Peripheral ossifying fibroma is a reactive lesion found on the gingiva and nonneoplastic in nature. Peripheral ossifying fibroma pof is a reactive, inflammatory, hyperplastic soft tissue growth of the gingiva. Peripheral ossifying fibroma pof is a nonneoplastic growth on the gingiva thought to arise from the periodontal ligament. Ossifying fibroma of the ethmoid sinus included in the group of benign fibroosseous lesions are fibrous dysplasias and ossifying fibromas. The peripheral ossifying fibroma pof, a benign gingival overgrowth, occurs mainly in the anterior portion of the maxilla in young adults.
Peripheral ossifying fibroma was first identified as a lesion by shephard in 1844 1 and eversole and rovin 3 gave it its current nomenclature along with highlighting its similarities with pyogenic granuloma, peripheral giant cell granuloma or ossifying fibroma all of which are reactive intraoral lesions developing in response to local irritants. Peracetic acidaldehyde fuschinmodified hami stain collagen appears green. Peripheral ossifying fibroma pof is a lesion of the gingival tissues 15 representing up to 2% of all oral lesions that are biopsied 1. Many of the fibrous growths originate from underneath the periodontium, similar to peripheral ossifying fibroma pof. The commonly used synonyms for pof include peripheral cementifying fibroma, peripheral fibroma with cementogenesis, peripheral fibroma with osteogenesis, peripheral fibroma with calcification, calcifying or ossifying fibrous epulis and. Other terms used in reference to pof are peripheral cementifying fibroma, peripheral fibroma with cementogenesis, peripheral fibroma with osteogenesis, peripheral fibroma with calcification, calcified or ossified fibrous epulis, and calcified fibroblastic granuloma. Peripheral ossifying fibroma pof is usually a fibroma of the gingival which shows areas of calcification or ossification. Cementoossifying fibroma radiology reference article. We report a case of a venezuelan female patient with a gigantic peripheral ossifying fibroma in the anterior mandibular region, sized 5. Peripheral ossifying fibroma has to be differentiated from traumatic fibroma, peripheral giant cell granuloma, pyogenic granuloma, and peripheral odontogenic fibroma. Ossifying fibromas are benign bone lesions that should be differentiated from non ossifying fibromas and fibrous dysplasia. We present a case of pof in a 65yearold male patient in the posterior.
This study reports on an acute presentation of giant peripheral ossifying fibroma, clinically mimicking a malignant lesion due to its atypical presentation along with. A lot of confusion has prevailed in the nomenclature of peripheral ossifying fibroma, with various synonyms being used, such as peripheral cementifying fibroma, ossifying fibroepithelial polyp, peripheral fibroma with. Calcification can be seen in association with odontogenic epithelium and when extensive could consider classification as ossifying variant of odontogenic fibroma rare variants and associations. Authors herein presented a case of juvenile ossifying fibroma of the mandible which caused expansion and destruction of mandibular cortex. Peripheral ossifying fibroma a clinical and histological. Peripheral ossifying fibroma is a benign swelling of the gum, most commonly seen in teenagers and young adults. Peripheral ossifying fibroma is such a gingival lesion with a high recurrence rate. The differential diagnosis, treatment options and possible etiology are presented and discussed. Peripheral odontogenic fibroma is an uncommon neoplasm that is believed to arise from odontogenic epithelial rests in periodontal ligament or attached gingiva itself. Peripheral ossifying fibroma pof is a reactive overgrowth occurring frequently in anterior maxilla originating from connective tissue or periodontal ligament. On comparing the two lesions, if was found that the ox. Additionally, cemento ossifying fibroma may have areas of cementum, appearing as psammoma bodies embedded in a benign fibrous stroma. The aim of this study was to assess and present the radiological morphology of the nonossifying fibroma nof, to describe the life span according to the ritschlstages in an effort to determine critical stages with regard to pathological fractures and discuss the need for a followup.
Aarthinisha sree balaji dental college and hospital, bharath university, chennai, india abstract. What is peripheral ossifying fibroma peripheral ossifying fibroma is a benign swelling of the gum, most commonly seen in teenagers and young adults. Most commonly small, although the origin of massive lesions can be difficult to identify without the use cross sectional imaging ann maxillofac surg 2016. Osteofibrous dysplasia is considered as a separate pathological entity in view of its different presentation and treatment, although histopathologically similar to ossifying fibroma. Endothelial proliferation can be profuse in the areas of. Peripheral ossifying fibroma, oral cavity, gingival growth, histopathologic differential diagnosis introduction gingiva is a common site for neoplastic and non. An ossifying fibroma can be one of two different types of tumor, or growth. American journal of pharmacology and pharmacotherapeutics. It is derived from cells of the periodontal ligament and is usually classified as a reactive hyperplasia but sometimes as a benign neoplasm.
