Management of an Idiopathic Gingival Fibromatosis (Elephantiasis): A Case Report With a Two-Year Follow-up

Background: Generalized gingival enlargement can arise from various causes. It may be hereditary, as observed in hereditary gingival fibromatosis, which occurs in association with syndromic conditions or results from the side effects of certain systemic medications such as phenytoin, cyclosporin, and nifedipine. This report discusses the condition of a 13-year-old girl who exhibited severe gingival overgrowth affecting both maxillary and mandibular arches, leading to substantial coverage of nearly all her teeth. The differential diagnosis included drug-induced enlargement and idiopathic gingival fibromatosis. Methods: A conventional flap surgery alongside osteoplasty was performed to address the excess gingival tissue. Due to the generalized nature of the enlargement, the surgery was conducted quadrant by quadrant. Results: The postoperative recovery was smooth, and the patient showed significant improvements in appearance. Follow-up evaluations over two years post-surgery indicated that the gingival condition remained stable. Conclusion: Idiopathic gingival fibromatosis, although rare, is marked by significant gingival overgrowth. Surgical resection enhances aesthetics and improves functionality. While the recurrence of the condition is common, it may be managed or delayed through careful monitoring and scheduled follow-up appointments.