title: Palatal neurofibroma associated with localized periodontitis.
abstract: BACKGROUND
  Neurofibromatosis type 1 (NF1) is the most common form of neurofibromatosis. While typically considered a dermatologic disorder, intraoral signs of neurofibromatosis occur quite commonly. This clinical entity can be confused with periodontitis because of the presence of periodontal pockets. In this report, we present the case of a palatal neurofibroma with radiographic involvement in a patient with NF1.
  
  
  METHODS
  A 40-year-old female patient was referred from her general dentist to evaluate advanced periodontitis in the maxillary left quadrant. The patient's medical history was significant for a soft tissue lesion excised from her back 11 years previously and diagnosed as a neurofibroma. Subsequent medical examination at that time confirmed a systemic diagnosis of NF1. A comprehensive periodontal evaluation was performed, and panoramic and periapical radiographs were taken. Teeth were tested for vitality. An incisional biopsy was completed for histopathologic examination.
  
  
  RESULTS
  The periodontal evaluation revealed the presence of 6 to 9 mm probing depths adjacent to teeth #14 and #15. Panoramic and periapical radiographs showed a circumscribed 0.8x0.9-cm unilocular radiolucency superimposed over the root of tooth #13 and extensive horizontal bone loss on the distal side of #15. Incisional biopsy confirmed the presence of a neurofibroma, and because of the extent of the lesion, the patient was referred to the Oral and Maxillofacial Surgery service for complete excision.
  
  
  CONCLUSIONS
  Neurofibromas can cause extensive destruction of alveolar bone, mimicking periodontitis. Due to the potential systemic and genetic implications, the diagnosis of neurofibroma requires appropriate medical referral.
authors.affiliation: U.S. Air Force Periodontics Residency, Wilford Hall Medical Center, Lackland Air Force Base, TX 78236, USA. charles.powell@lackland.af.mil
authors.forename: Charles A
authors.initials: CA
authors.lastname: Powell
authors.forename: Corey M
authors.initials: CM
authors.lastname: Stanley
authors.forename: Sharon R
authors.initials: SR
authors.lastname: Bannister
authors.forename: Howard T
authors.initials: HT
authors.lastname: McDonnell
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Moritz
authors.forename: David E
authors.initials: DE
authors.lastname: Deas
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000209:etiology; D006801:Humans; D009455:Neurofibroma / Q000150:complications*; D009456:Neurofibromatosis 1 / Q000150:complications; D010157:Palatal Neoplasms / Q000150:complications*; D017622:Periodontal Attachment Loss / Q000209:etiology; D010514:Periodontal Pocket / Q000209:etiology; D010518:Periodontitis / Q000209:etiology*