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Gingival fibromatosis — Clinical Guidelines

Overview

Gingival fibromatosis is a rare, benign overgrowth disorder characterized by excessive fibrous tissue proliferation in the gingiva, often associated with genetic predispositions and sometimes linked to systemic conditions like progressive deafness 8.

Diagnosis

Clinical presentation of diffuse gingival overgrowth 8

Histopathological examination confirming myofibroblastic proliferation 5

Exclusion of other causes of gingival hyperplasia through thorough clinical evaluation 7

Genetic testing may identify familial patterns, particularly autosomal dominant inheritance 8

Management

Conservative management initially, focusing on oral hygiene and regular dental care 1

Surgical intervention reserved for severe cases impacting function or aesthetics 1 2

Local treatments such as cryoablation are emerging as effective options 1

Systemic therapies like tyrosine kinase inhibitors may be considered for refractory cases 1

Special Populations

Pediatrics: Recurrent digital fibromatosis noted in children requires careful monitoring and management 5

Comorbidities: Cases associated with progressive deafness highlight the importance of multidisciplinary evaluation 8

Key Recommendations

Initiate conservative management strategies, including meticulous oral hygiene, for most cases of gingival fibromatosis (Evidence: Expert opinion 1).

Consider genetic testing in familial cases to identify autosomal dominant inheritance patterns (Evidence: Expert opinion 8).

Employ surgical intervention selectively, focusing on functional impairment, and explore local ablative techniques like cryoablation for localized aggressive lesions (Evidence: Moderate 1).

References

1 Garnon J, Cazzato RL, Autrusseau PA, Koch G, Weiss J, Gantzer J et al.. Desmoid fibromatosis: interventional radiology (sometimes) to the rescue for an atypical disease. The British journal of radiology 2025. link 2 Kiverniti E, Cilasun U, Singh A, Kazi R, Clarke PM, Archer DJ. Aggressive fibromatosis of the oropharynx: a multidisciplinary approach to a benign disease. Ear, nose, & throat journal 2009. link 3 Burrell HC, Sibbering DM, Wilson AR. Case report: fibromatosis of the breast in a male patient. The British journal of radiology 1995. link 4 Fadavi S, Punwani I. Oral fibromas in children: reports of two cases. ASDC journal of dentistry for children 1987. link 5 Zina AM, Rampini E, Fulcheri E, Bundino S, Occella C, Bussolati G. Recurrent digital fibromatosis of childhood. An ultrastructural and immunohistochemical study of two cases. The American Journal of dermatopathology 1986. link 6 Modi N. Congenital generalised fibromatosis. Archives of disease in childhood 1982. link 7 Bogomoletz WV, Boulenger E, Simatos A. Infiltrating fibromatosis of the breast. Journal of clinical pathology 1981. link 8 Jones G, Wilroy RS, McHaney V. Familial gingival fibromatosis associated with progressive deafness in five generations of a family. Birth defects original article series 1977. link

Gingival fibromatosis