'Gigantiform' Peripheral Ossifying Fibroma: Report of a Case

The differential diagnosis of exophytic gingival lesions include peripheral odontogenic fibroma, peripheral giant cell granuloma, pyogenic granuloma, and peripheral ossifying fibroma (POF). The peripheral odontogenic broma, the peripheral counterpart of the central dontogenic fibroma, is neoplastic, whereas the othrs are generally regarded reactive in nature. The roliferative activity of the reactive lesions are conidered to be initiated by local irritants occurring in he gingival crevice or associated with adjacent teeth. hese irritants stimulate the gingival fibers of the eriodontal ligament, a specialized periosteal tissue, r the periosteum itself. Depending on the tissue timulated, these fibrous growths may contain bone nd/or cementum. The POF has been described by many names, includng ossifying fibroid epulis, peripheral fibroma with alcification, calcifying fibroplastic granuloma, and eripheral odontogenic fibroma. Gardner convincingly argued that the term peripheral odontogenic fibroma be reserved for those lesions that are neoplastic and have characteristic odontogenic epithelium. This diagnosis would include only those lesions that meet the World Health Organization criteria. He also reinforced the concept that the POF is not the peripheral variant of the central ossifying fibroma, a true neoplasm, but a distinct non-neoplastic inflammatory proliferation. POF occurs more frequently in female than in male individuals, is more common in the maxilla, and generally presents as a painless mass smaller than 2 cm. Occasionally larger lesions have been reported in the literature. The generally ac