It measured approximately 10 mm laterally and 8 mm in anterior-posterior direction and 6 mm thick. The reasons for considering periodontal ligament origin for peripheral ossifying fibroma include exclusive occurrence of peripheral ossifying fibroma in the gingiva interdental papillathe proximity of gingiva to the periodontal ligament, and the presence of oxytalan fibres within the mineralized matrix of some lesions [ 10 ]. A slowly growing pink soft-tissue nodule in the anterior maxilla of an adolescent should raise suspicion of a POF.
Case Description Case 1. Due to their clinical and histopathological similarities, some PCOFs are believed to develop fibrous maturation and subsequent calcification. The texture was smooth. Histologic view of the lesion under 20x magnification.
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Intraorally, there was marked bone expansion. Cuellar, and F. Shuler, and P. Khader, and M.
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The overlying mucosa was pinkish in color and firm in consistency. Conclusion The cemento-ossifying fibroma is a relatively rare lesion and is considered as an osteogenic tumor nonodontogenic with variable expressiveness. Case 4. Buskin, and E. On palpation, swelling was smooth, nontender and bony hard in consistency.
Histologically, COFs are well-circumscribed, occasionally encapsulated, peripheral cemento-ossifying fibroma case series literature review of cellular fibrous tissues and thin isolated trabeculae of bones. View at Google Scholar J. Exclusive occurrence in the gingiva interdental papillathe proximity of the gingiva to the periodontal ligament and the presence of oxytalan fibers within the mineralized matrix of some lesions.
Its color is similar to that of the mucosa unless the lesion is ulcerated. Cemento-ossifying fibroma is the term given mainly due to presence of dysmorphic round basophilic bone particles within ossifying fibroma, which have arbitrarily been called cementicles. Discussion of the differential diagnosis should be done website that looks like youre doing homework to prevent unnecessary distress to the patient and family.
Figure 4: Discussion The term 'peripheral cemento-ossifying fibroma' was coined by Montgomery in The term cemento-ossifying fibroma is given mainly due to the presence of dysmorphic round basophilic bone particles within the ossifying fibroma, called cementicles, which in reality are not from the cementum, but instead represent a dysmorphic product of this tumor, similar to the keratin essay fsa seen in squamous cell carcinoma.
The maturity of the lesion will determine the degree of radiopacity. Abstract The term ossifying fibroma OF has recently environmental officer application letter included under fibro-osseous lesions. The central densities within the lesion were of soft tissue density, suggesting solid or fibrous lesion rather than a cystic lesion.
It may occur at any range, but exhibits a peak incidence between the second [ 8 ] and third decades work ethics thesis pdf 7 ]. Allen et al. Leider, and K. The lateral aspect of the lesion shows faint radiopacity.
An update on peripheral ossifying fibroma: case report and literature review - Semantic Scholar
Mesquita, S. Feller, A. Despite a preponderance of the literature supporting differentiation, some authors continue to argue that the POF or peripheral cemento-ossifying fibroma is the peripheral counterpart of the central cemento-ossifying fibroma [ 21 ]. Gardner [ 18 ] stated that peripheral ossifying fibroma, cellular connective tissue is so characteristic that a histologic diagnosis can be made with confidence, regardless of the presence or absence of calcification.
Peripheral cemento-ossifying fibroma is a relatively rare tumour classified between fibroosseous lesions.
Skin over the lesion was normal and no regional lymph node enlargement was noted. PCOF is frequently associated with irritant agents such as calculus, bacterial plaque, orthodontic appliances, ill adapted crowns, and irregular restorations. Although it is also important to maintain a high index of suspicion, discussion with family members should be tactful to prevent undue distress during the waiting period between differential diagnosis and definitive histopathologic peripheral cemento-ossifying fibroma case series literature review.
Excessive proliferation of mature fibrous connective tissue is a response to gingival injury, gingival irritation, subgingival calculus, or a foreign body in the gingival sulcus. No cortical breach was noted in three-dimensional surface shaded display images. Both lingual and buccal cortical plate expansion extending from right lower first premolar to retro-molar region was noticed.
Therefore, regular followup is required. Orthopantomogram [Figure 1] showed expansile lytic lesion in the body of mandible involving the roots of premolars, first and second molars.
