Odontogenic fibroma WHO-type simulating periodontal disease: Report of a case
A 54-year-old Caucasian woman was referred to the clinic of Periodontology at the School of Dentistry of the University of Sγo Paulo, complaining of mobility of tooth 25. Oral examination showed the overlying mucosa and gingiva to be with normal color and texture, with no swelling, accentuated mobility of tooth 25, and no other symptoms or history of pain. Percussion and palpation tests showed normal response. There was generalized advanced periodontal disease compromising the other teeth.\nThe radiographic examination showed the presence of a unilocular radiolucent area between the left superior lateral incisor and the first left molar []. Computed tomography (CT) showed bone wall reabsorption between the right first premolar and first molar, compromising of the maxillary sinus floor.\nAn incisional biopsy was performed; removing all the granulomatous tissue present in the area and tooth 25 was removed, as it was decayed []. The specimen was sent for histopathological analysis []. The microscopic examination revealed a cellular connective tissue with multiple islands and strands of odontogenic epithelium covered by stratified squamous epithelium []. Immunohistochemical reactions for AE1/AE3 showed positive staining for an odontogenic epithelium, confirming the central odontogenic fibroma WHO-type diagnosis [].\nThe lesion was surgically removed along with other teeth extractions, as the bone support was lost. The patient showed no signs of recidivism after the six-month follow up.