Bony Exostosis Development in a Patient Following Free Gingival Graft and Orthodontic Treatment: A Case Report.

Free gingival grafts are commonly used to address mucogingival deformities and increase the zone of keratinized tissue. However, the development of bone exostosis after soft tissue graft procedures, such as the free gingival graft, is infrequent. This case report presents the development of a 12x5 mm bony exostosis in the buccal region of the maxillary right canine in a 28-year-old female medical student after a free gingival graft preceding orthodontic treatment. A patient-centric treatment plan, initiated with consultation from an oral pathologist, suggested a biopsy for a definitive diagnosis of a suspected peripheral ossifying fibroma. However, the patient declined due to the absence of symptoms. Therefore, a non-invasive approach involving close monitoring through regular follow-ups has been chosen. In conclusion, this case report highlights the rarity of bony exostosis development after a free gingival graft and orthodontic treatment. The patient's asymptomatic presentation, coupled with the decision to decline the biopsy, underscores the importance of vigilant monitoring. It is significant for dentists to be knowledgeable about this potential complication and its identification to avoid misdiagnosis as oral lesions.