This study will examine common features of gingival overgrowth (excessive growth of the gums
around the teeth) that develops in patients with the hereditary form of the condition and in
those who develop the condition as a side effect of medications. A better understanding of
gingival overgrowth may help scientists develop medications with fewer oral side effects.
Patients of any age with hereditary gingival fibromatosis and their blood relatives, and
patients of any age with gingival overgrowth who are taking medications associated with
development of the disorder, including phenytoin (diphenylhydantoin or Dilantin),
cyclosporine, and calcium-channel blockers, may be eligible for this study.
Participants undergo a medical and dental history, including a history of medication use;
detailed examination of the teeth, periodontium, head, and neck; photographs of teeth with
gingival overgrowth; dental x-rays; and blood tests. DNA is extracted from a blood sample to
look for genes related to gingival overgrowth.
Patients with gingival overgrowth are offered two options, as follows:
- Tissue biopsy: A tissue sample is taken from each affected site, with a maximum of
three biopsies. For the procedure, lidocaine is first injected into the gum to numb the
tissue. Then, a cookie-cutter instrument is pushed into the numbed skin, and a small
piece of tissue is removed.
- Gingivectomy: Surgical removal of the overgrown gingival.
The purpose of this protocol is twofold: 1) to continue identification of genes associated
with hereditary gingival fibromatosis (HGF), a type of gingival overgrowth 2) to investigate
the genes up-regulated by medications that induce gingival overgrowth. These studies will
establish if common mechanisms are involved in the hereditary and drug-induced processes. If
a common pathway is identified, it could lead to the development of assays that could be
used to screen new medications for their potential deleterious effects on periodontal
tissues. In addition, understanding the mechanisms involved in gingival overgrowth could
lead to the development of tissue engineering approaches to repair gingival defects. Genes
will be identified from DNA samples collected from patients with hereditary gingival
fibromatosis. These will be compared with DNA and tissue samples taken from patients taking
medications known to induce gingival overgrowth (phenytoin, cyclosporine and calcium channel
- INCLUSION CRITERIA:
Patients of any age, gender, and racial/ethnic group with hereditary gingival fibromatosis
(HFG) as diagnosed with HGF by clinical appearance that consists of attached gingival
covering the lower 1/3 or more of the clinical crowns of teeth in an individual not taking
medications associated with gingival changes.
Blood relatives of affected individuals who are at risk of inheriting HGF.
Patients of any age, gender, and racial/ethnic group taking one of the three medications
associated with drug-induced gingival overgrowth (phenytoin diphenylhydantoin or Dilantin,
cyclosporine, or calcium-channel blockers).
Patients with six or more teeth.
Patients with significant cognitive impairment.
Pregnant patients or lactating patients.
Patients unwilling to give informed consent.
Patients with less than six teeth.