History of the present illness

This 14-year-old white male was referred to the oral surgeon in October 2008 for surgical exposure of impacted teeth #s 6 and 11 and placement of brackets with gold chains to facilitate orthodontic eruption. The maxillary incisor teeth showed severe resorption. Surgical exposure with bracket placement was accomplished in January 2009. In May 2010 the bracket with gold chain on tooth #6 had come off and the patient was referred back for replacement (Figure 1). The alveolar mucosa overlying tooth #6 was swollen and inflamed; this tissue was debrided and a new bracket with chain was placed. The patient was referred again in June 2011 to evaluate an exophytic, grayish-brown gingival swelling between teeth #s 5 & 6 (Figure 2). The area was asymptomatic and the lesion was described to be 7 x 10 mm in size.

Figure 1 This photograph was taken in May 2010 where a small pinkish-red swelling is identified in the area of unerupted tooth #6.

Figure 2 This photograph was taken in June 2011, one year after the small swelling in figure 1 was debrided. This is the recurrent lesion. The swelling on the buccal gingiva between teeth #s 5 & 6. It is exophytic and has a grayish brown color.