Mandibular Gingiva Research Articles

Dysplastic Lesions of the Gingiva: Prevalence and Risk Factors Including Human Papillomavirus (HPV) Infection

<h3>Background</h3> Verrucous gingival lesions are common within the spectrum of proliferative verrucous leukoplakia (PVL), and the gingiva is not an unusual location for oral carcinoma. However, non-PVL associated dysplastic gingival lesions appear to be less common and may not progress directly to malignancy. In addition, it appears HPV likely plays a limited etiologic role in any form of dysplasia of the gingiva. <h3>Materials and Methods</h3> Following IRB approval, all "dysplasia" cases between 2009-2019 were identified from the archives of the University of Florida Oral Pathology Biopsy Service. Exclusion criteria included verrucous lesions, lesions from multiple sites compatible with PVL, and cases diagnosed as mild atypia/dysplasia. The remaining gingival dysplasia cases were evaluated for age, gender, contributory history, clinical appearance/impression, symptoms, duration, and p16INK4a immunohistochemistry (IHC) results. <h3>Results</h3> A total of 72 biopsies were included in our database from 54 patients. The mean age was 70.3 years (range of 27 - 90), with a female: male ratio of 1.4:1. 69.4% (n=50) were located on the posterior gingiva and 62.5% (n=45) the mandibular gingiva. Reported contributing histories included smoking (n=9, 12.5%), previous oral dysplasia (n=9, 12.5%), or oral cavity malignancy (n=24, 33.3%). The two most common clinical impressions were leukoplakia (n=16, 16.7%) and carcinoma (n=18, 25%). Twenty-five of the 72 cases (34.7%) were symptomatic with pain, swelling and/or bleeding. The most recent biopsy from 32 of the patients was low-grade dysplasia, 34 had high-grade dysplasia, and 6 koilocytic dysplasia. Only 4 of 6 koilocytic dysplasia cases were positive for p16, with no low-grade or high-grade lesions demonstrating positivity. <h3>Conclusion</h3> This study confirms that p16 expression is rarely present in dysplastic lesions of the gingiva, unless koilocytic dysplasia is also present.

Oral Melanoacanthoma: A series of 33 cases and Review of the Literature

<h3>Background</h3> Oral Melanoacanthoma (OM) is an unusual, likely reactive heavily pigmented, benign epithelial proliferation. OM often grows rapidly mimicking melanoma and leading to anxiety for both the patient and the clinician. We present a large series of OM including demographics, description of clinical appearance and characteristics, histology, and literature review. To the best of our knowledge, this is the largest series of OM reported to date. <h3>Materials and Methods</h3> Following IRB approval, OM cases from the University of Florida Oral Pathology Biopsy Service archives (1998-2020) were included. Demographics and clinical features were collected and slides were reviewed. <h3>Results</h3> 33 cases were included with a mean age of 38 years, female: male ratio of 2.6:1. The most common location was buccal mucosa (n = 16, 48.48%), followed by palate (n = 11, 33.33%), tongue and labial mucosa (n = 2 each, 6.06%), maxillary and mandibular gingiva (n = 1 each, 3.03%). Most lesions are dark black/brown, and often described as macular in nature. Duration ranged from one week to twelve months, and all cases were asymptomatic. The clinical impression in the majority of cases were that of a benign melanotic lesion. Ethnicity was only documented in 6/33 cases, of which five cases were African American and one was Caucasian. Histomorphologically, majority of cases (n=27, 81.8%) were hyperplastic/acanthotic, while atrophic epithelium cases were (n=4, 12.1%) and less commonly, spongiotic epithelium cases were (n=2, 6.06%). <h3>Conclusion</h3> The findings of this study are consistent with those in the literature concerning demographics and clinical presentation. Histologically, presence of dendritic melanocytes extending into the spinous cell layer along with acanthosis of the spinous cell layer is diagnostic for OM when combined with the clinical presentation. However, it is important to add cases of OM to the literature so clinicians can be more aware of this lesion.

