Peripheral ossifying fibroma: A clinicopathologic study of 27 cases and review of the literature with emphasis on histomorphologic features

Abstract

The peripheral ossifying fibroma (POF) is a relatively uncommon, reactive gingival overgrowth usually composed of cellular fibroblastic tissue containing one or more mineralized tissues, namely bone, cementum-like material, or dystrophic calcification. The aetiology and pathogenesis of POF are yet not clear, but some authors have hypothesized a reaction originating from the periodontal ligament, as a result of irritating agents such as dental calculus, plaque, orthodontic appliances, and ill-fitting restorations. The aim of our study was to report the clinicopathologic features of a case series of POF from a single Italian institution. A total of 27 cases were collected over an 18-year period. Detailed relevant medical history, clinical and histological information were recorded for each patient. The age range of patients (m = 6; f = 21) was 17.2-80.1 years with a mean of 42.9 ± 18.1 years. Occurrence of the lesion in the mandibular and maxillary arches was similar, and 67.0% occurred in the incisor-cuspid region. The lesions ranged in size from 0.3 to 5.0 cm (mean, 1.3 cm ± 1.1 cm). All the different types of mineralization were present, with higher prevalence of lamellar bone. The lesions were treated by surgical excision and four lesions in three patients recurred after surgery. Surgeons should consider the high recurrence rate of POF and remove the lesion down to the bone involving also the adjacent periosteum and the periodontal ligament. Professional prophylaxis should precede any surgical procedure, and periodical dental hygiene recalls are important in order to remove any possible irritating factor.

The role of Osterix protein in the pathogenesis of peripheral ossifying fibroma

“…Patient age varied widely from 11 to 70 years in the present study when compared with the literature, which reports a higher prevalence in the second decade of life. 12 Sessile or pedunculated nodules of variable size were observed, similar to the reports of other authors. 4,12,14 POF exhibits clinical features akin to those of pyogenic granuloma, peripheral giant cell lesion, 14,15 and osteoblastoma.…”

“…12 Sessile or pedunculated nodules of variable size were observed, similar to the reports of other authors. 4,12,14 POF exhibits clinical features akin to those of pyogenic granuloma, peripheral giant cell lesion, 14,15 and osteoblastoma. 16 In the present study, epithelial proliferation accompanied by inflammation of the underlying tissue was a common finding, probably because inflammatory and connective tissue cells secrete cytokines and other chemical mediators that stimulate epithelial cell proliferation.…”

“…4,11,12 When the maxillary anterior area is affected, complete excision can result in significant esthetic problems. 4 The aim of this study was to analyze the clinical and microscopic features and to investigate the immunoexpression of OSX and STRO-1 in POF.…”

Gingival Localized Reactive Lesions: A Demographic and Retrospective Study

“…Jinjival reaktif lezyonlar çeşitli terminolojilerle sınıflandırılabilmektedir. 6,[19][20][21][22] Buchner ve ark., 1.675 hasta üzerinde yaptıkları çalışmada, dört adet lezyonun reaktif jinjival lezyon olarak kabul edilebileceğini, diğer çalışmalarda bahsedilen reaktif lezyonların ya reaktif olmadığını ya da bu dört lezyona analog lezyonlar olduğunu belirtmişlerdir. 1 Türkçe literatürde de LRGB'ler çok ayrıntılı olmasa da değerlendirilmiştir.…”

Coverage Root after Removing Peripheral Ossifying Fibroma: 5-Year Follow-Up Case Report

“…The literature provides several ways of removing the lesion, such as the use of Nd:YAG laser or conventional surgery with scalpel [7]. …”