Case report peripheral ossifying fibroma in pregnancy. The definitive diagnosis though is established by histological examination, which reveals the presence of. Treatment of peripheral ossifying fibroma using er,cr. Peripheral ossifying fibroma pof represents a rare separate entity of reactive benign lesion of connective tissue origin, not being the soft tissue counterpart of central ossifying fibroma. Peripheral ossifying fibroma mimicking pyogenic granuloma.
The varying clinical presentations of peripheral ossifying. A histopathology test must be administered to receive a precise diagnosis. Clinically differentiating one from the other as a specific lesion is often difficult. It is possible that the excessive proliferation of mature tissue related to this pathology is a response to gingival injury due to chronic local irritant factors, especially. Adenomatoid odontogenic tumor odontogenic lesion that contains ductlike or glandlike structures microscopically behaving more. Unlike peripheral ossifying fibroma, however, it may occur on the alveolar mucosa of edentulous areas.
Peripheral odontogenic fibroma epulis in dog is the most common oral mass found in dogs. The peripheral ossifying fibroma is one such lesion. Peripheral cementoossifying fibroma in an adolescent. Unusual findings in common peripheral ossifying fibromas. A case of peripheral ossifying fibroma pof in the mandibular gingiva of a 30yearold man is described. It originates from the connective tissue of gingiva or periodontal ligament and presents as a benign, slow growing, painless mass. Clinically differentiating one from the other as a specific lesion is often difficult and requires histopathology examination. However, certain authors have stated that peripheral ossifying fibroma is a variant of central ossifying fibroma and, therefore, a neoplastic process. Surgical treatment of peripheral ossifying fibroma. Review and case report biomed res clin prac, 21 doi. Furthermore, the pof has a propensity to occur in the incisor cuspid area affecting maxilla more than the mandible. Mar 02, 2007 ossifying fibroma and fibrous dysplasia of the jaw are maxillofacial fibroosseous lesions that should be distinguished each other by a pathologist because they show distinct patterns of disease. Cementoossifying fibroma radiology reference article.
Jan 01, 2011 cemento ossifying fibroma is a benign osteogenic tumor with membranous ossification. These three diseases are associated because they appear frequently on gingiva. Periferal ossifying fibroma peripheral giant cell granuloma lobular capillary hemangioma epulis granulomatosa peripheral odontogenic neoplasm pyogenic granuloma histology typical appearance of a pyogenic granuloma involving the buccal gingiva of teeth numbers 20 and 21. Peripheral ossifying fibroma is a fairly common lesion, representing % of all oral biopsies in most series. Peripheral ossifying fibroma a clinical evaluation of 4.
The lesion was asymptomatic, firm, pink, and present on the lingual alveolar mucosa. Peripheral ossifying fibroma a clinical report scielo. Peripheral ossifying fibroma mirchandani nm, agrawal aa. There are two types of ossifying fibromas based on origin. Regarding clinical aspects, peripheral ossifying fibroma is usually presented as a. Eight were domestic shorthair cats and one a domestic longhair. It predominantly affects adolescents and young adults, but. Clinical differential diagnosis for this lesion includes peripheral giant cell granuloma, peripheral ossifying fibroma, pyogenic fig. Based on the clinical and histopathological findings a final diagnosis of peripheral ossifying fibroma was made. There was considerable confusion in the terminology used in the literature until it was distinguished. Peripheral ossifying fibroma is a focal, reactive, nonneoplastic tumorlike growth of the soft tissue that often arises from the interdental papilla 1. Cementoossifying fibroma of the mandible sciencedirect. Peripheral ossifying fibroma a clinical evaluation of. It therefore involves exclusively the maxillofacial bones 1, 2.
Pofs comprises of, one or more mineralized tissues, including bone, cementum like material or dystrophic calcification, within a matrix of cellular fibroblastic tissue 2. The color of peripheral ossifying fibromas range from red to pink and is frequently ulcerated. The lesion was gradually increased in size peripheral ossifying fibroma. The lesion occurs over a wide age range with females being affected more often than males. Peripheral ossifying fibroma pof is a nonneoplastic enlargement of the gingiva precipitated by local irritation and minor trauma.
