Gingival salivary gland choristoma in a pediatric patient: periodontal reconstruction of a rare oral heterotopia with 4-year follow-up

Choristoma is identified as the presence of histologically normal tissue growing in an atypical location. Gingival salivary gland choristomas are exceptionally rare in the literature and mostly observed as; asymptomatic, smooth surfaced masses without any bone involvement. Its treatment involves excisional biopsy and histopathological examination; however, the surgical reconstruction of the periodontal tissues has not yet been described in the literature. A 14-year-old female patient presented with an asymptomatic gingival overgrowth on the mandibular right buccal region. Clinical examination revealed a pink polypoid lesion measuring 0.5 × 0.8 × 0.3 cm without radiographic bone involvement. Following full-thickness excisional biopsy and minimal osteoplasty, the residual defect was reconstructed using a partially de-epithelialized free gingival graft placed under a combination of coronally advanced flap with laterally closed tunnel technique. Histopathological analysis confirmed gingival salivary gland choristoma. Healing was uneventful, and no recurrence was observed during 4 year follow-up. This case report demonstrates a successful periodontal reconstructive approach following the excision of a rare gingival salivary gland choristoma. The combined use of a partially de-epithelialized free gingival graft and coronally advanced flap with laterally closed tunnel technique provided adequate keratinized tissue, favorable aesthetic outcomes, and long-term clinical stability in a 14-year-old patient.