Unexplained Gingival Hyperplasia in a Girl with Symptomatic Generalized Epilepsy Resulting in Tooth Impaction of Primary Teeth―Report 1

Gingival hyperplasia is frequently encountered in the clinical practice of special needs dentistry. Gingival hyperplasia is classified into drug-induced gingival hyperplasia and hereditary gingival fibromatosis；furthermore, idiopathic horizontal gingival hyperplasia and idiopathic gingival fibromato...

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Published inJournal of the Japanese Society for Disability and Oral Health Vol. 45; no. 3; pp. 159 - 164
Main Authors YAWAKA, Yasutaka, ZHAO, Jimei, NAKAMURA, Koichi
Format Journal Article
LanguageJapanese
Published The Japanese Society for Disability and Oral Health 31.10.2024
一般社団法人 日本障害者歯科学会
Subjects
Gingival hyperplasia
Symptomatic generalized epilepsy
Tooth impaction
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ISSN0913-1663
2188-9708
DOI10.14958/jjsdh.45.159

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Abstract Gingival hyperplasia is frequently encountered in the clinical practice of special needs dentistry. Gingival hyperplasia is classified into drug-induced gingival hyperplasia and hereditary gingival fibromatosis；furthermore, idiopathic horizontal gingival hyperplasia and idiopathic gingival fibromatosis have been reported. We report a case of gingivectomy performed on a girl with tooth impaction of the maxillary primary incisors due to gingival hyperplasia of undetermined cause. On initial intraoral examination, only the mandibular deciduous incisors and first molars had erupted, while the maxillary teeth had not erupted. No family members had the same symptoms. Gingivectomy was performed several times under local anesthesia, and aesthetic improvement was observed.
AbstractList Gingival hyperplasia is frequently encountered in the clinical practice of special needs dentistry. Gingival hyperplasia is classified into drug-induced gingival hyperplasia and hereditary gingival fibromatosis；furthermore, idiopathic horizontal gingival hyperplasia and idiopathic gingival fibromatosis have been reported. We report a case of gingivectomy performed on a girl with tooth impaction of the maxillary primary incisors due to gingival hyperplasia of undetermined cause. On initial intraoral examination, only the mandibular deciduous incisors and first molars had erupted, while the maxillary teeth had not erupted. No family members had the same symptoms. Gingivectomy was performed several times under local anesthesia, and aesthetic improvement was observed. 障害者歯科臨床において歯肉増殖に遭遇することは多い．歯肉増殖は薬物性歯肉増殖症と遺伝性歯肉線維腫症に分類されているが，それらに当てはまらない特発性水平性歯肉肥大や特発性歯肉線維腫症が報告されている．当院小児・障がい者歯科外来において，原因を判別できない歯肉増殖により，上顎乳前歯の萌出障害を認めた女児に対して歯肉切除術を行った症例を報告する．初診時の口腔内所見では下顎乳切歯と第一乳臼歯のみ萌出しており，上顎の歯は未萌出であった．抗てんかん薬としてカルバマゼピンを服用していたが歯肉増殖の原因とされている代表的な薬物であるフェニトインの服用歴はなかった．また，患児の家族に同じ症状を認めた者はいなかった．歯肉切除術は局所麻酔下で数回に分けて行い，審美性の改善が認められた．
Gingival hyperplasia is frequently encountered in the clinical practice of special needs dentistry. Gingival hyperplasia is classified into drug-induced gingival hyperplasia and hereditary gingival fibromatosis；furthermore, idiopathic horizontal gingival hyperplasia and idiopathic gingival fibromatosis have been reported. We report a case of gingivectomy performed on a girl with tooth impaction of the maxillary primary incisors due to gingival hyperplasia of undetermined cause. On initial intraoral examination, only the mandibular deciduous incisors and first molars had erupted, while the maxillary teeth had not erupted. No family members had the same symptoms. Gingivectomy was performed several times under local anesthesia, and aesthetic improvement was observed.