Peripheral cemento ossifying fibroma shows parakeratinised epithelium and well cellularised connective tissue containing mineralized components ranging from. A case of peripheral ossifying fibroma of maxillary gingiva in a 55yearold indian woman is reported. Pof is defined as a well demarcated and occasionally encapsulated lesion consisting of fibrous tissue containing variable amounts of mineralized material resembling bone. Ossifying fibroma controversies, clinical features. The actual cause of peripheral ossifying fibroma pof has been debated over many years. Cemento ossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fibrous dysplasia and cement ossifying dysplasia. Recurrent multicentric peripheral ossifying fibromalike lesion in a. Radiographic image of 12, 14 region granuloma, fibrous hyperplasia, peripheral fibroma, showing no evidence of bony involvement and peripheral odontogenic tumours. Among the many fibroosseous lesions classified in literature, ossifying fibroma is a neoplastic fol with proliferative capabilities that exhibits bony expan. Peripheral ossifying fibroma is thought to be either reactive or neoplastic in nature 2,3. Histopathology and treatment of nine cats with multiple.
Histopathologic examination is needed in order to positively identify the lesion. Courtesy of manuel jacome, md, department of pathology of ipofgporto. Most commonly small, although the origin of massive lesions can be difficult to identify without the use cross sectional imaging ann maxillofac surg 2016. Peripheral odontogenic fibroma formerly known as fibromatous and ossifying epulis is a benign, often slowgrowing tumor that arises from periodontal structures. Peripheral ossifying fibroma mirchandani nm, agrawal aa, kale. Peripheral ossifying fibroma pof is usually a fibroma of the gingival which shows areas of calcification or ossification. Adjacent teeth were scaled to remove any local irritants. Peripheral odontogenic fibroma is an uncommon benign tumour of the gum and is the equivalent of a central odontogenic fibroma occuring outside of bone. It represents upto 2% of all lesions that are biopsied. This lesion represents the third most common lesion of all localized reactive hyperplastic lesions.
It predominantly affects adolescents and young adults, but rarely seen in infants. The lesion was asymptomatic, firm, pinkish red and pedunculated histologically showing cellular, fibrous connective tissue stroma with calcified osseous and cementumlike calcifications. Fibrous dysplasia and ossifying fibroma an advent in their. Epulis, ossifying epulis, fibromatous epulis, and fibroosseous epulis are all terms that have been used in the past. Shipra arora et al treatment of peripheral ossifying. Diode laser, histopathology, peripheral ossifying fibroma, surgical excision how to cite this article. This paper highlights the diverse clinical and histopathological presentations of peripheral ossifying fibroma through three cases encountered. Peracetic acidaldehyde fuschinmodified hami stain collagen appears green.
Fibrous dysplasia and ossifying fibroma an advent in. The clinical appearance is similar to that of the more common pg. Peripheral ossifying fibroma, also known as ossifying fibrous epulis, is a gingival nodule which is composed of a cellular fibroblastic connective tissue stroma which is associated with the formation of randomly dispersed foci of mineralised products, which consists of bone, cementumlike tissue, or a dystrophic calcification. Peripheral ossifying fibroma is a reactive lesion of the gingiva presenting as a firm and nodular mass more commonly in the anterior maxilla in adolescent females. Peripheral ossifying fibroma pof is a reactive gingival overgrowth which is relatively uncommon in nature. What is peripheral ossifying fibroma peripheral ossifying fibroma is a benign swelling of the gum, most commonly seen in teenagers and young adults.
Focal gingival enlargements are a diverse group of lesions with almost similar clinical presentation but varied etiology and histopathology. Peripheral ossifying fibroma is a relatively common gingival growth of reactive rather than neoplastic in nature. Peripheral ossifying fibroma, oral cavity, gingival growth, histopathologic differential diagnosis introduction gingiva is a common site for neoplastic and non. Peripheral giant cell granuloma, like the peripheral ossifying fibroma, is a lesion unique to the oral cavity, occurring only on the gingiva. Case report peripheral ossifying fibroma associated with a. The objectives of this current case series are to discuss the clinical manifestations, and histopathological presentations of four cases of pof, which were on regular. A novel approach for the treatment of peripheral ossifying. Peripheral ossifying fibroma journal of advanced clinical and. Peripheral ossifying fibroma is a reactive lesion and peripheral odontogenic fibroma is an extraosseous variant of central odontogenic fibroma. Peripheral ossifying fibroma is a gingival growth, usually arising from interdental papilla and occurring frequently in the anterior maxilla.
The clinical features suggested the diagnosis of idiopathic gingival fibromatosis, but the histopathological aspects did not confirm this hypothesis. Pofs are usually seen in childhood and younger ages. Gondivkar sm, gadbail ar, chole r, parikh rv, balsaraf s. Nov 10, 2015 the purpose of the present article was to present a clinical case of an 11yearold girl with peripheral ossifying fibroma pof. Histopathological analysis of the differential diagnosis.
