Esthetic Management of a Recurrent Peripheral Ossifying Fibroma

Area of Science:

• Oral pathology
• Periodontology
• Oral surgery

Background:

• Peripheral ossifying fibroma (POF) shares clinical similarities with other reactive gingival lesions.
• The pathogenesis of POFs is not fully understood.
• Standard surgical excision of POFs carries a risk of recurrence, especially in esthetic areas.

Observation:

• A 57-year-old female presented with a recurrent gingival mass diagnosed as POF.
• Initial conservative excision led to recurrence within 12 months.
• The recurrent lesion required aggressive excision, including surrounding tissues and root planing.

Findings:

• A novel surgical technique involved creating a recipient pouch for simultaneous soft tissue augmentation.
• Palatal connective tissue was harvested and used to fill the defect, covering exposed roots.
• The patient experienced no recurrence and maintained esthetic results over 48 months.

Implications:

• Aggressive surgical excision combined with soft tissue augmentation is a predictable approach for recurrent POFs.
• This technique addresses both the pathologic process and the esthetic concerns associated with POF recurrence.
• It offers a potential solution for managing challenging cases of recurrent peripheral ossifying fibromas.