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Peripheral ossifying fibromas: a series of 500 cases
Justin Bubola1, Iona Leong2, Grace Bradley1
1Oral Pathology & Oral Medicine, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
Objective:
To characterize the clinical and histopathologic features of peripheral ossifying fibromas (POFs).
Study Design:
A retrospective search of the archives of our diagnostic oral pathology service was performed for POFs diagnosed from January 1, 2017 to September 1, 2025.
Results:
There were 500 POFs in 474 patients. The female-to-male ratio was 1.6:1, and the mean age was 35.6 years. The anterior maxilla was the most common location. The majority of lesions were pink to red in colour, with a pedunculated base. They were frequently ulcerated (69.8%). Possible local and systemic contributing factors were reported in 16.6% of POFs, including 17 pregnant patients. Pyogenic granuloma (PG) was the most common entity included in the clinical differential diagnosis. Recurrence was documented in 13.9% of patients.
Conclusions:
To the best of our knowledge, this is the largest and most comprehensive series of POFs reported in the literature. Novel findings included POF development in pregnant patients, which is a setting classically associated with PGs. Additionally, we described a subset of recurrent POFs in which the histologic features of the initial excision specimen were not diagnostic for a POF. It is important for both clinicians and pathologists to be aware of these phenomena.