Solitary Gingival Lymphangioma: Case Series and Review of Literature

Lymphangiomas are benign malformations of lymphatic vessels. These anomalies likely arise from proliferation of lymphatic channels that do not communicate normally with the rest of the lymphatic system. Lymphangiomas show a marked predilection for the head and neck region with nearly 90% of cases clinically evident at the time of birth or during the first two years of life. Oral lymphangiomas are less common. The most common intraoral location is the anterior two thirds of the tongue followed by buccal mucosa. Extremely rare cases of solitary gingival lymphangiomas have been reported in the English language literature. Here we report an additional twenty cases of these rare solitary gingival lymphangiomas. Our cases demonstrate a 2:1 female-to-male ratio with a predilection for the first two decades of life. These cases show a nearly equal distribution between the maxillary and mandibular gingiva with a notable predisposition for the anterior gingival tissue presenting as hyperplastic, pebbly, and vesicular lesions. Microscopically, all the cases exhibit superficial thin, endothelial-lined lymphatic channels containing a luminal proteinaceous material. Immunohistochemical staining for D2-40 (podoplanin) was available for one of our cases and demonstrates cytoplasmic immunoreactivity of endothelial cells. These findings suggest gingival lymphangiomas, while uncommon, should be included in the differential diagnosis of the vesicular lesions of the gingiva.

Linear IgA Bullous Dermatosis adult variant: A report of a rare case and review of literature

Linear IgA bullous dermatosis is a rare autoimmune disorder of the skin and mucous membrane triggered by im- munoglobulin A autoantibodies directed against several different antigens in the basement membrane zone. This condition can affect both children and adults. Based on the age at the time of diagnosis it is categorized into two subtypes, Linear IgA bullous dermatosis of childhood and Linear IgA bullous dermatosis of the adult. The affected patients can present with lesions on the skin and/or mucous membrane. The adult form mainly affects the skin of the trunk, limbs, face and oral mucosa and can be associated with ulcerative colitis. Intraorally it can present as desquamative gingivitis, erosions or ulcers and intact vesicles or bullae. The palate, palatine arches, buccal mucosa and gingiva are the most frequently affected intraoral sites. As the lesion mimics mucous membrane pemphigoid both clinically and microscopically it may present a diagnostic challenge. Immunofluorescence studies are neces- sary for a definitive diagnosis of this condition. We report a case of Linear IgA bullous dermatosis in a 90 year old male patient who presented with desquamative gingivitis involving both the anterior maxillary and mandibular facial gingiva. Further investigation and physical examination by a dermatologist revealed cutaneous and extrao- ral mucosal lesions. The clinical presentation, histopathological features, immunofluorescence findings along with a review of the literature of this rare condition will be presented.

Oral Focal Mucinosis, an uncommon entity: Report of three cases

<h3>Introduction</h3> Oral focal mucinosis (OFM) is a rare soft tissue lesion of unknown etiology and it is considered the oral counterpart of cutaneous focal mucinosis or cutaneous myxoid cyst. The pathogenesis of OFM may be explained by fibroblast overproduction of hyaluronic acid. Clinically, it appears as painless swelling of the same color as the surrounding mucosa. The gingiva is the most common site and the diagnosis is established only by histopathological and immunohistological examination. <h3>Materials and Methods</h3> We present three cases of gingival oral focal mucinosis. Case 1: 40 year-old womatn with painless and slow-growing swelling of two years of evolution at buccal mandibular gingiva, between lateral incisor and canine. The lesion measured 2 cm. and exhibited the same color as the overlying mucosa; there was not radiographic involvement. Case 2: 48 year-old female with a hard palatal swelling. The lesion was sessile, firm, and not color change Case 3: 36 year-old male with a painless and same color as the normal mucosa gingival swelling. The lesion was between central and lateral right incisors, it was sessil and measured 1.5 cm Results In the three cases excisional biopsy was performed and histopathologically they shown the proliferation of elongated and mucinous material in a myxoid matrix. This myxoid stroma was surrounded by collagenous fibrous connective tissue and covered with squamous epithelium. Histochemical staining with Alcian blue was positive in the mucinous areas Conclusions These three cases are significant clinically as well as histopathologically. The lesions clinically mimic an ossifying peripheral fibroma or a fibroma. Thus, the histopathological and histochemical findings with special stains, such as Alcian blue, are determinant to establish the diagnosis of these conditions. Treatment is the complete surgical excision and its recurrence is not reported.

