Department of Oral and Maxillofacial Diagnostic Services, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL, 32610-0414, USA.
Department of Oral and Maxillofacial Diagnostic Services, University of Florida College of Dentistry, Gainesville, USA.
Head Neck Pathol. 2021 Sep;15(3):917-922. doi: 10.1007/s12105-021-01315-7. Epub 2021 Mar 8.
Gingival growths, barring a few are mostly reactive and seldom exhibit significant true neoplastic potential. The common etiology is local irritation from dental plaque/calculus, trauma as well as medication-related overgrowth. Such lesions are easily distinguishable and categorized into diagnoses such as pyogenic granuloma, peripheral ossifying fibroma, etc. We present a previously undescribed, but commonly encountered, reactive gingival growth with unique histologic features and suggest the diagnostic term "gingival fibroma." An IRB approved retrospective review of the University of Florida Oral Pathology Biopsy Service encompassing years 2010-2019, was performed to select cases. Demographics, clinical data, and microscopic diagnoses were recorded and analyzed. Four board-certified oral and maxillofacial pathologists agreed upon and established the diagnostic criteria. These are: a prominent fibromyxoid stroma, variable cellularity, a whorled or storiform pattern of arrangement of the cellular elements, lack of significant inflammation or vascularity, and complete absence of calcification, and/or odontogenic islands. A total of 60 cases met all criteria and were included in the study. Age range in years was 14-87 with the mean at 45.11 years. A striking female predilection (90%) was noted. Approximately 62% of cases were reported on the maxillary gingiva, followed by 38.3% in the mandibular gingiva. Majority, 66.7% were in the anterior incisor region followed by 11.7% in the canine/first premolar areas. All lesions were submitted as excisional biopsy, and 4 cases recurred within 2-3 years of excision. In all cases, lesional tissue appeared to extend to the surgical base of the specimen. We present 60 cases of a histologically unique entity occurring exclusively on the gingiva and introduce the diagnostic term "Gingival Fibroma" for these lesions. Further studies with adequate clinical follow-up may help understand the exact clinical behavior of these lesions.
牙龈增生，除少数外大多为反应性，很少表现出显著的真正肿瘤潜能。常见的病因是来自牙菌斑/牙石的局部刺激、创伤以及与药物相关的过度生长。这些病变很容易区分，并分为化脓性肉芽肿、外周骨化性纤维瘤等诊断。我们提出了一种以前未描述但常见的反应性牙龈增生，具有独特的组织学特征，并建议使用“牙龈纤维瘤”这一诊断术语。对佛罗里达大学口腔病理学活检服务 2010-2019 年的回顾性研究进行了 IRB 批准的回顾，以选择病例。记录并分析了人口统计学、临床数据和显微镜诊断。四位经过董事会认证的口腔颌面病理学家一致同意并建立了诊断标准。这些标准是：明显的纤维粘液样基质、细胞数量不等、细胞成分呈漩涡状或轮辐状排列、无明显炎症或血管生成、完全缺乏钙化和/或牙源性岛。共有 60 例符合所有标准并纳入研究。年龄范围为 14-87 岁，平均年龄为 45.11 岁。注意到明显的女性偏好（90%）。大约 62%的病例报告在上颌牙龈，其次是下颌牙龈 38.3%。大多数（66.7%）在前切牙区，其次是犬齿/第一前磨牙区 11.7%。所有病变均作为切除活检送检，4 例在切除后 2-3 年内复发。在所有病例中，病变组织似乎延伸到标本的手术基底。我们提出了 60 例独特的组织学实体病例，这些病例仅发生在牙龈上，并为这些病变引入了“牙龈纤维瘤”的诊断术语。进一步的研究和充分的临床随访可能有助于了解这些病变的确切临床行为。
