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Case- 2

The document presents a case of a 28-year-old female patient, Madhubala, with a painless, slow-growing peripheral ossifying fibroma located on the lingual gingiva of her lower right posterior teeth. The examination revealed a firm, exophytic growth measuring 3x3 cm, with bilateral palpable submandibular lymph nodes and no signs of pulpal involvement. The recommended treatment plan includes surgical excision and monitoring for recurrence.

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16 views

Case- 2

The document presents a case of a 28-year-old female patient, Madhubala, with a painless, slow-growing peripheral ossifying fibroma located on the lingual gingiva of her lower right posterior teeth. The examination revealed a firm, exophytic growth measuring 3x3 cm, with bilateral palpable submandibular lymph nodes and no signs of pulpal involvement. The recommended treatment plan includes surgical excision and monitoring for recurrence.

Uploaded by

kaypee.pareek
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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CASE

PRESENTATION
PERIPHERAL OSSIFYING FIBROMA

PRESENTED BY- DR. KANAK PAREEK (I YEAR MDS, OMR)


ST

GUIDED BY-Dr. Tulika Sharma (Reader Dept. OMR)


CO-GUIDED BY- DR. SABA KHAN (PROF. & HEAD DEPT.
OMR)
DEMOGRAPHIC DATA
Name : Madhubala OPD:2401023

Age : 28/F

Occupation : Housewife

Address: Udaipur


CHIEF COMPLAINT :

Patient complains of swelling in lower right back


tooth since 1 year.
HISTORY OF PRESENT ILLNESS :
- H/O growth since 3 yrs, initially small swelling

which enlarged till present size from last 1 yr


only.
- No H/O pain or any discharge from the

swelling
- Slow growing in nature.

PAST DENTAL HISTORY : 1st dental visit


FAMILY HISTORY: NRH
PERSONAL HISTORY

 Oral hygiene habits : cleans teeth once a day


with toothpaste and Brush
 Sometimes bleeding from the swelling at the time
of brushing.
 No deleterious habits reported
GENERAL EXAMINATION

Concious, cooperative and well oriented to


time, place and person.
Gait: Normal
Nourishment & Built: Moderate

Cyanosis,Jaundice,Edema,Clubbing,Pallor :-
Absent

Skin, Nails: NAD

Vital Signs: Under Normal limits


EXTRA ORAL EXAMINATION

Facial symmetry
Muscles of Mastication
TMJ: No deviation
No clicking sound NAD
No tenderness
MUSCLES OF MASTICATION
SALIVARY GLANDS:

LYMPH NODES: palpable right and left


submandibular lymph nodes
Intraoral examination

SOFT TISSUE EXAMINATION

Buccal mucosa
Labial mucosa
Tongue
NAD
Floor of the mouth
Hard palate
Soft palate and uvula
Gingiva & Periodontal Assessment:

 Color: Gen. pink in colour


 Consistency: firm and resilient
 Contour: scalloped margins
 Position: At CEJ
 SURFACE TEXTURE: Stippling Present
 Bleeding On Probing: Absent
 Exudation From Gingival Sulcus: Absent
 Pockets: Furcation Involvement: Grade I

Grade 2 Grade 3: NAD


 Mobility: Grade 1grade 2 Grade 3: NAD
INTRA ORAL
HARD TISSUES :
Dentition: permanent
 Inspection: exophytic,
pinkish red growth on
lingual gingiva extending
from mesial aspect of 45
till distal aspect of 46
and from occlusal line till
2mm above the sulcular
depth, measuring about
3*3cm with smooth
appearance and normal
adj mucosa.
 Palpation: Firm to hard in
consistency, no pockets,
non tender, can be lifted
with probe on mesial
aspect.
CASE SUMMARY
 Patient Overview: The primary case involves a 28-year-old female, Madhubala, presenting with a

painless, slow-growing swelling on the lingual gingiva of the lower right posterior teeth (45-46) over three

years.
 History: Asymptomatic, non-tender swelling with occasional bleeding during brushing. No systemic or

familial red flags.


 Examination:- Extraoral: Bilateral palpable submandibular lymph nodes (reactive?) facial symmetry, no

TMJ abnormalities. Intraoral: A 3x3 cm smooth, firm, exophytic growth on lingual gingiva (45-46). Lesion

is non-tender, non-ulcerated, and elevatable with a probe. Adjacent bone shows mild rarefaction. Vitality

Tests Teeth 44, 45, 46 are vital, ruling out pulpal involvement.
 Differential Diagnoses:1. Peripheral Ossifying Fibroma (POF):Most likely due to firm consistency,

calcification, and gingival origin. Common in young females, reactive etiology from periodontal ligament.

2.Peripheral Cementifying Fibroma: Similar to POF but with cementum-like calcifications. 3.Calcifying

Fibroblastic Granuloma:Less likely given the absence of rapid growth or inflammation. 4 Peripheral Giant

Cell Granuloma:Typically vascular and purplish, not consistent with this case. *Diagnostic Clincher:* POF

is favored due to clinical features (slow growth, calcification, gingival origin) and demographics.

Histopathology (biopsy) is essential to confirm and exclude other entities. Management:Surgical Excision:

Complete removal with periosteal curettage to prevent recurrence. - Radiographic Follow-up: Monitor

bone rarefaction for resolution. Oral Hygiene Reinforcement: Minimize local irritation.
PROVISIONAL DIAGNOSIS

 Epulis, peripheral fibroma with calcification,


 Peripheral ossifying fibroma,
 Calcifying fibroblastic granuloma,
 Peripheral cementifying fibroma, peripheral
fibroma with cementogenesis and peripheral
cemento-ossifying fibroma
INVESTIGATIONS

Mild rarefaction of bone extending from


mesial aspect of 45 till mesial aspect of 46.
 PUlp testing
 Vital : 44,45,46
FINAL DIAGNOSIS

PERIPHERAL OSSIFYING
FIBROMA
TREATMENT PLAN
THANK YOU

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