Inflammatory fibrous hyperplasia, pyogenic granuloma, peripheral ossifying fibroma, irritational fibroma (IF), peripheral giant cell granuloma, etc., are the different types of reactive gingival lesions that may occur in response to mild chronic irritation associated with subgingival factors, root remnant, iatrogenic factors, and trauma. Gingival IF is one of the most common reactive lesions and is usually sessile in nature, and its size is usually not more than 1.5 cm. Complete surgical excision along with the elimination of precipitating/aggravating factors is the treatment of choice generally adopted by a general dentist without giving due consideration to its size, location, and postoperative sequel. The present rare case describes the simple, easy to perform, and effective periodontal plastic treatment for the management of expected residual soft tissue defect, following surgical excision of large recurrent IF in the posterior maxillary teeth at 9 months postoperatively, in addition to its conceivable etiology and diagnosis.
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