International Journal of Clinical Case Reports 2015, Vol.5, No. 43, 1-4
1
A Letter Open Access
Peripheral Ossifying Fibroma of Posterior Mandible: A Rare Case Report
Sunitha K.
1
, Geetha P.
2
, Maloth K.N.
3
, Shetty N.
4
, Nayyar A.S.
5
1. Senior Lecturer, Department of Oral Medicine and Radiology, Mamata Dental College and Hospital, Khammam, Andhra Pradesh, India
2. Professor and Head, Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Narketpally, Andhra Pradesh, India
3. Senior Lecturer, Department of Oral Medicine and Radiology, Mamata Dental College and Hospital, Khammam, Andhra Pradesh, India
4. Senior Lecturer, Department of Oral Medicine and Radiology, KLEVK Institute of Dental Sciences, JN Medical College Campus, Nehru Nagar, Belgaum,
Karnataka, India
5. Reader, Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani,
Maharashtra, India
Corresponding author email
International Journal of Clinical Case Reports, 2015, Vol.5, No.43 doi: 10.5376/ijccr.2015.05.0043
Received: 02 Sep., 2015
Accepted: 13 Oct., 2015
Published: 19 Oct., 2015
Copyright
©
2015 Sunitha et al., This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Sunitha K., Geetha P., Maloth K.N., Shetty N., Nayyar A.S., 2015, Peripheral Ossifying Fibroma of Posterior Mandible: A Rare Case Report, International
Journal of Clinical Case Reports, 5(43) 1
-
5 (doi
Abstract
Peripheral Ossifying Fibroma is a non-neoplastic enlargement of the gingiva with randomly distributed calcifications,
immature bone and osteoid. It is found exclusively on the gingiva and does not arise in other oral mucosal locations. Clinically, it
resembles a peripheral fibroma, but histopathological analysis always reveals immature bone and osteoid within the lesion. Its
incidence is 0.5% in the older age group. We are herewith reporting a rare case of Peripheral Ossifying Fibroma on the mandibular
gingiva of a 60 year old male patient.
Keywords
Peripheral Ossifying Fibroma; Calcifying fibroblastic granuloma; Radiopaque foci
Introduction
There are two types of ossifying fibroma, central and
peripheral. The central type arises from the endosteum
or periodontal ligament adjacent to the root apex and
expands within the medullary cavity of the bone. The
peripheral type occurs solely on the soft tissue
overlying the alveolar process and is a ‘non-neoplastic’,
reactive, fibrous proliferation of gingiva (Neville et al.,
2002; Moon et al., 2007).
The pathogenesis of this
lesion is uncertain and is thought to arise from the
periosteal or the periodontal membrane (Kendrick and
Waggoner, 1996).
It has also been reported that it
represents a maturation of a pre-existing pyogenic
granuloma or a peripheral giant cell granuloma (Bhaskar
and Jacoway, 1966). Clinically, it resembles a peripheral
fibroma, but histopathological analysis always reveals
immature bone and osteoid within the lesion.
Peripheral Ossifying Fibroma (POF) is found exclusively
on the gingiva and does not arise in other oral mucosal
locations. It varies from pale pink to cherry red in
color, can be either pedunculated or sessile and is
typically located in the interdental papilla region
(Singh et al., 2010).
It is more commonly seen in the
1
st
and 2
nd
decades of life and has a female
preponderance. There is a slight predilection for the
maxillary arch and in the incisor cuspid region
(Jain
and Deepa, 2010). Herein, we are reporting a rare case
of a peripheral ossifying fibroma of posterior mandibular
gingiva in a 60 year old male patient.
Case Report
A 60 years old male patient came to our department
with complaint of a growth in the lower left back
tooth region since 2 years (Figure1). Patient was
asymptomatic 2 years back; initially the growth was
smaller in size, which gradually progressed to the
present size. The growth was not associated with pain
since its onset although the patient had difficulty in
chewing and swallowing food along with difficulty in
speech. The medical history was not contributory. On
intra-oral examination, a solitary, well-defined, pedu-
nculated, exophytic growth was seen on the posterior
aspect of left side of the mandible, arising from
edentulous region of 38 and marginal gingiva of 37 on
the lingual aspect, measuring approximately 4x 8 cm
in its greatest dimensions (Figure 2, 3). It extended
antero-posteriorly from the interdental region of 36
and 37 to the retromolar area and inferiorly, 0.5 cm
away from lingual sulcus to superiorly till the occlusal
level of 36 and 37. Medially, the growth was extending
