Peripheral ossifying fibroma is a benign, reactive lesion. It has been described by several synonyms and is thought to arise from the periodontal ligament and comprises about 9% of all gingival growths.
The size of the lesion is usually small. It is located mainly in the upper jaw in the anterior area, from canine to canine, with a greater predilection for women, and is more frequent in the second decade of life.
Peripheral ossifying fibroma is usually seen as a soft tissue growth located in the interdental papilla. It may be pedunculated or broad-based and usually has a smooth surface and is less than 2 cm in size.
The color of peripheral ossifying fibromas ranges from red to pink and is often ulcerated.
It is a relatively rare pathology, represented by a reactive inflammation of the gingiva composed of fibroblastic tissue inside which different types of mineralized tissue can be found, recognizable as bone tissue, root cement-like tissue or dystrophic calcifications.
This type of pathology, as previously mentioned , has a slightly higher frequency in the female sex, and occurs mainly in the fertile age. Peripheral ossifying fibroma should be placed in the differential diagnosis with other benign pathologies associated with the presence of hormones.
Fibroma ossificans is often diagnosed clinically as pyogenic granuloma. Radiologic and histopathologic examination is required to confirm the diagnosis although it may take weeks or months before it is clinically seen and diagnosed.
The etiology and pathogenesis of fibroma ossificans periphericans has not yet been fully elucidated, but for many authors, the most reputable hypotheses are associated with a reactive inflammatory reaction by the periodontal ligament correlated with the presence of local irritant factors, such as the presence of calculus under the gingival line, plaque, incongruent placement of orthodontic appliances or the presence of conservative or prosthetic restorations with incorrect closing edges.
An ossifying fibroma is first detected by swelling of the face. These slow-growing tumors are usually painless and asymptomatic, but can gradually displace teeth or cause root resorption. If you notice swelling of the face, you should see your dentist as soon as possible to determine the source of the problem.
Your dentist will take x-rays to determine the exact location of the tumor and confirm the diagnosis.
Treatment of fibroma ossificans usually requires surgical excision in which the oral surgeon removes the tumor completely from the tissue. Larger tumors may require a more complex procedure to reconstruct the affected bone. After healing, the dentist will determine if any additional treatment is necessary to restore and replace the affected teeth.
Removal of the ossifying fibroma usually resolves the problem. Several studies have estimated that the recurrence rate ranges from 6.7% to 28%. Some studies indicate that the recurrence rate is significantly higher in cases involving children. For these reasons, it is a priority to visit the dentist for regular follow-up.
As with many dental problems, early diagnosis and proper treatment of fibroma ossificans can provide the best path to a healthy mouth. Should you notice any swelling or growth along the gums or jaws, you should contact your dentist immediately.
Iossifying fibromas can occur in patients of any age and sex, being slightly more prevalent in females. Trauma, irritation caused by dental restorations and plaque under the gums may also play a role in the development, but the precise cause remains unknown.
Juvenile ossifying fibroma sometimes develops in areas where there is a congenital absence of a tooth. The recurrence rate of juvenile fibroma ossificans oscillates between 30 and 58%. Local recurrence is probably due to incomplete removal of the tumor, especially in the maxillary sinus and orbital region.
Pyogenic granuloma can occur anywhere in the oral cavity, whereas peripheral ossifying fibroma and peripheral giant cell granuloma only occur in the gingiva or alveolar mucosa. The clinical appearance, treatment and prognosis are the same for all three diseases.
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