Peripheral Ossifying Fibroma Evolved From Pyogenic Granuloma

Abstract

The aim of the present article is to present the clinical case of a large peripheral ossifying fibroma that evolved from a previously diagnosed pyogenic granuloma in a 50-year-old woman. The patient was referred for treatment of a lesion over the buccal and palatal gingiva close to the left upper first molar. It was purplish-red in color, approximately 3 cm in diameter, having a smooth surface, a pedicled and bleeding base, with seven years of evolution, and diagnosed as pyogenic granuloma. After three years of evasion, the patient returned reporting an increase in the lesion and difficulty in eating. Clinically the nodule was lobular in appearance, pink in color and smooth, pediculated, firm in consistency, non-bleeding, about 5 cm in its greatest extension, extending to the maxillary tuberosity. The lesion was excised and referred for histopathological examination, which led to the diagnosis of peripheral ossifying fibroma. The patient was followed for approximately 18 months, prosthetically rehabilitated, with satisfactory healing and no clinical signs of recurrence.The possible evolution of a pyogenic granuloma to a peripheral ossifying fibroma was observed in this case, based on the histopathological changes that occurred, with the development of calcified material, fibrous maturation, and decreased vascular content of the initial lesion after three years.

Diode Laser Surgery of Peripheral Ossifying Fibroma in Children: A Case Report with Narrative Review of the Literature

“…Overall, the histopathologic features, the exclusive gingival localization, and the common presence of irritative factors support the reactive origin of POF [8]. In contrast, the aforementioned hypothesis of POF derivation from Pyogenic Granuloma is based on the same irritative local factors and the role of osteopontin, a non-collagenous protein with high calcium binding potential, which may lead to mineralization of extracellular matrix [18]. Osteopontin is always present in POF and frequently present in Pyogenic Granuloma, suggesting a possible histopathological evolution of a single entity [19].…”

Pyogenic Granuloma with Calcification: An Enigmatic Case

“…Poor oral hygiene with accumulated plaque and calculus act as precipitating factors. 6 Certain factors like inducible nitric oxide synthase, vascular endothelial growth factor (VEGF), basic fibroblast growth factor, or connective tissue growth factor are responsible for angiogenesis and rapid growth of PG. 7 It is seen in the second decade and with female predilection due to the vascular effect of female hormones.…”

Assessment of estrogen receptor marker and smooth muscle actin marker in oral pyogenic granuloma

“…However, certain study have reveals only slight predilection 55-58% of female [4,5]. Pyogenic granuloma was significant in females with the upper gingivae (50.23%) [14].…”