The peripheral odontogenic fibroma is a relatively rare, benign, unencapsulated and gingival mass of fibrous connective tissue, considered to be the extraosseous counterpart of the central odontogenic fibroma. A case is reported of a lesion that recurred in the attached gingiva following initial excision. The clinical and histological data of 51 cases of peripheral ossifying fibroma were retrieved from the records of department of oral pathology and microbiology, a. Fibro osseous lesions of the jaw continue to present problems in diagnosis and classification to clinicians and pathologists. Females are more commonly affected than males, and anterior maxilla is the most prevalent location of. Of develops within the mandible six times more frequently than within the maxilla. A 32yearold male patient was referred to the clinic complaining of a localized gingival enlargement of the anterior maxillary region. 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.
Here, a case of central odontogenic fibroma in a 17yearold male is reported. Peripheral odontogenic fibromas have been extensively reported in a variety of domestic mammals and humans 1116. Multifocal peripheral odontogenic fibroma kamal r, palaskar s. Oral tumors peripheral odontogenic fibromas vca animal. Currently, localized reactive hyperplastic lesions of the gingiva have been classified as focal fibrous hyperplasia, pg, peripheral ossifying fibroma. Peripheral odontogenic ossifying fibroma registered. Peripheral ossifying fibroma pof is a nonneoplastic enlargement of gingiva that is classified as a reactive hyperplastic inflammatory lesion.
It is derived from cells of the periodontal ligament and is usually classified as a reactive hyperplasia but sometimes as a benign neoplasm. Who classification of head and neck tumours, 4th edition, 2017 odontogenic fibroma. Jun 30, 2017 peripheral odontogenic fibroma is considered to be a rare condition although, as shown in table 1, there have been 422 cases reported in the literature to date. Peripheral odontogenic fibroma is more common than central odontogenic fibroma peripheral odontogenic fibroma. A case of peripheral odontogenic fibroma with its clinicopathologic findings are documented here. American journal of pharmacology and pharmacotherapeutics peripheral ossifying fibroma mimicking pyogenic granuloma a case report sivakumarashankari, gaurav, jayanthi k and kamala r.
A peripheral odontogenic fibroma presents as a slow growing firm lump on the gum. The peripheral odontogenic fibroma podf is a rare benign neoplasm of odontogenic origin with limited data on recurrence. Clinical features of peripheral odontogenic fibroma. Since the present case showed a multilocular radiolucency with partially illdefined border between the right mandibular condyle and the distal root of the right mandibular third molar. However, certain authors have stated that peripheral ossifying fibroma is a variant of central ossifying fibroma and, therefore, a neoplastic process. Peripheral lesions have higher prediliction in 2nd and 4th decades of life, occurring commonly in the anterior mandibular gingival region than maxilla 1.
It is considered an uncommon neoplasm that affects patients in a wide age group, with certain predominance in girls and women. It commonly mimics other peripheral exophytic lesions like pyogenic granuloma, peripheral. Goldschmidt department of pathobiology, laboratory of pathology, university of pennsylvania school of veterinary medicine, 3 800 spruce street, philadelphia, pa abstract. To present the clinical presence, histopathological features, and management of a rare peripheral odontogenic fibroma pof case. Recurrent peripheral odontogenic fibroma of the attached. Peripheral odontogenic fibroma is an uncommon neoplasm that is believed to arise from odontogenic epithelial rests in periodontal ligament or attached gingiva itself. The peripheral ossifying fibroma pof is a relatively uncommon reactive lesion of the gingiva, associated with mineralization and derived from the periodontal ligament cells 6. Journal of oral and maxillofacial pathology jomfp is the official publication of the indian association of oral and maxillofacial pathology, india. Peripheral odontogenic fibroma in the mandibular gingiva. Peripheral odontogenic fibroma was earlier quite commonly confused with peripheral ossifying fibroma, until who classification 1992, classified it under odontogenic tumours. It may also contain dysplastic dentin, cementumlike calcifications, and bony trabeculae. It commonly mimics other peripheral exophytic lesions like pyogenic granuloma. At animal dentistry and oral surgery specialists, llc, we diagnose first to treat optimally correctly. Odontogenic epithelium and mineralized material may be found in the mass.
This paper presents a report of peripheral odontogenic fibroma of maxilla in a 61 year old male which clinically presented as a slow growing, firm, solitary mass in the gingiva in relation to right upper canine and premolar region. Peripheral odontogenic fibroma pof is a rare odontogenic tumor, characterized by a fibrous or fibromyxomatous proliferation that contains varying amounts of odontogenic or presumed odontogenic epithelium, occasionally with the presence of dentin or cementum like bodies or other forms of calcification. Surgical resection of peripheral odontogenic fibromas in. Pdf peripheral odontogenic fibroma pof is a rare odontogenic tumor.