Intraoral ossifying fibromas have been described in the literature since the late 1940s. Considerable confusion has prevailed in the nomenclature of peripheral ossifying fibroma with various synonyms being used, such as peripheral cementifying fibroma, ossifying fibroepithelial polyp, peripheral fibroma with osteogenesis. Peripheral giantcell granuloma an overview sciencedirect. Tissue was repositioned using 50 polypropylene wire and the piece was sent to histopathological examination. Due to its clinical and histopathological similarities, some pofs are believed to develop initially as a pyogenic granuloma that undergoes fibrous maturation and. The definitive diagnosis though is established by histological examination, which reveals the presence of cellular connective tissue with focal calcifications. The present article is a case report related to peripheral ossifying fibroma in a year male who reported with a painless growth in the mandibular. It comprises fibrous tissue containing a variable quantity of mineralized material resembling bone andor cement, whence the term cemento ossifying. It must be distinguished from the more common peripheral ossifying fibroma. Peripheral ossifying fibroma roy a, shivaprasad s, ashok l. Peripheral cemento ossifying fibroma shows parakeratinised epithelium and well cellularised connective tissue containing mineralized components ranging from bone to cementum.
It has been reported from birth to old age, but peaks in the teenage years. Jul 03, 2017 peripheral ossifying fibroma pof is one of the few reactive lesions of the gingiva which are clinically similar in presentation. Nov 16, 2016 unusual findings in common peripheral ossifying fibromas. Gingival enlargement excision with the periodontal flap. Lesions histologically similar to peripheral ossifying fibroma pof have been given various names in. Shipra arora et al treatment of peripheral ossifying fibroma. The histomorphologic spectrum of peripheral ossifying fibroma. It is derived from cells of the periodontal ligament and is usually classified as a reactive hyperplasia but sometimes as a benign neoplasm. In 8 of the cases, cure was achieved by gingivoplasty and extraction of all premolars and molars and sometimes the incisors. Peripheral ossifying fibroma differential diagnosis.
A case of peripheral ossifying fibroma pof in the mandibular gingiva of a 17yearold male is described. Peripheral ossifying fibroma canadian dental association. Oncology prelims 02042020 caem nonodontogenic tumors a. Ossifying fibroma nos a irregular osteoid rimmed by osteoblasts and a fibrous stroma. Cuisia ze, brannon rb 2001 peripheral ossifying fibroma a clinical evaluation of 4 pediatric cases. Psammomatoid ossifying fibroma of the ethmoid sinus with. Peripheral ossifying fibroma journal of oral science jstage. The tissue was submitted to the oral pathology division for histopathologic diagnosis. Many fibromas may be maturing pgs 3 peripheral giant cell granuloma bluish 4 neural lesion e. They can be further subclassified as peripheral odontogenic fibromas and acanthomatus ameloblastomas. Discussion fibromas of the gingiva arise mainly from the connective tissue or the periodontal ligament. Ossifying fibroma benign neoplasm of bone that has the potential for excessive growth, bone destruction and recurrence composed of a fibrous connective tissue stroma in which new bone is formed, it is classified as one of the benign fibroosseous lesions of the jaws o clinical feature occurs in 3 rd to 4 th decades of life. Mesquita ra, orsini sc, sousa m, araujo ns 1998 proliferative activity in peripheral ossifying fibroma and ossifying fibroma.
Peripheral cemento ossifying fibroma a case report with. However, the peripheral odontogenic fibroma is now considered to be the extraosseous counterpart of the neoplas. Peripheral giantcell granuloma pgcg is an oral pathologic condition that appears in the mouth as an overgrowth of tissue due to irritation or trauma. On comparing the two lesions, if was found that the ox.
A novel approach for the treatment of peripheral ossifying fibroma. Peripheral odontogenic fibroma is the preferred name of a mass in the oral cavity of a dog that is derived from the periodontal ligament. Oncology prelims 01282020 caem ameloblastoma odontogenic myxoma adenomatoid odontogenic tumor ameloblastic fibroodontoma ossifying fibroma osteoblastoma o treatment and prognosis enucleation resection 20% recurrence rate c. Report of two cases international journal of laser dentistry, septemberdecember 20.
Oral tumors peripheral odontogenic fibromas vca animal. Jun 19, 2018 buchner a, hansen ls 1987 the histomorphologic spectrum of peripheral ossifying fibroma. Singh ap, raju ms, mittal m 2010 peripheral ossifying fibroma. Due to its clinical and histopathological similarities, some pofs are believed to develop initially as a. Pathology outlines cementoossifying fibroma ossifying. Ossifying fibroma occurs mostly in craniofacial bones and is generally categorized into two types. Many pofs may be matured and calcified pgs 3 peripheral giant cell granuloma 4 bony exostosis.
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