Peripheral Odontogenic Fibroma- Case Series of a Rare Benign Tumor

Peripheral odontogenic fibroma (POdF) is a rare benign odontogenic tumor of ectomesenchymal origin which is composed of fibrous connective tissue containing islands, strands or cords of odontogenic epithelium. The lesion is more common among females, commonly seen between the second to fourth decades of life, mostly affecting the anterior region of mandible. Clinically, it may present similar characteristics with other more common gingival lesions such as pyogenic granuloma, peripheral ossifying fibroma and peripheral giant cell granuloma. So, histopathological examination is required for accurate diagnosis. We present here three rare clinical cases of peripheral odontogenic fibroma and their management by complete excision of the lesion with good postoperative outcomes.

Clinopathological assessment of epulis lesions from Sindh Pakistan

BACKGROUND & OBJECTIVES: Gingival enlargement is a common characteristic of gums infection. Enlargement of the gums can possibly occur due to numerous factors, comprising of inflammatory disorders as well as certain meditational side effects. Pyogenic granuloma expresses as red, small erythematous papules on pedunculated or rather sessile base. The current study aims to evaluate the cases of epulis and to grade histological types of epulis. METHODOLOGY: This descriptive cross-sectional study was carried out at oral surgery OPD ISRA Dental College for a six-month duration. The diagnosis of epulis was made on the basis of clinical and histological examination. The research data was recorded on pre-designed proforma, and data were analyzed using SPSS version 22.0 (IBM, Corporation). RESULTS: Out of 150 study subjects, 90 (60%) patients were female, while 60 (40%) were male. Majority of the cases in our study were found with a maxillary site (n=93, 62.0%). Most had a size of 2cm-3cm (n=132, 76%). Coral Pink color was the most common in (n=90, 60%) patients, followed by red color (n=45, 30%) and pale color was found in (n=15,10%) of the cases. The histological findings proved pyogenic granuloma was most common in (n=75, 50%) of the cases followed by fibrous epulis (n=63, 42%), peripheral giant cell granuloma (n=6, 4%) and Peripheral ossifying fibroma (n=6, 4%). CONCLUSION: Pyogenic granulomas are the most prevalent reactive lesion. The lesions were more common in females in maxilla portion, and they were mostly found in the second to third decade of life.

Retrospective Clinicopathological Analysis of 65 Peri-Implant Lesions

Background and Objectives: Peri-implantitis is a common finding among patients with dental implants. There is no consensus regarding the treatment of this disease, but in many cases, surgical treatment is common practice. A histopathological analysis is not an integral part of suggested protocols. The present study investigated the clinical and histopathological parameters of lesions mimicking peri-implantitis and correlated them with the outcome and follow-up data. Materials and Methods: The study included 65 consecutive biopsies taken from peri-implantitis patients between 2008–2019. Results: The three common diagnoses were fibro-epithelial hyperplasia 20 (30.7%), pyogenic granuloma 16 (24.6%), and peripheral giant cell granuloma 15 (23%). There were 18 cases of recurrent lesions in the study group (27.7%). The recurrence rate was the highest in peripheral giant cell granuloma (8, 12.3%), versus 6% in pyogenic granuloma and fibro-epithelial hyperplasia. These differences in the recurrence rate were statistically significant (p = 0.014). Conclusions: This study emphasizes the necessity of submitting tissue of peri-implantitis cases for histopathological analysis since the more locally aggressive lesions (peripheral giant cell granuloma and pyogenic granuloma), which comprise nearly half of the cases in this study, do not differ in clinical or radiographic characteristics from other peri-implant lesions.

