Excision and Repair of the Peripheral Ossifying Fibroma: A Report of 3 Cases

Abstract

The peripheral ossifying fibroma (POF), one of the most common gingival lesions, has a recurrence rate of nearly 20%. To minimize the reappearance of this lesion, it must be completely excised. In the maxillary anterior region, total excision of a POF can result in an unsightly gingival defect. Three cases are presented in which a POF was excised from the gingiva facial to a maxillary central incisor. One of these lesions had previously undergone 2 cycles of conservative excision and recurrence. In all cases, the lesions were excised down to bone. Each of the resulting gingival defects was repaired by a distinct plastic surgery procedure, including a laterally positioned flap, a subepithelial connective tissue graft, and a coronally positioned flap. The defects resulting from the biopsies were satisfactorily repaired. The patients were followed over postsurgical intervals of 10 to 30 months. None of the lesions recurred. It is customary to manage POF by aggressive excisional biopsy. Several different surgical approaches may potentially be used to repair the resultant gingival defect and minimize patient esthetic concerns.