Lymphoepithelial carcinoma of the oral mucosa. A rare histopathologic subtype of squamous cell carcinoma

<h3>Objectives</h3> Lymphoepithelial carcinoma (LEC) represents a rare histopathologic subtype of squamous cell carcinoma (SCC), which shares morphologic similarities with non-keratinizing undifferentiated nasopharyngeal carcinoma (NPC). LEC may be etiologically associated with EBV, especially in endemic regions. Although being described in several locations of the head and neck, the oral mucosa seems to be an infrequent site of involvement. Herein, we present a case of an EBV-negative oral LEC and discuss the diagnostic challenges. <h3>Findings</h3> A 51 year-old male Filipino patient suffering from chronic kidney disease presented for the evaluation of a swelling in the right mandible, first noticed by the patient a few days ago. Clinically, the right posterior mandibular gingiva appeared enlarged and hemorrhagic, covered by ulcerated mucosa, while the adjacent teeth displayed high mobility. Extraorally, a painful and slightly movable lymph node in the right submandibular area was palpated. Radiographic evaluation revealed extensive bone loss in the right posterior mandible. With a provisional diagnosis of lymphoma or SCC, an incisional biopsy was performed. Histopathologic examination revealed invasion of the underlying connective tissue by pleomorphic cells of epithelioid morphology, occasionally arranged in syncytial islands, arising from a partially ulcerated, non-keratinized squamous epithelium. A prominent diffuse lymphocytic cell infiltrate surrounding the tumor cells was also detected. The neoplastic cells expressed pancytokeratin, CK5/6, p63, and p40, while p16, LMP-1, and in situ hybridization for EBV RNA were negative. A final diagnosis of moderately to poorly differentiated SCC with features indicative of LEC was rendered and the patient was referred for further management. <h3>Conclusions</h3> LEC should be considered in the differential diagnosis of undifferentiated malignant neoplasms displaying close association with diffuse lymphoid aggregates. The evaluation of nasopharynx is justified to rule out metastatic NPC, as the separation of these two entities microscopically is not feasible.

METASTATIC LEIOMYOSARCOMA OF THE PALATAL GINGIVA MASQUERADING AS A PYOGENIC GRANULOMA

Leiomyosarcoma (LMS) is a smooth muscle neoplasm, accounting for 7% of soft-tissue and 1-4% of head-neck sarco- mas. Oral-LMS is extremely uncommon and may represent primary or metastatic disease. We describe a 46-year- old female with a medical history of "stomach cancer" who presented with a palatal mass. Upon further inquiry, it was discovered that the patient had been diagnosed with high-grade LMS of the retroperitoneum six years prior, which had been treated with radical resection and right nephrectomy followed by post-operative radiation and ad- juvant chemotherapy. She subsequently developed liver metastasis requiring modification of her chemotherapy. However, she had elected to discontinue treatment one year prior to the presentation of the oral lesion. A biopsy of the palatal mass revealed a malignant spindle-cell proliferation expanding the overlying epithelium, with brisk mitotic activity and atypical mitosis, nuclear pleomorphism, and focal areas of tumor necrosis, raising the concern for LMS. Immunohistochemical (IHC) stains for SMA were strongly positive while negative for DOG1 and CD 117. Based on the history and supportive histopathological and IHC findings, a diagnosis of metastatic LMS of the palate was given. Oral metastases of LMS are exceedingly rare and aggressive lesions that arise mostly in females in their sixth-decade. Literature review shows that metastases to the tongue, gingiva, lip, and buccal mucosa are typically associated with primary uterine tumors, while metastasis to the mandibular gingiva is documented frequently with non-uterine primaries. Clinically, lesions can present as a nonspecific painful mass. Microscopic diagnosis is often challenging due to significant overlap with other spindle-cell neoplasms, requiring careful correlation with medical history, physical examination, and ancillary studies. We herein report a rare case of a retroperitoneal LMS that metastasized to the palate. A literature review of metastatic oral-LMS and retrospective institutional analysis of oral metastases will also be presented.

