Multicentric Peripheral Ossifying Fibroma: Case Report and Review
Journal name: Journal of Indian Society of Periodontology
Original article title: Multicentric peripheral ossifying fibroma: A case report and review of the literature
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:
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Fayiza Yaqoob Khan, Suhail Majid Jan, Mubashir Mushtaq
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Multicentric peripheral ossifying fibroma: A case report and review of the literature
Year: 2013 | Doi: 10.4103/0972-124X.119285
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Peripheral ossifying fibroma (POF) is a benign fibro-osseous lesion primarily characterized by its reactive nature rather than neoplastic origin. Predominantly affecting adolescents and young adults, especially females, these lesions are frequently found in the maxillary region and represent about 9.6% of all gingival lesions. The exact pathogenesis remains uncertain, though it is thought to stem from the transformation of periodontal ligament cells in response to various irritants. POF typically presents as a solitary, well-demarcated, nodular mass that is slow-growing and firm in consistency. Recurrence is relatively common post-surgery and requires careful monitoring.
Unique Multicentric Variant of POF
In this article, a unique case of multicentric POF affecting both maxillary and mandibular gingiva in an 11-year-old boy is presented, marking one of the few reported instances of this multicentric variant. The patient initially observed small papules that evolved into multiple lesions over the span of two months, leading to discomfort and occasional bleeding. Detailed clinical and radiographic examinations revealed no underlying bone involvement, while histopathological assessment confirmed the diagnosis of POF. This case underscores the variability in presentation among POF lesions and the necessity for thorough investigation to differentiate them from other gingival growths.
Conclusion
In summary, peripheral ossifying fibroma is a reactive lesion with distinct clinical and histological features, requiring surgical excision for treatment. The presented case of multicentric POF highlights the need for clinicians to be aware of atypical presentations of this condition, especially in younger patients. Although the recovery for the patient was successful, with no recurrence observed for over a year, continuous follow-up remains crucial due to the potential for regrowth. Ultimately, increased awareness and understanding of POF can aid in accurate diagnosis and management for affected individuals.
FAQ section (important questions/answers):
What is a peripheral ossifying fibroma (POF)?
A peripheral ossifying fibroma is a benign fibro-osseous lesion arising from the periodontal ligament. It usually presents as a slow-growing, painless mass on the gingiva and predominantly affects adolescents and young adults, particularly females.
What causes a peripheral ossifying fibroma to develop?
The exact cause of POF is unclear, but it is thought to arise in response to irritants such as plaque, calculus, or dental appliances. Hormonal influences may also play a role due to its higher prevalence in young females.
How is a peripheral ossifying fibroma diagnosed?
Diagnosis of POF typically involves clinical examination, followed by histopathological evaluation of a biopsy specimen. The histology reveals characteristic ossifications within the connective tissue, aiding in differentiation from other gingival lesions.
What treatment options are available for peripheral ossifying fibroma?
The primary treatment for POF is complete surgical excision of the lesions, including the surrounding calculus or irritants. Postoperative follow-up is essential to monitor for potential recurrence, as incomplete removal may lead to regrowth.
What is the expected recovery period after the excision of POF?
Recovery after excision usually proceeds uneventfully, with healing typically occurring within weeks. Regular follow-up is necessary, as the lesion has a recurrence rate of 8-20%.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Multicentric Peripheral Ossifying Fibroma: Case Report and Review”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Irritation:
Irritation is a key factor in the pathogenesis of peripheral ossifying fibroma. It arises as a response to chronic irritants such as dental plaque, calculus, or poorly fitting restorations. These irritants stimulate the pluripotent cells in the periodontal ligament to react, leading to the formation of this benign lesion.
2) Surface:
The surface of a peripheral ossifying fibroma typically presents as a smooth, nodular mass that can exhibit an erythematous or ulcerated appearance. Its clinical features, particularly the surface characteristics, are crucial for differential diagnosis, assisting in distinguishing POF from other gingival lesions by evaluating its texture and color.
3) Table:
In the context of this case study, a table is used to summarize relevant literature regarding the etiology and clinical presentation of peripheral ossifying fibroma. This provides a structured overview of findings, aiding in comparisons and contributing to a better understanding of factors influencing the condition's occurrence.
4) Blood:
Blood parameters, including a complete blood count, were evaluated to rule out systemic issues or infections in the patient. Notably, the patient's total leukocyte count was slightly elevated, suggesting mild inflammation. Blood analysis serves as an important diagnostic tool to assess general health prior to surgical intervention.
5) Controversy:
Controversy exists in the classification of lesions similar to peripheral ossifying fibroma due to varied nomenclature and overlapping histological features. The distinction between ossifying and cementifying fibromas has generated debates over terminologies and treatment approaches, emphasizing the importance of clear definitions in both clinical and academic settings.
6) Surrounding:
The surrounding tissues play a significant role in the clinical management of peripheral ossifying fibroma. Surgical excision involves removing not only the lesion but also the surrounding periosteum to prevent recurrence. Understanding the relationship of the lesion with adjacent structures is critical for effective treatment planning and postoperative care.
7) Transformation (Transform, Transforming):
Transform refers to the ability of pluripotent cells in the periodontal ligament to change into osteoblasts or fibroblasts in response to irritants. This transformation is a pivotal mechanism in the development of peripheral ossifying fibromas, as it leads to the reactive hyperplastic tissues characteristic of the condition.
8) Bleeding:
Bleeding may occur from peripheral ossifying fibromas due to their vascular nature and ulceration. Such symptoms can cause discomfort, prompting patients to seek treatment. The presence of bleeding also signifies a need for careful assessment and management in clinical practice to minimize complications during surgical excision.
9) Disease:
The term disease relates to the pathological alterations in the oral cavity associated with lesions like peripheral ossifying fibroma, though it is classified as benign and reactive rather than neoplastic. Understanding its disease mechanisms aids clinicians in recognizing the condition's implications and planning appropriate treatment strategies.
10) Account:
In medical literature, the account of a specific case indicates a comprehensive review and detailed documentation of observations, findings, and patient management. Such accounts are essential for advancing knowledge and understanding of conditions like peripheral ossifying fibroma, contributing to improved diagnostic and therapeutic approaches.
11) Nature:
The nature of peripheral ossifying fibromas is characterized by their benign, reactive quality rather than being a neoplastic growth. This understanding underpins the clinical approach to diagnosis and treatment, as practitioners must recognize the underlying mechanisms driving the lesion's development and eventual healing.
12) Study (Studying):
The study of peripheral ossifying fibroma encompasses clinical, histopathological, and epidemiological aspects. Research and literature reviews contribute valuable insights into its etiology, demographic trends, and treatment outcomes, reinforcing the importance of systematic investigation in improving patient care and management strategies.
13) Hand:
The term hand is metaphorically relevant in the context of clinical examination, where practitioners assess lesions manually. The evaluation involves palpation to determine characteristics like consistency and tenderness, highlighting the importance of the clinician's hands-on approach in diagnosing and managing oral pathologies effectively.
Other Health Sciences Concepts:
Discover the significance of concepts within the article: ‘Multicentric Peripheral Ossifying Fibroma: Case Report and Review’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:
Surgical excision, Regular Follow-up, Histopathological examination, Hormonal influence, Oral tumors, Pyogenic granuloma, Peripheral ossifying fibroma, Maxillary bone, Clinical differential diagnosis, Soft tissue masses, Gingival lesion, Exophytic lesion, Recurrent lesion.