|Year : 2015 | Volume
| Issue : 1 | Page : 13-15
Prevalence of gingival fibrous nodule in South Indians
Srikanth H Srivathsa1, Karthikeya Patil2, Mahima V Guledgud2
1 Department of Oral Medicine and Radiology, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka, India
2 Department of Oral Medicine and Radiology, JSS Dental College and Hospital, JSS University, Mysore, Karnataka, India
|Date of Submission||09-Oct-2014|
|Date of Acceptance||13-Jul-2015|
|Date of Web Publication||12-Oct-2015|
Srikanth H Srivathsa
Department of Oral Medicine and Radiology, Sri Hasanamba Dental College and Hospital, Vidyanagar, Hassan - 573 202, Karnataka
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Aims and Objectives: Gingival fibrous nodule is considered a normal variant of oral mucosa. So far no studies have been done to determine the prevalence and other characteristics of this entity. Hence, this study was taken up to study the prevalence of gingival fibrous nodule is south Indians. Materials and Methods: This clinical study consisted of 4642 adult subjects who were examined for the presence of gingival fibrous nodules. The age range of the subjects was 10-89 years. The study consisted of 2818 males and 1824 females. Results: One hundred and forty-five gingival fibrous nodules were identified in 128 individuals with a prevalence of 2.75%. They were predominant in males, in the mandibular anterior region. Multiple gingival fibrous nodules were more common than solitary form. Conclusion: This study demonstrates the prevalence of gingival fibrous nodules in south Indians.
Keywords: Gingival, fibrous nodules, gingival papules, muco-gingival papule
|How to cite this article:|
Srivathsa SH, Patil K, Guledgud MV. Prevalence of gingival fibrous nodule in South Indians. J Indian Acad Oral Med Radiol 2015;27:13-5
|How to cite this URL:|
Srivathsa SH, Patil K, Guledgud MV. Prevalence of gingival fibrous nodule in South Indians. J Indian Acad Oral Med Radiol [serial online] 2015 [cited 2020 May 26];27:13-5. Available from: http://www.jiaomr.in/text.asp?2015/27/1/13/167067
| Introduction|| |
Gingival fibrous nodule (GFN) is considered a normal variant of the oral mucosa. It appears as a raised, pink to yellowish-colored nodule occurring on the attached gingiva and alveolar mucosa junction, of the maxilla or mandible. It may be solitary or multiple and tends to be asymptomatic altogether. ,, Different terminologies have been suggested by previous researchers for this entity. Giunta, in 1999, introduced the term gingival fibrous nodule, who apparently first reported this lesion.  Another term, mucogingival papule was suggested by Brannon and Pousson. 
| Materials and Methods|| |
This study consisted of 4642 adult subjects attending as outpatients in the Department of Oral Medicine and Radiology, seeking dental treatment. The study was approved by the Institutional Ethical Committee. Informed consent was obtained from all the subjects who agreed to participate. Subjects in the age group of 10-89 years were selected and were grouped into eight groups based on the age, starting with group 1 in the age range 10-19 years. Inclusion criteria were South Indians who were dentulous with no tumors, surgeries or trauma and other pathologies in the maxillary and mandibular arches. The subjects were examined clinically by a single trained clinician for the presence of GFN. Gingival fibrous nodule were identified based on the clinical features as described in the literature.  The data collected was analysed statistically using Microsoft Excel for Windows. [Figure 1] shows multiple gingival fibrous nodules in the maxillary anterior region.
|Figure 1: Clinical photograph showing multiple gingival fi brous nodules in the maxillary anterior region|
Click here to view
| Results|| |
A total of 4642 subjects were examined for GFNs. The age range of the study subjects was 10-89 years. Mean age of the study subjects was 33.8 years. There were 2818 males and 1824 females with male to female ratio being 1.5:1. A total of 145 GFNs were identified in 128 individuals making the prevalence of 2.75%. The mean age of subjects with GFNs was 31.9 years. There were 90 males and 38 female subjects in whom GFNs were identified [Graph 1 [Additional file 1] ]. Maximum GFNs were found in Group 2 (n = 48) and group 3 (n = 33), followed by group 1 and 4 (n = 17) [Graph 2 [Additional file 2] ]. One hundred and eighteen GFNs were noted in the mandible and 27 in the maxilla, with maxilla to mandible ratio being 0.2:1 [Graph 3 [Additional file 3] ]. One hundred and forty (140) GFNs occurred in the anterior region and 5 in the posterior region with anterior to posterior ratio being 28:1. There were 42 solitary and 103 multiple GFNs [Graph 4 [Additional file 4] ]. There were 17 subjects who had multiple lesions both in the maxilla and mandible.
| Discussion|| |
No appropriate etio-pathogenesis has been put forth so far for describing this entity; however, GFNs are considered akin to other collagenous normal variants of the oral mucosa such as retro-cuspid papilla, and hence considered as normal variants. ,, Further, it is also proposed that GFNs represent accentuated anatomy which gives them the atypical manifestation. ,
Epidemiological details of GFNs are lacking as there has been no prevalence studies done so far on this entity. Hence, this study happens to be the first one. Anecdotal case reports are available, wherein a total of 12 cases are reported.  Prevalence of this entity remained undetermined hitherto. In the present study, the prevalence was found to be 2.75%. Previous reports mention that GFNs are common in male subjects and in the second or third decade of life. , In the present research, it was found that the lesions were more common in the 4th decade of life followed by the third decade. Equal number of lesions were found in second and fifth decade of life. It was uncommon after the sixth decade. Further, the lesions tend to occur predominantly in the anterior region, more so in the mandible than maxilla. Also, they tend to occur as multiple lesions and solitary lesions are rare. Preponderance of GFNs in male subjects was noted in this study.
Clinical appearance of GFNs has been described as well-defined, pink-white or sometimes yellowish, slightly elevated solitary or multiple nodules with smooth surface. They tend to be solid and firm in consistency. The size may range from 1 to 4 mm and non-tender and non-mobile upon palpation. They remain entirely symptomless. ,,,, Although the clinical appearance of GFNs is characteristic, nevertheless some lesions tend to appear analogous. The diseases that may mimic GFNs are exostosis, gingival papillomas, gingival fibromas, gingival cysts, and multiple hamartomas. Further, gingival lesions of tuberous sclerosis also tend to appear as GFNs. ,,
When examined under haematoxylin and eosin stain, GFNs show nothing but build-up of collagen tissue under normal epithelium. ,, Normal variants of oral mucosa do not require treatment and hence, GFNs also do not require any treatment. ,, Literature states that if GFNs are identified then there is no need of biopsy and they can be left alone. ,
| Conclusion|| |
Gingival fibrous nodule is a rarely studied entity. So far, the epidemiological characteristics remained unexplored. This study has been successful in determining the prevalence and the other characteristics of this normal variant. Further longitudinal studies need to be taken up to determine the clinical course of GFN.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Giunta JL. Gingival fibrous nodule. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:451-4.
Srivathsa SH, Guledgud M, Patil K. Gingival fibrous nodules: Report of four cases. J Res Pract Dent 2013;1:1-8.
Brannon RB, Pousson RR. Gingival fibrous nodule--anomaly or pathology? J Dent Hyg 2003;77:50-2.
Hata T, Irei I, Hosoda M, Mandai T, Ishida K, Ito S, et al
. Secondarily--developed gingival cyst of the adult: A case report. Kawasaki Med J 2009;35:333-5.
Harutunian K, Figueiredo R, Gay-Escoda C. Tuberous sclerosis complex with oral manifestations: A case report and literature review. Med Oral Patol Oral Cir Bucal 2011;16:e478-81.