Giant Cell Fibroma Clinically Mimicking Malignancy: A Case Report

Giant Cell Fibroma (GCF) is a benign rare fibrous lesion that predominantly occurs on the mandibular gingiva. Clinically, it is presented as a sessile or pedunculated mass that frequently occurs in the third decade with a slight female predilection. The lesion is usually characterized by stellate and multinucleated fibroblasts located in the lamina propria near the overlying epithelium and radiographically treated as a benign lesion.&#x0D; A 20-year-old female was referred to the Oral and Maxillofacial Medicine Department of Semnan Dental School, with the chief complaint of tooth displacement and gingivitis. Clinical examination revealed maxillary protrusion, mouth breathing, localized gingivitis in the interdental areas of the papilla of the lateral and canine teeth; also alveolar bone with pus discharge in the right mandibular premolar area. Radiographically, the lesion leads to the bone resorption and linguistic movement of the teeth in the right side of Mandible. There were no root resorption and no bone expansion. Gentle scaling and root planning, biopsy, and second premolar extraction were performed. The presence of the giant fibroblasts in superficial connective tissue confirmed the diagnosis of Giant Cell Fibroma. At the follow-up session, tissue repair was accomplished, and the first premolar was immobile and was no longer loose.&#x0D; Nevertheless, further studies are required to investigate the precise nature of the mono or multinucleated cells, i.e., atypical fibroblasts that illustrate degenerative and functional changes. Moreover, a high index of suspicion and appropriate analytical examination is required for distinct lesions to achieve a proper diagnosis and suggest an appropriate treatment.

Changing Trends in Benign Human Papillomavirus (HPV) Related Epithelial Neoplasms of the Oral Cavity: 1995-2015.

Human papillomavirus (HPV)-related benign papillary epithelial neoplasms are common lesions affecting any region of the oral cavity. This study evaluated the trends in frequency, location, and demographics of these lesions over 20 years in a large biopsy service. Following IRB approval, the archives of UF Oral Pathology Biopsy Service between 1995 and 2015 were queried. Cases diagnosed as squamous papilloma, verruca vulgaris, and condyloma acuminatum were included. Extraoral locations, inconclusive diagnoses, or syndrome-related HPV lesions were excluded. Age, gender, location, clinical presentation, and diagnoses were recorded. Data from one calendar year per 5-year span was assessed including the years 1995, 2000, 2005, 2010, and 2015. A total of 1458 cases were identified over the total 5 calendar years assessed. Papilloma as a percentage of total biopsies per year was as follows: 1995 (2.6%), 2000 (3.3%), 2005 (3.6%), 2010 (4.0%) and 2015 (4.5%), representing a 73% (1.9×) percentage increase. Males (56%) were affected more commonly; however, in patients under 19 years, a female predominance was observed. The overall percentage of lesions in females increased by 30.6% over the time frame. The mean age was 54 years (range 1-93 years) with an increase of 10 years over time. About 1.1% of patients had multifocal lesions and 0.2% had a recurrence. In descending order of frequency, the tongue, soft palate, and mandibular gingiva were most involved. Maxillary gingiva and lower lip were the most common locations in patients under 19. Location varied over time, however, the biggest increase was noted for lesions on the gingiva. Squamous papilloma was the most common histologic variant (93.6%). The incidence of benign HPV-related oral lesions increased substantially over the 2 decades studied. This increase was statistically significant with a p-value <0.00045. Other trends noted included increase in the following: the average age, female involvement, and gingival location. Our results indicate a trend for the overall increase in the prevalence of benign oral HPV lesions in our population.

Oral carcinoma cuniculatum: an unacquainted entity with diagnostic challenges\u2014a case report

BackgroundOral carcinoma cuniculatum (OCC) is an unacquainted well-differentiated subtype of oral squamous cell carcinoma, which displays unique clinic-pathological features. Up to date, OCC remains rare with about 75 reported cases, and is frequently missed or even misdiagnosed.Case presentationThe aim of the present work was: to report a case of OCC in mandibular gingiva and to highlight its main clinic-pathological diagnostic features: with an exophytic cobble-stone surface and a characteristic endophytic burrowing architecture, as well as to differentiate between it and other closely similar lesions including verrucous carcinoma, papillary squamous cell carcinoma, and well-differentiated conventional oral squamous cell carcinoma.ConclusionsAn accurate diagnosis of OCC entails awareness of the clinicians and pathologists about its entity, proper knowledge of the diagnostic clinical and histopathological evidence, and the ability to differentiate it from closely similar lesions.

