Cowden syndrome, also known as
multiple hamartoma syndrome, is a rare autosomal dominant disorder characterized by multiple
hamartomas and a high risk of development of
malignancy. Oral findings, such as papillomatous lesions and
fibromas, are common features; however, a periodontal phenotype has not been reported previously. Therefore, this report presents a case of
gingival overgrowth associated with
Cowden syndrome, its successful surgical management, and the 12-month follow-up results. Additionally, we discuss the implications for clinicians. A 23-year-old woman was referred to the Department of
Periodontics, Piracicaba Dental School, presenting with generalized
gingival overgrowth. A detailed dental and medical history and clinical examination confirmed the systemic diagnosis of
Cowden syndrome. Histology, radiographs, and clinical data document the entire clinical approach and follow-up. Clinically, there were minor signs of recurrence of
gingival overgrowth in a 12-month period after
gingivectomy; however, papular lesions reappeared in keratinized gingiva immediately after healing. No signs of bone loss related to the systemic condition were observed radiographically. Histologically, a dense connective tissue with a moderate chronic inflammatory infiltrate and epithelial acanthosis, which is characteristic of
gingival hyperplasia, were demonstrated.
Gingival overgrowth may occur as an oral phenotype related to
Cowden syndrome and can be successfully treated by means of external bevel
gingivectomy, followed by regular maintenance
therapy, contributing to the patient's well-being, both functionally and esthetically.