Granular cell peripheral odontogenic fibroma lownie 1976. These granular cells are similar to those previously described in the granular cell myoblastoma, congenital epulis and the granular cell ameloblastic fibroma. Peripheral odontogenic fibroma is considered to be a rare condition although, as shown in table 1, there have been 422 cases reported in the literature to date. Peripheral odontogenic fibroma is an uncommon, benign, unencapsulated, exophytic gingival mass of fibrous connective tissue covered with a surface epithelium. It was previously known as a fibromatous epulis and ossifying epulis depending on the degree of mineralization. Peripheral odontogenic fibroma is the preferred name of a help. Peripheral odontogenic fibroma who type is an uncommon neoplasm that is believed to arise from odontogenic epithelial rests in periodontal ligament or attached gingiva itself. Peripheral odontogenic fibroma is often misdiagnosed as fibrous epulis and easily confused. What is peripheral ossifying fibroma peripheral ossifying fibroma is a benign swelling of the gum, most commonly seen in teenagers and young adults. In contrast to the peripheral ossifying fibroma, the peripheral odontogenic fibroma is a rare lesion. It develops more commonly on the gum of the lower jaw mandible than the upper jaw maxilla. Oral masses can be very serious or malignant, while others are much less serious, or benign.
Who classification of head and neck tumours, 4th edition. The peripheral odontogenic fibroma is an uncommon gingival mass. American journal of pharmacology and pharmacotherapeutics. Peripheral odontogenic fibroma was earlier quite commonly confused with peripheral ossifying fibroma, until who classification 1992, classified it under. Ossifying epulis, fibromatous epulis, and fibroosseous epulis are all terms that have been used in the past. Granular cell peripheral odontogenic fibroma lownie. Comparison between the peripheral ossifying fibroma and. Peripheral odontogenic fibroma pof is a rare odontogenic tumor. Peripheral odontogenic fibroma definition of peripheral. The tumours occurring in the oral cavity may be of odontogenic or non odontogenic in origin. Peripheral odontogenic fibroma synonyms, peripheral odontogenic fibroma pronunciation, peripheral odontogenic fibroma translation, english dictionary definition of peripheral odontogenic fibroma.
Peripheral odontogenic fibroma formerly known as fibromatous and ossifying epulis is a benign, often slowgrowing tumor that arises from periodontal structures. Sep 03, 2010 at one time, the terms peripheral ossifying fibroma and peripheral odontogenic fibroma were used quite interchangeably till gardener published a clarification in terminology. Peripheral odontogenic fibroma pof is defined as a benign neoplasm of the jaws of odontogenic ectomesenchymal origin. Interrelationship between pyogenic granuloma and peripheral. Shetty memorial institute of dental sciences, mangalore. Pofs comprises of, one or more mineralized tissues, including bone, cementum like material or dystrophic calcification, within a matrix of cellular fibroblastic tissue 2. Odontogenic tumors mainly occur as intraosseous growths but sometimes may present in a peripheral location on the gingiva where they are referred to as peripheral odontogenic tumors pots which are a rare entity, the most common of them being the peripheral odontogenic fibroma that is an otherwise uncommon, slowly growing, benign. It must be distinguished from the more common peripheral ossifying fibroma. Odontogenic fibroma of, a rare odontogenic tumor of mesodermal origin, has been thought to originate from either dental follicle, periodontal ligament, or dental papilla 1. The age and sex of the patients and the distribution by site and histology of the lesions are compared with those of other cases of fibrous tumors and neoplasms of odontogenic origin. Central odontogenic fibroma is a rare odontogenic neoplasm that originates from odontogenic ectomesenchyme.
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. Different studies reported high variability in the incidence rate as being between 3 and 23% of all odontogenic tumors 2,3. There was considerable confusion in the terminology used in the literature until it was distinguished from peripheral odontogenic fibroma in a recent who classification. This is the reason we might recommend either an incisional or excisional biopsy to first obtain the correct. The ccot and the keratocystic odontogenic tumor may also occur in gingiva at any age, but keratocystic odontogenic tumor usually present in older adults, whereas other rare peripheral odontogenic tumors. Peripheral odontogenic fibroma is a benign tumour that arises from the periodontal ligament. The podf is a benign, slowgrowing, exophytic lesion.
Peripheral odontogenic fibroma is often misdiagnosed as fibrous epulis and easily confused with peripheral osteofibroma. It can be confused with the peripheral ossifying fibroma. Obstruction of the eruption pathway by peripheral odontogenic fibroma. It has also been reported that they commonly occur in association with an impacted tooth. A retrospective histological study was conducted on 37 1 neoplasms of the oral cavity in cats. Peripheral ossifying fibroma pof is a reactive gingival overgrowth which is relatively uncommon in nature. They present as firm, smooth swellings of the gingiva and are normally indistinguishable from gingival hyperplasia. Peripheral ossifying fibroma a clinical and histological. On presentation, the area of concern typically is a firm, pink, smooth swelling of the gingiva and normally seen as gingival hyperplasia. Odontogenic tumours occur commonly as an intraosseous counterpart but may also present in the peripheral location on the gingiva and in such cases they are. The latter is a reactive lesion, derived from the periosteum and can produce osteoid and woven bone 14. World health organization has recognized peripheral odontogenic fibroma as a distinct and different entity from the pof 7. Odontogenic fibroma odonf is a mesenchymal odontogenic tumor 1. According to the literature, the most common tumors of.
