Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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Long-term Management of a Gingival Fibromatosis Patient with the Primary Dentition

유치열기에서 나타난 치은섬유종증 환자의 장기간 관리

  • Kang, Chungmin (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Jaeho (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Choi, Hyungjun (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Song, Jeseon (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Kim, Seongoh (Department of Pediatric Dentistry, College of Dentistry, Yonsei University)
  • 강정민 (연세대학교 치과대학 소아치과학교실) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실) ;
  • 최형준 (연세대학교 치과대학 소아치과학교실) ;
  • 송제선 (연세대학교 치과대학 소아치과학교실) ;
  • 김성오 (연세대학교 치과대학 소아치과학교실)
  • Received : 2014.04.22
  • Accepted : 2014.09.04
  • Published : 2014.11.30
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Abstract

Gingival fibromatosis is a rare oral condition that is characterized by proliferative fibrous overgrowth of the attached gingiva, the marginal gingiva, and the interdental papilla, typically presenting in the growth period. A case of a 27-month-old girl with a generalized severe gingival overgrowth is described herein. The patient had no known systemic disease, but enlarged gingival tissue had gradually covered her teeth. The excess gingival tissue was removed by conventional gingivectomy, which involved extraction of the retentive primary teeth under general anesthesia when she was 5 years old. Post surgical follow-up at 18 months after the surgery demonstrated no recurrence. Resectional surgery of the enlarged gingival tissue is the treatment choice for gingival fibromatosis, although there is a high risk of recurrence. More frequent professional follow-ups and oral hygiene instruction might be required. A delay in the surgical treatment may have significant consequences for the patient, such as primary dentition retention and consequent delay in the eruption of the permanent teeth, difficulties in mastication and phonation, malpositioning of the teeth, and psychological problems. Early surgical treatment should be performed according to the severity of enlargement.

치은 섬유종증은 흔하지 않은 성장기 구강질환으로, 치은 변연과 치간 유두뿐만 아니라 부착치은의 전반에 걸친 섬유성 증식을 특징으로 한다. 본 증례의 환아는 전반적인 치은비대를 보이는 27개월 여아로 특별한 의학적 전신병력은 없으나 오빠에게서 같은 증상을 보이는 가족력이 존재하였다. 심미적 요구와 영구치 맹출 시기를 고려하여 만 5세경에 전신마취 하에 치은절제술 및 잔존 유치의 발치를 시행하였고 이후 1년 6개월의 추적검사 기간 동안 재발 양상은 관찰되지 않았다. 치은 섬유종증의 치료법으로 과증식된 치은 조직의 외과적 절제술을 고려할 수 있으며, 수 년 내에 재발하려는 경향이 있으므로 전문적이고 지속적인 구강 위생 관리가 필요하다. 외과적 치료를 지연하면 영구치의 맹출 지연으로 인한 유치의 잔존, 저작과 발음의 어려움, 부정교합 및 환자의 심리적인 문제 등을 초래하므로 치은 비대의 정도에 따라 유치열에서 외과적 치료를 할 수 있다.

Keywords

References

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