Peripheral Ossifying Fibroma with Superficial Bone Erosion: A Case Report
Abstract
This study was aimed to present a case report of a case of peripheral ossifying fibroma which is a rare case. This case was a 30 years non smoker male with the chief complaint of growth of gum tissue, moderately large in the mandibular posterior region. On intraoral examination, a peduncalated growth of 17 x 12 x 6 mm on marginal and attached gingiva with respect to tooth number 47 considerably hard in consistency and movable was seen. The lesion was erythmatous having a smooth non ulcerated surface. It was asymptomatic with no sign of pain. Intra oral periapical radiograph was taken which revealed slight erosion of crest of bone which was later confirmed during surgical excision. The possible reason of crestal bone erosion may be constant pressure of the growth. Differential diagnosis of irritation fibroma, pyogenic granuloma and peripheral giant cell granuloma was considered. However, clinical appearance and consistency was of a hard fibrous growth, which therefore led to a provisional diagnosis of peripheral ossifying fibroma or peripheral odontogenic fibroma.
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Introduction
Peripheral ossifying fibroma which is characterised by high degree of cellularity usually exhibiting bone formation, although occasionally cementum like material or rarely dystrophic calcification may be found instead1
There are numerous histologically different types of focal overgrowth which may occur on the gingiva, such as peripheral giant cell granuloma, giant cell fibroma, pyogenic granuloma, simple fibroma (which may be simply a healed pyogenic granuloma in many cases) and the present lesion which has been known by names like peripheral odontogenic fibroma, peripheral cementifying fibroma, calcifying or ossifying fibroid epulis and peripheral fibroma with calcification in the past. The lesions have a more female predilection (female: male – 4.3:1) with reported recurrence as high as 20%, and a nearly equal maxilla to mandible ratio has been recorded2 .
Conclusion
To conclude, peripheral cemento ossifying fibroma is a non neoplastic enlargement of the gingiva that is classified as a reactive hyperplastic inflammatory lesion. It resembles peripheral giant cell granuloma, pyogenic granuloma and irritation fibroma, hence thorough knowledge and histopathological examination is important to draw a conclusion.