Peripheral ossifying fibroma europe pmc article europe. The peripheral odontogenic fibroma is a tumor of the oral submucosa, or periodontal ligament caused by chronic irritation, local trauma, dental calculus foreign agents or certain agents that may transform the connective tissue of the mucous membranes in fibrous tissue. The peripheral odontogenic fibroma epulis is a clinical term referring to a slow growing, localized, exophytic mass on the gingiva resulting from chronic irritation. The lesion is a sessile mass covered by normallooking mucosa. He also suggested that the name peripheral ossifying fibroma should be retained for this lesion. The differences between the two lesions are discussed, and com parisons are. Presence of hypocellular stroma containing inactive odontogenic epithelium and dysplastic dentin or cementum like material is found in peripheral odontogenic fibroma. P eripheral odontogenic fibroma is an uncommon, benign, unencapsulated, exophytic gingival mass of fibrous connective tissue covered with a surface epithelium.
The present report appears to be the first in which external tooth resorption in the coronal and cervical regions has been associated with a peripheral odontogenic fibroma. Odontogenic tumors mainly occur as intraosseous growths but sometimes may present in a peripheral location on the gingiva where they are referred to as. In the past, pof was mixed with peripheral ossifying fibroma due to the similarity of clinical and histologic findings. Layfield ll, shopper tp, weir jc 1995 a diagnostic survey of biopsied gingival lesions. Odontogenic fibroma definition of odontogenic fibroma by. A case of a peripheral odontogenic fibroma which contained aggregates of large granular cells is reported. Peripheral odontogenic fibroma formerly known as fibromatous and ossifying epulis is a benign, often slowgrowing tumor that arises from periodontal structures gums, ligaments, and bone. The patient is a 51yearold white female maintenance patient who has not had a dental appointment in over two years. Peripheral ossifying fibroma has to be differentiated from traumatic fibroma, peripheral giant cell granuloma, pyogenic granuloma, and peripheral odontogenic fibroma. We also suggest that the term who type be used to distinguish peripheral odontogenic fibromas from the peripheral ossifying fibroma with which they have often. The purpose of this study was to define the clinical and histopathologic spectrum of podf and to investigate its recurrence rate and variables associated with its recurrence. Peripheral odontogenic fibroma pof, whotype is a relatively rare benign tumor composed of uncapsulated and fibrous connective tissue and containing odontogenic epithelium. 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. Initial periodontal treatment was delivered and the patient was informed about proper oral hygiene.
They can be further subclassified as peripheral odontogenic fibromas and acanthomatus ameloblastomas. Peripheral odontogenic fibroma is a benign, slowgrowing, exophytic lesion occurring on the gingiva. Kenney jn, kaugars ge, abbey lm 1989 comparison between the peripheral ossifying fibroma and peripheral odontogenic fibroma. While the former one is a commonly found reactive lesion with wellformed bone, numerous giant cells and only rarely, if present, odontogenic epithelial rests, the latter. Peripheral odontogenic fibroma pof is a rare benign neoplasm of odontogenic mesenchymal origin that accounts for approximately 4. Peripheral odontogenic fibroma is an uncommon benign tumour of the gum and is the equivalent of a central odontogenic fibroma occuring outside of bone. In an operative procedure the electrosurgical excision of an extensive finding as well as the modeling of the gingiva in the lower jaw regio 4345 was carried out. In the present case, a treatment option for the removal of odontogenic peripheral fibroma is presented.
The tumours occurring in the oral cavity may be of odontogenic or nonodontogenic in origin. Peripheral odontogenic fibromacase report sciencedirect. Dec 01, 2015 odontogenic fibroma of, a rare odontogenic tumor of mesodermal origin, has been thought to originate from either dental follicle, periodontal ligament, or dental papilla 1. Peripheral odontogenic fibroma is an uncommon neoplasm that is believed to arise from. It can be found on either the inner lingualpalatal or outer labialbuccal surface of the gum. Peripheral odontogenic tumor is one of the rare forms of benign gingival enlargements. However, to our knowledge, there is no information concerning peripheral odontogenic fibroma in the african pygmy hedgehog. Pdf obstruction of the eruption pathway by peripheral. It appears to be far more common than its intraosseous counterpart, central odontogenic fibroma.
Peripheral odontogenic fibroma epulis is the most common oral mass found in dogs. A central odontogenic fibroma cof is a rare tumor of odontogenic origin with a diverse histopathology found in both the mandible and the maxilla. Lesions diagnosed as peripheral odontogenic fibroma was excluded from the study. External tooth resorption associated with a peripheral. Within the mandible it usually develops in the posterior area, whereas in the case of the maxilla it occurs in the area of the front teeth 6.
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