Author NAKAMURA, Koichi
YAWAKA, Yasutaka
ZHAO, Jimei
Author_FL 八若 保孝
趙 継美
中村 光一
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DocumentTitleAlternate 症候性全般てんかんの女児にみられた原因不明の歯肉増殖により乳歯の萌出に障害をきたした症例　第１報
DocumentTitle_FL 症候性全般てんかんの女児にみられた原因不明の歯肉増殖により乳歯の萌出に障害をきたした症例　第１報
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一般社団法人 日本障害者歯科学会
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References 18) Farrer-Brown G, Lucas RB, Winstock D. Familial gingival fibromatosis：An unusual pathology. J Oral Pathol 1972；1：76-83.
2) 日本歯周病学会編．歯周治療のガイドライン2022．東京：医歯薬出版；2022．11
14) Camargo PM, Melnick PR, Pirih FQ, et al. Treatment of drug-induced gingival enlargement：Aesthetic and functional considerations. Periodontol 2001；27：131-8.
8) Mavrogiannis M, Ellis JS, Thomason JM, et al. The management of drug-induced gingival overgrowth. J Clin Periodontol 2006；33：434-9.
17) 新居由紀，久保寺友子，今井裕樹，他．生後2カ月の女児にみられた遺伝性歯肉線維腫症の1例．小児歯誌2020；58：188-94
15) Reali L, Zuliani E, Gabutti L, et al. Poor oral hygiene enhances gingival overgrowth caused by calcineurin inhibitors. J Clin Pharm Ther 2009；34：255-60.
16) Gawron K, Łazarz-Bartyzel K, Potempa J, et al. Gingival fibromatosis：Clinical, molecular and therapeutic issues. Orphanet J Rare Dis 2016；11：9.
5) Casetta I, Granieri E, Desidera M, et al. Phenytoin-induced gingival overgrowth：A community-based cross-sectional study in Ferrara, Neuroepidemiology 1997；16：296-303.
1) 日本障害者歯科学会編．スペシャルニーズ・デンティストリー障害者歯科．第2版．東京：医歯薬出版；2017．103-5
6) Teoh L, Moses G, McCullough MJ. A review and guide to drug-associated oral adverse effects―Dental, salivary and neurosensory reactions. Part 1. J Oral Pathol Med 2019；48：626-36.
7) Hart TC, Zhang Y, Gorry MC, et al. A mutation in the SOS1 gene causes hereditary gingival fibromatosis type 1. Am J Hum Genet 2002；70：943-54.
10) Hatahira H, Abe J, Hane Y, et al. Drug-induced gingival hyperplasia：A retrospective study using spontaneous reporting system databases. J Pharm Health Care Sci 2017；3：19.
19) Roman-Malo L, Bullon B, Miguel M, et al. Fibroblasts collagen production and histological alterations in hereditary gingival fibromatosis, Diseases 2019；39：1-8.
9) 木村将士，町田純一郎，山口聖士，他．歯肉切除後に長期経過観察を行った遺伝性歯肉線維腫症の1例．日口外誌2013；59：708-12
11) Suneja B, Chopra S, Thomas AM, et al. Clinical evaluation of gingival overgrowth in children on antiepileptic drug therapy. J Clin Diagn Res 2016；10：32-6.
12) 有田憲司，阿部洋子，仲野和彦，他．日本人小児における乳歯・永久歯の萌出時期に関する調査研究Ⅱ―その1．乳歯について―．小児歯誌2019；57：45-53
20) Okanobu A, Matsuda S, Kajiya M, et al. A novel gingival overgrowth mouse model induced by the combination of CsA and ligature-induced inflammation. J Immunol Methods 2017；445：31-6.
21) 米田栄吉．薬物性歯肉増殖症の発症機序を探る．日歯周誌2002；44：315-21
13) Trackman PC, Kantarci A. Molecular and clinical aspects of drug induced gingival overgrowth. J Dent Res 2015；94：540-6.
4) 脇本仁奈，小笠原　正，薦田　智，他．重症心身障害児・者にみられた特発性水平性歯肉肥大．障歯誌2021；42：84-90
3) 小林奈未子，藤田晴子，菊池恭子，他．歯肉線維腫症2症例の長期経過観察．小児歯誌2014；52：103-9
References_xml – reference: 1) 日本障害者歯科学会編．スペシャルニーズ・デンティストリー障害者歯科．第2版．東京：医歯薬出版；2017．103-5．
– reference: 3) 小林奈未子，藤田晴子，菊池恭子，他．歯肉線維腫症2症例の長期経過観察．小児歯誌2014；52：103-9．
– reference: 6) Teoh L, Moses G, McCullough MJ. A review and guide to drug-associated oral adverse effects―Dental, salivary and neurosensory reactions. Part 1. J Oral Pathol Med 2019；48：626-36.