Ossifying fibromas are benign bone lesions that should be differentiated from nonossifying fibromas and fibrous dysplasia. Central ossifying fibroma cof is a benign osseous neoplasm which consists of highly cellular, fibrous tissue with varying amounts of calcified tissue, which resembles the bone, the cementum or both 1, 2. Peripheral ossifying fibromas comprises of fibrous connective tissue, endothelial proliferation and mineralization. Peripheral ossifying fibroma pof is a type of nonneoplastic gingival enlargement which shows areas of calcification or ossification.
Fibrous dysplasia and ossifying fibroma an advent in their. Campanacci described this condition in two leg bones, the tibia and fibula, and coined the term. Peripheral ossifying fibroma is known by various names in the literature such as peripheral cementifying fibroma, calcifying or ossifying fibroid epulis, and peripheral fibroma 2 with. Peripheral ossifying fibroma pof represents a rare separate entity of reactive benign lesion of connective tissue origin, not being the soft. They are firm, nodular, slow growing, spherical non neoplastic tumors. Ossifying fibroma definition of ossifying fibroma by. Ossifying fibroma article about ossifying fibroma by the. Peripheral ossifying fibroma is a focal, reactive, nonneoplastic tumorlike growth of the soft tissue that often arises from the interdental papilla 1. Peripheral ossifying fibroma is a rejuvenation of the reactive gingiva, usually occurring in the anterior maxillary gingiva. The mineralized component of peripheral ossifying fibroma varies from 23% to 75%. Most of these lesions, such as irritational fibroma, pyogenic granuloma, peripheral ossifying fibroma and peripheral giant cell granuloma, are innocuous and rarely present with aggressive features.
Giant peripheral ossifying fibroma of the posterior mandiblea rare. A case of peripheral ossifying fibroma of maxillary gingiva in a 55yearold indian woman is reported. Peripheral ossifying fibroma pof has been cited in the literature under various names such as cemento ossifying fibroma, peripheral fibroma with osteogenesis, peripheral odontogenic fibroma, calcifying fibroblastic. This condition should be differentiated from nonossifying fibroma and fibrous dysplasia of bone. Pof or peripheral cemento ossifying fibroma is the peripheral counterpart of the central cemento ossifying fibroma. It is a slowgrowing benign tumor with non odontogenic origin which may. Peripheral ossifying fibroma europe pmc article europe. There was considerable confusion in the terminology used in the literature until it was distinguished. The term ossifying fibroma includes lesions with similar histological compositions and different forms of clinical behavior. Peripheral ossifying fibroma definition of peripheral.
It has been reported from birth to old age, but peaks in the teenage years. Peripheral ossifying fibroma is a fairly common lesion, representing % of all oral biopsies in most series. Electrosurgical management of a peripheral ossifying fibroma. Peripheral ossifying fibroma of the posterior maxilla. First description of ossifying fibroma was given by menzel in 1872 while the term was given by montgomery in 1927. It represents a separate clinical entity rather than a transitional form of pyogenic granuloma and shares unique clinical characteristics and diverse histopathological features. Aadhirai muthukumaran abstract increase in size is a common feature of gingival disease. Reports of a consecutive series of 87 patients with 103 nofs and a mean followup of 27 months were analysed. This paper presents the case of a 40yearold female patient presented with minimal clinical symptoms, diagnosed to be suffering from aggressive form of ossifying fibroma of maxilla involving the maxillary sinus and. Peripheral ossifying fibroma is one such reactive lesion.
The histomorphogenic spectrum of peripheral ossifying fibroma. Excision and repair of the peripheral ossifying fibroma. Fibrous dysplasia and ossifying fibroma an advent in. It is reactive lesion which usually arises from interdental gingiva and mostly in the anterior maxillary region.
Due to its clinical and histopathological similarities, some pofs are believed to develop initially as a pyogenic granuloma that. Menzel first described the lesion ossifying fibroma in 1872 5, but its terminology was given by montgomery in 1927. Cemento ossifying fibroma is a benign fibroosseous maxillary tumor belonging to the same category as fibrous dysplasia and cement ossifying dysplasia. It represents upto 2% of all lesions that are biopsied. Cemento ossifying fibroma is a benign, non odontogenic tumour of the jaw, a subdivision of. S, ravi david austin department of oral medicine and radiology, rajah muthiah dental college and hospital, annamalai university, chidambaram, tamil nadu, india 608002. Treatment of peripheral ossifying fibroma using er,cr. Peripheral cementoossifying fibroma n ravi1 and shyam prasad reddy d2 abstract. Intraoral ossifying fibromas have been described in the literature since the late 1940s. Peripheral ossifying broma occurs mostly in craniofacial bones and categorized into two types central and peripheral. Peripheral ossifying fibroma introduction gingival growths are one of the most frequently encountered lesions in the oral cavity. Other terms used in reference to pof are peripheral cementifying fibroma, peripheral fibroma with cementogenesis, peripheral fibroma with osteogenesis, peripheral fibroma with calcification, calcified.
