History of the present illness

This is a 61-year-old white male seen at a periodontology clinic in October 2008 for an extraction and implant placement on tooth #13. Upon examination, this small (about 3mm), unilateral, exophytic, sessile and smooth-surfaced lesion was noted on the lingual gingiva of tooth #28 (Figure 1).  It was of unknown duration and was asymptomatic.  Radiographic findings were within normal limits with no evidence of bony involvement.  The patient was unaware of its presence.

Figure 1 Photograph taken at first clinical presentation; note the small, pink, sessile and dome-shaped and smooth-surfaced nodule on the lingual gingiva of tooth #28.