Idiopathic gingival fibromatosis is a gradually progressive benign enlargement that affects the marginal, interdental, & attached gingiva
. The fibromatosis may potentially cover the exposed tooth surfaces, thereby hampering the functioning of the stomatognathic system.
Some sources define it as merely another form of GCF, (8, 10) but the retrocuspid papilla has a very characteristic location on the mandibular lingual attached gingiva
, inferior to the canine.
All the periodontal parameters including plaque index, gingival index, probing depth, clinical attachment level and number of gingival recessions were compared with the mean width of keratinized gingiva and thickness of attached gingiva
using Karl Pearson correlation coefficient within the groups.
In addition to the loss of attached gingiva
, observations in this case included ulcerations at the free gingival margin, tooth abrasion, deposits of dental plaque related to the affected area and an increase in dental hypersensitivity.
However, if gingivectomy removes all of the attached gingiva
, creating mucogingival problems, then flap operation is indicated.
In the present report, the patient was 51 years old and the cyst was located in the attached gingiva
between the mandibular left canine and first incisor, as expected according to the literature reviewed herein.
The advantages of lateral pedicle flap are its simplicity, presence of only one surgical site and good vascularity of pedicle.9,10 Whereas its disadvantages are that the amount of keratinized attached gingiva
that is the pre requisite, probable recession at donor site, dehiscence or fenestration at donor and limitation to only 1 or 2 teeth.
On clinical examination a solitary well defined spherical shaped ulcer was seen on right posterolateral part of palate measuring about 2 x 2 cm extending anteriorly from 16 regions and posteriorly till junction of hard & soft palate, medially 1 cm away from median palatine raphae and laterally till attached gingiva
in relation to 16, 17, 18.
Aphthous ulcers never appear on hard tissues like the hard palate and attached gingiva
; they will appear on soft tissues like unattached moveable mucosa, the floor of the mouth (figure 5) and the tongue (figure 3).
The amount of attached gingiva
can be calculated by subtracting the probing depth from the width of the keratinized gingiva.
Thin biotypes are delicate, highly scalloped and translucent in appearance.The soft tissue appears to be delicate and friable with minimal amount of attached gingiva
and thin labial plate with possible presence of dehiscence and fenestrations.Thin scalloped biotypes are considered to be at risk as they have been associated with compromised soft tissue response following surgical or restorative treatment.
Camargo, "The modified apically repositioned flap to increase the dimensions of attached gingiva
: the single incision technique for multiple adjacent teeth," International Journal of Periodontics and Restorative Dentistry, vol.