Ossifying fibrous epulis as an IgG4-related disease of the oral cavity: a case report and literature review

BackgroundFibrous sclerosing tumours and hypertrophic lesions in IgG4-related disease (IgG4-RD) are formed in various organs throughout the body, but disease in the oral region is not included among individual organ manifestations. We report a case of ossifying fibrous epulis that developed from the gingiva, as an instance of IgG4-RD.Case presentationA 60-year-old Japanese man visited the Department of Oral and Maxillofacial Surgery, Gunma University Hospital, with a chief complaint of swelling of the left mandibular gingiva. A 65 mm × 45 mm pedunculated tumour was observed. The bilateral submandibular lymph nodes were enlarged. The intraoperative pathological diagnosis of the enlarged cervical lymph nodes was inflammation. Based on this diagnosis, surgical excision was limited to the intraoral tumour, which was subsequently pathologically diagnosed as ossifying fibrous epulis. Histopathologically, the ossifying fibrous epulis exhibited increased levels of fibroblasts and collagen fibres, as well as infiltration by numerous plasma cells. The IgG4/IgG cell ratio was > 40%. Serologic analysis revealed hyper-IgG4-emia (> 135 mg/dL). The patient met the comprehensive clinical diagnosis criteria and the American College of Rheumatology and European League Against Rheumatism classification criteria for IgG4-RD. Based on these criteria, we diagnosed the ossifying fibrous epulis in our patient as an IgG4-related disease. A pathological diagnosis of IgG4-related lymphadenopathy was established for the cervical lymph nodes. Concomitant clinical findings were consistent with type II IgG4-related lymphadenopathy.ConclusionsA routine serological test may be needed in cases with marked fibrous changes (such as epulis) in the oral cavity and plasma cells, accompanied by tumour formation, to determine the possibility of individual-organ manifestations of IgG4-related disease.

Peripheral acanthomatous mandibular ameloblastoma - A rare case report

Peripheral ameloblastoma (PA) is a rare odontogenic neoplasm occurring commonly in the mandibular gingiva with prevalence of 1–5%. It clinically resembles other peripherally occurring lesions like pyogenic granuloma, peripheral ossifying fibroma, peripheral giant cell granuloma, and squamous papilloma. This paper describes a rare case of peripheral acanthomatous ameloblastoma in a 60-year-old male involving anterior mandibular region which was treated successfully with enucleation and chemical cauterization.

Forearm tendinocutaneous flap reconstruction in a patient with carcinoma of the mandibular gingiva extending deeply to the lower lip

Forearm tendinocutaneous flap reconstruction in a patient with carcinoma of the mandibular gingiva extending deeply to the lower lip

A case of squamous cell carcinoma of the mandibular gingiva in patient who developed pulmonary thromboembolism during cetuximab with FP therapy

A case of squamous cell carcinoma of the mandibular gingiva in patient who developed pulmonary thromboembolism during cetuximab with FP therapy

Hemorrhagic enlargement of the mandibular gingiva

A 50-year-old woman sought treatment for a 4-month history of pain and bleeding of the mandibular anterior gingiva. She reported a swelling on the back of the mandibular anterior teeth that had increased in size over time. She also reported numbness and increased mobility of the mandibular anterior teeth that had begun 2 months earlier. The patient had self-medicated with 500 mg of acetaminophen without significant improvement of symptoms. Her medical history was significant for leukemia, in remission for 3 years after chemotherapy.

Lung carcinoma presenting as bilateral metastases in the mandibular gingivae: a case report and literature review

This case report describes the rare presentation of lung carcinoma as bilateral masses affecting the mandibular gingivae. Although metastatic disease to the mouth is rare, accounting for only 1% of oral malignancies, it is essential to ensure that the presence of cancer is included in any differential diagnosis. CPD/Clinical Relevance: All oral abnormalities persisting for longer than 3 weeks should be referred urgently for specialist assessment and biopsy.

Effectivity of Camellia sinensis Extract with Nanochitosan to Fibroblast Amounts of Wistar Rats Gingival Wound Healing Process

Green tea (Camellia sinensis) has high level of flavonoids which are proven to have anti-inflammatory activity. Effect of flavonoids can be enhanced by nano-chitosan capsulation as drug carrier. Chitosan is polysaccharide derived from crustacean shells that mostly used as matrix of various drugs and plant extracts. The aim of this study was to determine the effectivity of flavonoids in green tea extract in nanochitosan capsulation towards the number of fibroblasts on proliferative phase of gingival wound healing process. Green tea was extracted, encapsulated with nano-chitosan and then made into gel. Gingiva labial of 24 male white 3-month-old Wistar rats were wounded by punch biopsy (2 mm diameter), then were treated two times a day, and were divided randomly into four groups of topical gel applications: green tea extract gel encapsulated nano-chitosan, green tea extract gel, base gel as negative control, and NSAIDs gel as positive control, starting at 0 day until 7th day. At 5th and 7th day, three rats from each group were decapitated and the mandibular gingiva was taken in order to make histology slides with hematoxylin eosin staining. Under microscope, the number of fibroblasts were examined. The data were analysed using ANOVA test with 95% confidence level. The results showed that the number of fibroblasts on proliferative phase was significantly higher than control negative (p &lt; 0.05) and has no significant differences (p &gt; 0.05) with control positive. In conclusion, topical application of green tea extract gel encapsulated nano-chitosan was effective to accelerate rats gingival wound healing process by increasing the fibroblasts.

