ABSTRACT : A peripheral ossifying fibroma (POF) is a reactive soft tissue growth whose pathogenesis is uncertain and seen mainly in the anterior portion of maxilla in young adults. After elimination of local etiological factors, local surgical excision of POF is the preferred treatment. Present case is considerable as it reports an occasional entity of POF seen in posterior maxilla in an adult lady in her fourth decade of life and the first time use of a bi layer collagen matrix to cover the soft tissue defect in addition to conventional treatment. Present article highlights the several distinct advantages of use of bovine collagen in treating POF and briefly review the current literature on this condition. 1 2 3 4 Prateek Agarwal, Sunil Sharma Neha Bhargava, Mridula Trehan 1 Assistant Professor Department of Oral and Maxillofacial Surgery Mahatma Gandhi Dental College and Hospital, Jaipur 2 Dean, Principal, Head of Department Department of Oral and Maxillofacial Surgery Mahatma Gandhi Dental College and Hospital, Jaipur 3 Assistant Professor, Department of Pediatric and Preventive Dentistry Rajasthan Dental College and Hospital, Jaipur 4 Director, P.G Studies Head, Department of Orthodontics and Dentofacial Orthopaedics, Mahatma Gandhi Dental College and Hospital, Jaipur INTRODUCTION : Peripheral ossifying fibroma (POF) is a benign fibro osseous lesion comprising about 9% of all gingival growths. [1] Surgical excision followed by aggressive curettage of the underlying periosteum to reduce recurrence rate is the treatment of choice for POF. [2] However conventional treatment leaves a large soft tissue defect which may cause extensive pain, increased risk of infection and delayed healing. The present article is probably the first to be reported in literature to use biodegradable bi layer collagen matrix (EUCARE Pharmaceuticals Pvt. Ltd Chennai, India) as a temporary dressing material with favorable prognosis in patients with POF. CASE REPORT : A 43-year-old female patient reported to Department of Oral and Maxillofacial surgery, with a complaint of growth of gum tissue in upper back tooth region for the past 6 months. There was no contributory past medical and dental history. Intraoral examination revealed an exophytic growth on the buccal gingiva of teeth 44 and 45 extending from mesial aspect of first premolar to distal aspect of second premolar also extending occlusally between the two premolars [Figure 1], measuring around 1.1x0.8x0.4cms in size; irregular margins with smooth surface, firm in consistency and slightly pedunculated. As reported by the patient, the tissue growth was interfering with her bite and felt uncomfortable. Occasionally bleeding occurred when she brushed her teeth. Periodontal examination showed moderate amount of supra-gingival calculus with respect to 44, 45 and 46 and gingival recession was also seen. Panoramic radiograph were obtained and did not reveal any abnormality. After detailed history, clinical and radiographic examination a provisional diagnosis of peripheral ossifying fibroma was made and the differential diagnosis included pyogenic granuloma, peripheral fibroma, peripheral giant cell granuloma, and fibro epithelial polyp. TREATMENT : After approval of the protocol by the institutional review board and obtained signed informed consent by the patient and ensuring that the hemogram of the patient was within normal limits, excisional biopsy of the lesion was performed under local anesthesia followed by aggressive curettage of underlying periosteum to reduce chances of recurrence and specimen [Figures 2 and 3] sent for histopathological study. Bilayer Collagen matrix removed PERIPHERAL OSSIFYING FIBROMA : NEW TREATMENT APPROACH AND REVIEW OF THE LITERATURE Key Words : Peripheral ossifying fibroma, gingival overgrowth, bovine collagen. Source of support : Nil Conflict of interest: None Journal of Dental Sciences University University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India 76 University J Dent Scie 2017; No. 3, Vol. 1 Case Report
4
Embed
16 PERIPHERAL OSSIFYING - Aligarh Muslim University OSSIFYING.pdf · ABSTRACT : A peripheral ossifying fibroma (POF) is a reactive soft tissue growth whose pathogenesis is uncertain
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
ABSTRACT : A peripheral ossifying fibroma (POF) is a reactive soft tissue growth
whose pathogenesis is uncertain and seen mainly in the anterior portion of maxilla in
young adults. After elimination of local etiological factors, local surgical excision of POF
is the preferred treatment. Present case is considerable as it reports an occasional entity of
POF seen in posterior maxilla in an adult lady in her fourth decade of life and the first time
use of a bi layer collagen matrix to cover the soft tissue defect in addition to conventional
treatment. Present article highlights the several distinct advantages of use of bovine
collagen in treating POF and briefly review the current literature on this condition.
1 2 3 4Prateek Agarwal, Sunil Sharma Neha Bhargava, Mridula Trehan 1Assistant Professor Department of Oral and Maxillofacial SurgeryMahatma Gandhi Dental College and Hospital, Jaipur 2Dean, Principal, Head of Department Department of Oral and Maxillofacial SurgeryMahatma Gandhi Dental College and Hospital, Jaipur 3Assistant Professor, Department of Pediatric and Preventive Dentistry Rajasthan Dental College and Hospital, Jaipur4Director, P.G Studies Head, Department of Orthodontics and Dentofacial Orthopaedics, Mahatma Gandhi Dental College and Hospital, Jaipur
INTRODUCTION : Peripheral ossifying fibroma (POF) is a
benign fibro osseous lesion comprising about 9% of all
gingival growths. [1] Surgical excision followed by
aggressive curettage of the underlying periosteum to reduce
recurrence rate is the treatment of choice for POF. [2]
However conventional treatment leaves a large soft tissue
defect which may cause extensive pain, increased risk of
infection and delayed healing. The present article is probably
the first to be reported in literature to use biodegradable bi