Peripheral ossifying fibroma, some rare findings
A 27-year-old male patient reported to the department of periodontology and oral implantology, with the chief complaint of a growth of gum tissue in between the upper front teeth []. The lesion had been present for approximately one year. There was no contributory past medical history. Past dental history revealed that patient had a similar growth, which was excised ten years back. He also gave the history of wearing a removable partial denture for a brief period two years back, but he stopped wearing the same as the partial denture broke.\nIntra-oral examination revealed a sessile growth (1 cm × 0.7 cm × 0.5 cm) in between the upper central incisors on marginal and attached gingival. The lesion was firm and erythematous having a smooth, non-ulcerated surface. On occlusal examination, the patient had a traumatic deep bite where the lower central incisors interfered with the lesion during biting []. However, the lesion was asymptomatic, with no sign of pain. Upon swallowing, the patient exhibited a habit of tongue thrusting with midline diastema.\nAn intra-oral periapical radiograph was obtained. The radiographic examination revealed the superficial erosion of the bone [], which was later reconfirmed during surgical excision.\nDifferential diagnosis: Irritation fibroma, pyogenic granuloma, and peripheral giant cell granuloma (PGCG) were considered.\nFull mouth scaling was done to remove local irritants []. Occlusal correction was also done at this stage []. Excision and microscopic examination were planned, and patient's consent for the same was taken.\nA full thickness flap was elevated facial to tooth 11, 21 using crevicular incision []. The lesion was excised completely using a 15 no. B.P blade []. The flap was repositioned over the exposed teeth of 11, 21 and stabilized with 3-0 silk sutures under local anesthesia []. During reflection of flap, the superficial erosion of bone was seen []. The excised tissue measured 1 cm × 0.7 cm × 0.5 cm []. The tissue was submitted to the oral pathology division for histopathological examination.\n“H and E-stained soft tissue section shown fibrous connective tissue, which is composed of varying degree of cellularity, which includes plumb hyperchromatic, fibroblasts, calcification (Bone like), dense bundles of collagen fiber, chronic inflammatory cells comprising mostly of lymphocytes, and blood vessels [].\nOverlying epithelium is parakeratinized stratified squamous epithelium, which shows long and narrow rete ridge."\nThe histopathological findings confirmed the lesion as POF.\nThe patient presented for follow-up examination 7 days, 15 days, and 45 days postoperatively []. The surgical site appeared to be healing well. There was no evidence of recurrence of the lesion, and the patient had no complaints pertaining to the lesion.