GENERAL PROFILE OF THE GINGIVAL LESIONS PRESENTED BY EPULIS: AN ANALYSIS OF 90 CASES

<h3>Background</h3> Epulis is a nonspecific historical term applied to localized enlargement of gingiva. Although gingival enlargement often develops because of simple reactive lesions, it sometimes may also be the clinical presentation form of malignant and benign neoplastic lesions. <h3>Objective and Methods</h3> A total of 90 cases with a clinical diagnosis of "epulis" were included in the study. Histopathologic findings of the cases were analyzed with demographic and clinical information. <h3>Results</h3> Of the 90 patients, 65 were female (72.2%) and 25 were male (27.8%). The mean age was 40.13 ± 18.04 years (range, 6 days to 78 years) and about one-third of cases were discovered in the fifth decade. The most frequent localization was mandibular gingiva (50 cases) compared to the maxillary gingiva. Histopathologically, reactive lesions were detected in the vast majority of cases and only 11 cases had a neoplastic lesion (12.2%). The most detected reactive lesion was peripheral giant cell granuloma (38.9%), followed by focal fibrous hyperplasia (35.6%) and pyogenic granuloma (13.3%). Of the 11 neoplastic lesions, 6 benign tumors (2 congenital granular cell tumor, 1 lipoma, 1 osteoma, 1 peripheral developing odontoma, and 1 peripheral ossifying fibroma) and 5 malignant tumors (2 Langerhans cell histiocytosis, 1 malignant melanoma, 1 mucoepidermoid carcinoma, and 1 osteosarcoma) were diagnosed. <h3>Conclusions</h3> In our study, neoplastic lesions were detected in 12.2% of patients and the risk of malignancy was determined as 5.5% in lesions presented by epulis. Histopathologic examination is a gold standard for differentiation of such lesions.

Endoscopically Assisted Marginal Mandibulectomy Using an Intraoral Approach Alone for Squamous Cell Carcinoma of the Posterior Mandibular Gingiva: A Technical Note.

Technical note. Marginal mandibulectomy is a surgical procedure for treatment of mandibular gingival tumors. The intraoral approach to the posterior region of the mandible for marginal mandibulectomy is difficult due to limited access and operating field visibility; the conventional surgical procedure may require some skin incisions. This report discusses the effectiveness of endoscopic assistance in marginal mandibulectomy. This article describes endoscopically assisted marginal mandibulectomy using an intraoral approach alone for squamous cell carcinoma of the posterior mandibular gingiva. The advantages of this surgical method are twofold: (1) superior visibility to the lower edge of the mandible without any skin incision; and (2) safe surgical confirmation of important anatomy on the buccolingual side (e.g., mental foramen, lingual nerve, mandibular foramen, and neurovascular bundle). This minimally invasive approach without any skin incision, as well as the superior visibility of the operating field, are important advantages of endoscopically assisted marginal mandibulectomy that cannot be obtained by other surgical methods. Endoscopically assisted marginal mandibulectomy using an intraoral approach alone may be useful because it avoids damage to facial skin and improves safety by employing an enlarged bright field.

Management of localised gingival overgrowth: An overview from a case report

Gingival overgrowth presents itself in various forms and clinical features. Gingival overgrowth can have localised or generalised presentation. It becomes a reason of primary concern when it appears in area of aesthetics. This case report focuses on the diagnosis and treatment of a male patient who had reported to the department with gingival overgrowth. The patient reported with localised gingival overgrowth involving the mandibular anterior region. The gingival overgrowth was a single well defined overgrowth involving the buccal aspect of mandibular gingiva. Thorough blood investigations and radiographic investigations were carried out. The case report highlights the management of localised gingival overgrowth.