A rare case of peripheral giant cell granuloma

Peripheral Giant Cell Granuloma or the so called “Giant Cell Epulis” is the most common oral giant cell lesion. It is described as non-neoplastic, hyperplastic lesion occurring exclusively on gingival/alveolar crest that appears as a overgrowth of tissues, following trauma or irritation arising from periosteum or periodontal membrane. It can be sessile or pedunculated with size usually less than 2cm. Although being uncommon, this lesion carries a lot of uncertainity in terms of its etiology, growth potential, biological behavior (recurrence), histogenesis of its cells and its treatment. We hereby report a case of a 49-year old male patient, with peripheral giant cell granuloma in mandibular posterior region, who was successfully treated and is on regular follow up since 6 months.

Aggressive behavior of peripheral giant cell granuloma: A case report

Background: Peripheral Giant Cell Granuloma (PGCG) considered one of the commonest oral giant cell lesions and gingival epulis. It is probably a non neoplastic lesion but rather reactive in nature which originates from the periodontal membrane or the periosteum as a reaction to chronic trauma or local irritation. This article reports a case of PGCG in a 6 years old male patient complaining of massive gingival swelling associated with looseness of related teeth which is highly unlikely to occur with such lesions, that may lead to misdiagnosis. Material and method: Surgical excision followed by histopathological examination was performed and confirmed using CD34 and CD45 for detection and confirming the origin of multinucleated giant cells (MNGCs). Results: Immunopositivity for CD34 was demonstrated only as cytoplasmic reaction of endothelial cells lining blood vessels while negative reaction was observed in MNGCs or in stromal mononuclear cell. Moreover, cytoplasmic immunoreactivity for CD45 was revealed in MNGCs and few stromal cells. Conclusion: Correlating clinical, radiographic and histopathologic examination reaching definite and early diagnosis is mandatory for management of such lesions thus eliminating potential risk of damaging to adjacent hard tissue structures. Keywords: Peripheral giant cell granuloma; multinucleated giant cells; CD34; CD45.

An analysis of the prevalence of peripheral giant cell granuloma and pyogenic granuloma in relation to a dental implant

Background The aim of the present investigation was to evaluate the literature recurrence of peripheral giant cell granuloma and pyogenic granuloma associated with dental implants. It’s important to know the characteristics present in these lesions and possible effects on the prognosis of dental implants. Methods An electronic search without time restrictions was done in the databases: PubMed/Medline. With the keywords "Granuloma" OR "Granuloma, Giant Cell" OR "peripheral giant cell" OR "Granuloma, Pyogenic” AND "Dental implants" OR "Oral implants”. Results After applying the inclusion and exclusion criteria, a total of 20 articles were included, which reported 32 lesions (10 pyogenic granulomas, 21 peripheral giant cell granulomas and one peripheral giant cell granuloma combined with peripheral ossifying fibroma, all associated with implants). According to our review, these lesions are more frequent in males and in the posterior region of the mandible. Both excision and curettage of the lesion, compared to only excision, presented similar recurrences (40%). Explantation of the implant was performed in 41% of cases without additional recurrences. The results are not statistically significant when comparing one lesion to the other in terms of explantation (p = 0.97), recurrence (p = 0.57) or bone loss (p = 0.67). Conclusions The main therapeutic approach is tissue excision. The lesions show a high recurrence rate (34.4%), which often requires explantation of the associated implant. This recurrence rate is not affected by curettage after excision.

Dental Management of Peripheral Giant Cell Granuloma in an 8-Year-Old Boy: A Case Report

Background: Peripheral giant cell granuloma (PGCG) or the so-called giant cell epulis is the most common oral giant cell lesion. It normally appears as a soft tissue purple-red nodule. This lesion is certainly not a true neoplasm, but in nature, it may be reactive, thought to be stimulated by local irritation or trauma. Nonetheless, the exact cause is definitely not understood well. In appearance, lesions vary from smooth, uniformly outlined masses to irregularly developed, multilobed surface indentation protuberances. Margin ulcerations are occasionally observed as well. The lesions are painless, differ in size, and can cover many teeth. It may be a lesion on the gingiva or alveolar crest that is sessile or pedunculated, common with respect to the molars and incisors and occurs in reaction to the local response.