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A Periodontal Perspective on the Successful Treatment of Recurrent Benign Gingival Lesions Affecting the Anterior Dentition: Two Case Reports

Hannah A. Liss, DDS/Yu Wang, DDS, MDS, MS, DMD/Reza Hakim Shoushtari, DMD, MS/Dennis Sourvanos, BSDH, DDS/Faizan Alawi, DDS/Joseph P. Fiorellini, DMD, DMS/Jonathan Korostoff, DMD, PhD

DOI: 10.11607/prd.6137

Recurrent benign gingival lesions occurring in the anterior dentition are clinical dilemmas. While complete removal of such lesions is required to prevent recurrence, this can result in a poor esthetic outcome. Relative to this conundrum, this report discusses the diagnosis, psychological management and clinical treatment of two patients with recurring lesions on the facial gingiva of the mandibular and maxillary incisors, respectively. Patient A, a 55-year-old Caucasian female, presented with a recurrent peripheral ossifying fibroma (POF) and Patient B, a 76-year-old Caucasian male, presented with a recurrent pyogenic granuloma (PG). Both patients underwent multiple procedures and were ultimately treated without recurrence of their lesions. The efficacious surgical treatment of recurrent gingival lesions, such as POF and PG, requires an aggressive approach involving removal of the lesion as well as a 1.0 to 2.0 mm margin of normal tissue, underlying alveolar bone, and associated periodontal ligament. The rationale for this approach is explained stressing the potential periodontal and esthetic ramifications that were considered. In summary, when recurrent benign gingival lesions are localized to the anterior part of the mouth, the approach to their surgical removal should be modified to minimize the extent of gingival recession and other potential esthetic issues. Int J Periodontics Restorative Dent. doi: 10.11607/prd.6137

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