Gingival enlargement excision with the periodontal flap operation procedure in peripheral ossifying fibroma patient (four-year follow-up case report)

Gingival enlargement is common among periodontal patients. Peripheral ossifying fibroma (POF) is one form of a gingival enlargement with a tumor-like appearance and a high recurrence rate. The periodontal ligament may be the origin of gingival enlargements in the interdental papilla region. This report presents a case of a 35-year-old woman with a chief complaint of a gingival enlargement in the anterior tooth of the upper jaw, showing significant growth and interference with occlusion. Malocclusion with an anterior cross bite between the right maxillary central incisive tooth and the right mandible central incisive tooth diagnosed a local chronic irritation. The patient was treated with an excisional biopsy and then sent to the pathology laboratory. After the histopathology diagnosis was confirmed to be POF, we performed an excision surgery using the periodontal flap procedure. In terms of the clinical appearance after a four-year follow-up, despite no orthodontic treatment, there is no evidence and no recurrence of the lesion. The involvement of the bone and periodontal ligament could be the origin of POF. The removal of all irritants and etiological factors could prevent recurrence.