Massive Gingival Fibrous Lesion Excision Using Acellular Dermal Matrix for Gingival Regeneration: A Case Report

Introduction: Localized gingival fibrous lesions (GFLs) can be esthetically disfiguring and may be associated with specific local, systemic, or unknown factors. Treatment of GFLs includes wide excision of the lesion, followed by the often difficult task of restoring soft-tissue function and esthetics. This case report describes the use of acellular dermal matrix (ADM) for wound coverage after lesion removal. Case Presentation: A 50-year-old African-American female presented with a very large, facially located, GFL between teeth # 10 and # 11. She reported that a similar lesion had been removed twice before this recurrence. No local irritants were noted that might be associated with this type of lesion. The lesion was excised, including periosteum, leaving a large area of denuded bone that was covered with ADM. This resulted in regeneration of the gingiva and provided an excellent esthetic outcome for the patient. Conclusions: There was no evidence of recurrence of the lesion in the first 15 months. The etiology of the lesion is unknown, and it was difficult to classify histologically using the current classification system for these lesions. Using ADM improved postoperative pain management, facilitated healing of the denuded bone, and resulted in an acceptable functional and esthetic regeneration of the gingiva.