目的:遗传性牙龈纤维瘤病(HGF)是一种罕见的,遗传性牙龈缓慢进行性纤维增生。由于它与咀嚼有关,演讲,和咬合问题,早期诊断很重要。我们试图总结有关流行病学的现有数据,临床特征,和HGF患儿(<18岁)的结局。
方法:对MEDLINE和CochraneLibrary数据库进行了系统文献综述,涉及系统综述和荟萃分析声明的首选报告项目(搜索结束日期:2019年3月1日)。
结果:共纳入报告146例患者的99篇文章。平均年龄10.82±3.93岁,在97.16%(95%CI92.69至99.14)中发现了广泛的牙龈肿大。下巴,牙龈,和牙齿异常;口腔卫生差;进食;或言语困难是典型的HGF引起的,而60.90%有口外表现(95%CI52.41~68.78)。该疾病通常以常染色体显性遗传(88.41%,95%CI78.5至94.26),约三分之一的患者患有综合征性HGF(33.85%,95%CI23.50至46.00)。在大多数情况下进行了牙龈切除术(91.15%,95%CI84.31至95.29),复发的发生率为33.85%(95%CI23.50至46.00)。
结论:在有结节和牙龈纤维化的儿童中应怀疑HGF,牙齿异常,或下巴变形。家族史可以帮助建立诊断。
结论:更多病例应关注牙龈切除术后的长期随访,因为疾病复发并不少见。
OBJECTIVE: Hereditary gingival fibromatosis (HGF) is an uncommon, inherited condition with slow and progressive fibrous hyperplasia of the gingiva. Due to its association with mastication, speech, and occlusion problems, early diagnosis is important. We sought to summarize the available data regarding the epidemiology, clinical characteristics, and outcomes of children with HGF (< 18 years).
METHODS: A systematic literature review of the MEDLINE and Cochrane Library databases was conducted with respect to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (end-of-search date: March 1, 2019).
RESULTS: A total of 99 articles reporting on 146 patients were included. The mean age was 10.82 ± 3.93 years, and generalized gingival enlargement was seen in 97.16% (95% CI 92.69 to 99.14). Jaw, gingival, and teeth abnormalities; poor oral hygiene; eating; or speech difficulties were typical HGF-induced, while 60.90% had extraoral manifestations (95% CI 52.41 to 68.78). The disease was most commonly inherited in an autosomal dominant manner (88.41%, 95% CI 78.5 to 94.26), and about one-third of the patients had syndromic HGF (33.85%, 95% CI 23.50 to 46.00). Gingivectomy was performed in the majority of cases (91.15%, 95% CI 84.31 to 95.29), and recurrence was seen in 33.85% (95% CI 23.50 to 46.00).
CONCLUSIONS: HGF should be suspected in children with nodularity and gingival fibrosis, teeth abnormalities, or jaw distortion. Family history can help to establish the diagnosis.
CONCLUSIONS: More cases should focus on longer-term follow-up after gingivectomy as disease recurrence is not uncommon.