstract]
    ABSTRACT: In situ observations of CO<sub>2</sub> hydrate formation and dissociation processes were carried out in a liquid CO<sub>2</sub> and water system. Propagation rates of CO<sub>2</sub> hydrate films at the interface of the liquids, ν<sub>f</sub>, were measured for various conditions. Representing ν<sub>f</sub> as a function of temperature made it possible to predict ν<sub>f</sub> in the deep sea. ν<sub>f </sub> was found to be much greater than the growth rate of the film thickness. Dissociation processes of CO<sub>2</sub> hydrates were found to depend on whether temperature or pressure was changed to induce decomposition. These differences are important for engineering applications of gas hydrates
    No preview · Conference Paper · Jan 1997
  • [Show abstract] [Hide abstract]
    ABSTRACT: Clinical manifestations of tuberous sclerosis (TS) are variable, and oral involvement occurs in less than 10% of the affected patients. We reported herein a nine-year-old boy with dental enamel pits and gingival nodular lesions, histologically diagnosed as angiofibromas that leaded to the diagnosis of a family with TS. In this report, we demonstrated the multiprofessional importance in the diagnosis of TS. Early diagnosis of TS is essential for an appropriate treatment of the affected patients and genetic counseling.
    No preview · Article · Jan 2010 · Indian journal of dental research: official publication of Indian Society for Dental Research
Show more