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Türk Periodontoloji Derneği 54. Bilimsel Kongresi ve 32. Bilimsel Sempozyumu, Ankara, Turkey, 14 - 16 November 2025, (Summary Text)
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