PMC7398881_01
(A) Labial view of gingival enlargement in relation to maxillary left central incisor (21) (B) Gingival enlargement has displaced 21 palatally.
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Intraoral examination revealed a solitary firm nontender enlargement (1x0.5 cm) of marginal and attached gingiva covering the cervical third of the tooth in relation to a palatally displaced 21 (Figure 1).
(A) Periapical radiography of 21 region does not show any significant bone lesion. (B) Maxillary occlusal radiography does not reveal any significant bone changes. (C) Orthopantomography does not show any bone lesion either.
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Intraoral periapical and occlusal radiographs did not reveal any significant findings (Figure 2).
CBCT images showing the bone destruction and cortical plate expansion in relation to labial aspect of 21.
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CBCT revealed a well-defined corticate radiolucency on the buccal aspect of 21 (Figure 3).
(A) Internal bevel incision given and flap raised. Gingival enlargement is seen attached to underlying tissue. (B) Lesion excised (C) after curettage of surgical site. Bone loss is seen in the buccal aspect of 21. (D) After suturing.
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The lesion was carefully enucleated and curettage done under local anesthesia (Figure 4).
Histopathology of lesion. (A) Nodular proliferation of columnar or cuboidal cells in nests, whorls, and strands (black arrow). A few duct-like structures of varying sizes lined by columnar cells with an eosinophilic rim inside and basophilic inhomogeneous material seen within the lumen (blue arrow). Fibrous connective tissue is seen on the periphery (brown arrow). H&E staining, 100x. (B) Rosette-like structures of odontogenic epithelial cells. Trabecular patterns with numerous small ovoid and larger irregular basophilic calcifications (black arrow). H&E staining, 40x. (C) Duct-like spaces lined by a row of columnar epithelial cells (black arrow). H&E staining, 400x.
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Trabecular patterns with numerous small ovoid and larger irregular basophilic calcifications and eosinophilic material between spindle and polygonal cells, as well as in the duct-like structures, were seen (Figure 5).