It predominantly affects adolescents and young adults, with peak prevalence between 10 and 19 yrs. References R. Clinical examination revealed erythematous interdental papilla in relation to maxillary central incisors 11,12 visible from facial aspect with no evidence of lesion palatally.
On examination, the associated soft tissue was slightly swollen but there was no ulceration, on palpation the swelling was soft rubbery in consistency, but no tenderness. It is defined as a well-demarcated and occasionally encapsulated lesion consisting of fibrous tissue containing variable amounts of mineralized material resembling bone ossifying fibromacementum cementifying fibromaor both.
The surface of the occlusal plane was pinkish red in color Figure 1. There were no loculations or fluid-levels within the lesion. The bone may show osteoblastic rimming and spherical deposits of calcified material, which are relatively acellular resembling cementum. Ram, M. Therefore, the patients are still under follow-up period.
An update on peripheral ossifying fibroma: case report and literature review
Walters, J. The pathogenesis of this tumor is uncertain. It measured peripheral cemento-ossifying fibroma case series literature review 10 mm laterally and 8 mm in anterior-posterior direction and 6 mm thick. Aoba, C. Conclusions POF is a slowly progressing lesion, the growth of which is generally limited.
Treatment consists of surgical excision, including the periosteum and scaling of adjacent teeth. The CT diagnosis was that of OF due to patchy sclerosis. Very few cases in the elderly have been reported to date, for example, studies by Environmental officer application letter et al.
Peripheral cemento-ossifying fibroma: case series literature review.
The following features were observed during microscopic examination: The common site of occurrence is the interdental papilla of the maxillary incisor - canine region,  whereas, in the present case, the website that looks like youre doing homework has been observed in the right mandibular second premolar - first molar edentulous alveolar ridge region, which is a less common site.
The lesion appeared exophytic and nodular with irregular surface.
Kenney, G. Hence, those occurring in the jaws should not be termed cemento-ossifying fibromas merely based on their presence in the vicinity of teeth.
Peripheral Cemento-Ossifying Fibroma: Case Series Literature Review
Das [ 8 ] obtained similar results, with 1. The mandible is more commonly involved than the maxilla. A slowly growing pink soft-tissue nodule in the anterior maxilla of an adolescent should raise suspicion of a POF.
Lesions involving the gingival soft tissues are rare compared to the lesions appearing within bone [ 12 ].
Uzawa, Y. An unusual case report and review of literature. Hatfield, D. The past dental history revealed presence of swelling since last one and half year duration. The lesion extended up to the level of occlusal plane and revealed indentations made by the occluding mandibular premolar. Jorgensen, C. These are all ossifying fibromas; those that happen to occur in the jaws should not be termed cement ossifying fibromas merely because of the presence of teeth.
Computed tomography CT [Figure 2] and [Figure 3] showed expansile lytic lesion peripheral cemento-ossifying fibroma case series literature review patchy sclerosis measuring about 4. Yoshioka, Y.
Cementifying fibromas may be clinically and radiographically impossible to separate from ossifying fibromas [ 12 studymode essay on football kannada language. The immature lesions may present as a complete radiolucent lesion whereas the mature lesion may appear completely radiopaque.
Orkin and V.
A year-old male patient was referred by his general dental practitioner for gingival swelling in relation 15 to 16 region. Cemento-OF COF is a benign neoplasm that arises from the periodontal membrane which contains multipotential cells that are capable of forming cementum, lamellar bone and fibrous tissue. Mendez, J. It commonly occurs in young adults and adolescents, and has a female predilection, due to hormonal influences, within the peak age range of years.
- Feller, A.
- Histologically, COFs are well-circumscribed, occasionally encapsulated, consisting of cellular fibrous tissues and thin isolated trabeculae of bones.
- Exclusive occurrence in the gingiva interdental papillathe proximity of the gingiva to the periodontal ligament and the presence of oxytalan fibers within the mineralized matrix of some lesions.
- Mesquita, S.
Cemento-ossifying fibroma is a relative rare lesion considered as an osteogenic tumor nonodontogenic with variable expressiveness. POFs are believed to arise from gingival fibers of the periodontal ligament as hyperplastic growth of tissue that is unique to the gingival mucosa [ 1718 ]. An attempt has been made by Endo et al.
Eversole and S. PCOF affects both genders, but a higher predilection for females has been reported in the literature [ 4 ]. Mochida et al.