Microscopic findings confirmed the diagnosis of pof. Asymptomatic presentation of aggressive ossifying fibroma. Peripheral cemento ossifying fibroma is a relatively rare tumour classified between fibroosseous lesions. The condition is often clinically ambiguous when diagnosed.
The lesion is considered part of an ossifying fibroma, but that. The varying clinical presentations of peripheral ossifying fibroma. Peripheral ossifying fibroma is a gingival growth, usually arising from interdental papilla and occurring frequently in the anterior maxilla. Jan 14, 20 the concept of fibroosseous lesions of bone has evolved over the last several decades and now includes two major entities. Photograph of a 9 year old girl with jof showing unilateral swelling extending from the right submandibular to the right mandibular ramus and corpus region. Peripheral ossifying fibroma pof is one of the inflammatory reactive hyperplasia of gingiva.
Its origin is still controversial, though periodontal ligament is considered to be. Menzel rst described the lesion ossifying broma in, but its terminology was given by montgomery in. Peripheral cementoossifying fibroma is a focal, reactive, nonneoplastic tumorlike growth of soft tissue, often arising from the interdental papilla. Pdf the purpose of the present article was to present a clinical case of an 11yearold girl with peripheral ossifying fibroma pof. Francobarrera mj, zavalacerna mg, fernandeztamayo r, vivancoperez i, fernandeztamayo nm, torresbugarin o 2016 an update on peripheral ossifying fibroma. In the 2005 who histological classification of odontogenic tumors, this tumor is referred to as ossifying fibroma but in this article, the term cemento ossifying tumor is used to differentiate from peripherally occurring ossifying fibromas. Peripheral ossifying fibroma 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. They are rare, benign, nonaggressive tumors that are commonly seen in head and neck region.
This is a growth that appears inside the mouth as a small lump on the gum. It was first described as relatively uncommon, solitary, nonneoplastic gingival growth by eversol and robin. Therefore, the patient is still under followup period. Peripheral ossifying fibroma pof is a lesion of the gingival tissues representing up to 2% of all oral lesions that are biopsied. This paper highlights the diverse clinical and histopathological presentations of peripheral ossifying fibroma through three cases encountered. This article describes a series of case reports involving peripheral ossifying fibroma in three patients to demonstrate the varying forms. Discussion peripheral ossifying fibroma pof is a common solitary gingival growth thought to arise from the periodontal ligament jain and deepa, 2010. Ossifying fibromas are benign asymptomatic neoplasms of the maxillae that generally have slow growth and present proliferation of fibrous cell tissue, with a varying quantity of bone products that include bone, cement or a combination of these. Gigantic peripheral ossifying fibroma of the mandible.
It has been described with various synonyms and is believed to arise from the periodontal ligament. Peripheral ossifying fibroma is an inflammatory growth of the gums developing in response to plaque and other associated local factors favoring plaque accumulation and originating from the cells. Pof or peripheral cementoossifying fibroma is the peripheral counterpart of the central cementoossifying fibroma. Additionally, cementoossifying fibroma may have areas of cementum, appearing as psammoma bodies embedded in a benign fibrous stroma. Lesions with histological features similar to pof have been given various. Other terms used to describe this lesion include peripheral ossifying fibroma, peripheral cementifying fibroma and calcified or ossified fibrous epulis. The peripheral ossifying fibroma pof is a reactive gingival overgrowth occurring frequently in the maxillary anterior region in teenagers and young adults. Peripheral ossifying fibroma of posterior mandible. Peripheral ossifying fibroma of the posterior maxilla international journal of scienti. A dermatofibroma is a common overgrowth of the fibrous tissue situated in the dermis also known as.
In some cases it may be what is called a peripheral ossifying fibroma. Peripheral cementoossifying fibroma pcof is a reactive gingival overgrowth occurring frequently in the maxillary anterior region in teenagers and young adults. Osteofibrous dysplasia is a rare, benign nonneoplastic condition with no known cause. It is most commonly seen between the third and fourth decades of. 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. Pof is an occasional growth of the anterior region of mandible and accounts for 3. He also suggested that the name peripheral ossifying fibroma should be retained for this lesion. Management of peripheral ossifying fibroma a relatively. Pof has also been described by various synonyms such as peripheral cemento ossifying fibroma, peripheral odontogenic fibroma podf with cementogenesis, peripheral fibroma with osteogenesis, peripheral fibroma with calcification, fibrous epulis, calcifying fibroblastic granuloma, etc. Ossifying fibromas form a part of the spectrum of fibroosseous lesions of the jaws. Pdf the purpose of the present article was to present a clinical case of an 11 yearold girl with peripheral ossifying fibroma pof.
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