Peripheral Ossifying Fibroma: A Case Report

Peripheral Ossifying Fibroma (POF) is a reactive gingival lesion predominantly observed in adolescents and young adults, with a higher incidence in females. It is most frequently localized in the maxillary incisor–canine region. Although POF typically presents during the second decade of life, rare occurrences have been reported in pediatric populations. This case report describes a POF in the anterior maxilla of a systemically healthy 10-year-old female patient, evaluated based on clinical, radiographic, and histopathological findings. The patient presented with a three-month history of gingival enlargement, occasionally accompanied by spontaneous bleeding. Intraoral examination revealed a lobulated, firm, pedunculated mass, while radiographic evaluation demonstrated no evidence of bone involvement. The patient exhibited inadequate oral hygiene. Although the initial clinical impression suggested an irritation fibroma, excisional biopsy and histopathological assessment confirmed the diagnosis of POF by revealing a cellular fibrous stroma with foci of calcification. Prior to surgical excision, local irritants were effectively controlled. While the precise etiology of POF remains uncertain, local irritative factors—including plaque accumulation, periodontal disease, and orthodontic appliances—are considered contributory to lesion development. Furthermore, detailed anamnesis and periodontal evaluation indicated that the patient’s family had limited awareness regarding oral hygiene, and the patient had not yet established adequate oral care habits. These findings underscore the significance of local irritants in the pathogenesis of POF and highlight the critical role of effective oral hygiene education and management of local contributing factors, particularly in pediatric populations.