Peripheral ossifying fibroma affecting the anterior dentition: a case report


Oktopcu H., Atak M., Kurgan Ş.

Türk Periodontoloji Derneği 54. Bilimsel Kongresi ve 32. Bilimsel Sempozyumu, Ankara, Türkiye, 14 - 16 Kasım 2025, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Ankara
  • Basıldığı Ülke: Türkiye
  • Ankara Üniversitesi Adresli: Evet

Özet

Localized gingival enlargements are generally reactive rather than neoplastic. These include peripheral giant cell granuloma, pyogenic granuloma, fibrous hyperplasia, and peripheral ossifying fibroma (POF). POF typically occurs in the maxilla and anterior regions as a sessile or pedunculated, exophytic lesion arising from the mucosa. It is thought to result from the fibrous maturation of a pyogenic granuloma based on clinical and histopathological findings. The lesion often originates from the interdental papilla and may cause tooth migration or mobility. A 34-year-old systemically healthy male patient with heavy smoking habits (>30 cigarettes/day) and alcohol consumption presented to our clinic with a complaint of a painless, rapidly growing gingival swelling in the left mandibular canine region that had developed over the past 6 months. Clinical examination revealed a reddish-pink, lobulated, firm, exophytic lesion. Radiographs showed generalized calculus, bone loss, and periapical lesions. Based on these findings, stage IV grade C periodontitis was diagnosed. Initial treatment included supragingival debridement and oral hygiene instructions. The patient was advised to seek support to reduce smoking and alcohol use. The lesion was excised with preliminary diagnoses of pyogenic granuloma and peripheral giant cell granuloma and sent for histopathological analysis. Sections showed fibroblast-to-osteoblast metaplasia and membranous-type ossification, confirming POF. Postoperative healing on day 10 was uneventful. Due to a recurrence risk of up to 35%, root coverage in the area is not planned for at least one year. This case illustrates the impact of poor oral hygiene and substance use on periodontal health and reactive gingival enlargements.

Keywords: oral hygiene, peripheral ossifying fibroma, periodontitis, reactive gingival enlargement