– reference: 15) Reali L, Zuliani E, Gabutti L, et al. Poor oral hygiene enhances gingival overgrowth caused by calcineurin inhibitors. J Clin Pharm Ther 2009；34：255-60.
– reference: 21) 米田栄吉．薬物性歯肉増殖症の発症機序を探る．日歯周誌2002；44：315-21．
– reference: 4) 脇本仁奈，小笠原　正，薦田　智，他．重症心身障害児・者にみられた特発性水平性歯肉肥大．障歯誌2021；42：84-90．
– reference: 8) Mavrogiannis M, Ellis JS, Thomason JM, et al. The management of drug-induced gingival overgrowth. J Clin Periodontol 2006；33：434-9.
– reference: 19) Roman-Malo L, Bullon B, Miguel M, et al. Fibroblasts collagen production and histological alterations in hereditary gingival fibromatosis, Diseases 2019；39：1-8.
– reference: 2) 日本歯周病学会編．歯周治療のガイドライン2022．東京：医歯薬出版；2022．11．
– reference: 17) 新居由紀，久保寺友子，今井裕樹，他．生後2カ月の女児にみられた遺伝性歯肉線維腫症の1例．小児歯誌2020；58：188-94．
– reference: 10) Hatahira H, Abe J, Hane Y, et al. Drug-induced gingival hyperplasia：A retrospective study using spontaneous reporting system databases. J Pharm Health Care Sci 2017；3：19.
– reference: 14) Camargo PM, Melnick PR, Pirih FQ, et al. Treatment of drug-induced gingival enlargement：Aesthetic and functional considerations. Periodontol 2001；27：131-8.
– reference: 20) Okanobu A, Matsuda S, Kajiya M, et al. A novel gingival overgrowth mouse model induced by the combination of CsA and ligature-induced inflammation. J Immunol Methods 2017；445：31-6.
– reference: 7) Hart TC, Zhang Y, Gorry MC, et al. A mutation in the SOS1 gene causes hereditary gingival fibromatosis type 1. Am J Hum Genet 2002；70：943-54.
– reference: 18) Farrer-Brown G, Lucas RB, Winstock D. Familial gingival fibromatosis：An unusual pathology. J Oral Pathol 1972；1：76-83.
– reference: 16) Gawron K, Łazarz-Bartyzel K, Potempa J, et al. Gingival fibromatosis：Clinical, molecular and therapeutic issues. Orphanet J Rare Dis 2016；11：9.
– reference: 12) 有田憲司，阿部洋子，仲野和彦，他．日本人小児における乳歯・永久歯の萌出時期に関する調査研究Ⅱ―その1．乳歯について―．小児歯誌2019；57：45-53．
– reference: 5) Casetta I, Granieri E, Desidera M, et al. Phenytoin-induced gingival overgrowth：A community-based cross-sectional study in Ferrara, Neuroepidemiology 1997；16：296-303.
– reference: 9) 木村将士，町田純一郎，山口聖士，他．歯肉切除後に長期経過観察を行った遺伝性歯肉線維腫症の1例．日口外誌2013；59：708-12．
– reference: 11) Suneja B, Chopra S, Thomas AM, et al. Clinical evaluation of gingival overgrowth in children on antiepileptic drug therapy. J Clin Diagn Res 2016；10：32-6.
– reference: 13) Trackman PC, Kantarci A. Molecular and clinical aspects of drug induced gingival overgrowth. J Dent Res 2015；94：540-6.
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SubjectTerms Gingival hyperplasia
Symptomatic generalized epilepsy
Tooth impaction
Title Unexplained Gingival Hyperplasia in a Girl with Symptomatic Generalized Epilepsy Resulting in Tooth Impaction of Primary Teeth―Report 1
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