traumatic fibroma due to sharp cusp.pptx

brief summary

1. TRAUMATIC FIBROMA

2. INTRODUCTION Connective tissue tumor. The most common benign soft tissue neoplasm occurring in the oral cavity. A reactive hyperplasia of fibrous connective tissue in response to local irritation or trauma.

3. INTRODUCTION Fibrous Hyperplasia Irritation Fibroma Focal Fibrous Hyperplasia Fibrous Nodule A reactive hyperplasia of fibrous connective tissue in response to local irritation or trauma.

4. ETIOLOGY Traumatic irritants include: Chronic biting Margins of caries Calculi Overhanging margins of restoration Sharp spicules of bones, and

5. PATHOGENESIS

6. CLINICAL FEATURES Age: fourth to sixth decades of life. Gender: F>M 2:1 Site: Buccal mucosa (along the plane of occlusion ) – most common Tongue Labial mucosa Gingiva

7. Clinical Manifestations A smooth-surfaced elevated pink nodule. Similar in color to the surrounding mucosa. In some cases, the surface may appear white. Most fibromas are sessile, although some are pedunculated . Size: 1.5 cm or less in diameter. The lesion usually produces no symptoms, unless secondary traumatic ulceration of the surface has occurred. Well defined and slow growing.

8. Fibroma : Pink nodule of the posterior buccal mucosa near the level of the occlusal plane. Fibroma : Lesion on the lateral border of the tongue

9. HISTOPATHOLOGIC FEATURES Nodular mass of fibrous connective tissue covered by stratified squamous epithelium. C.t –densely collagenized . Epithelium- atrophy of rete ridges because of underlying fibrous mass. Surface may exhibit hyperkeratosis from secondary trauma.

10. DIFFERENTIAL DIAGNOSIS LESION FEATURES 1. Pyogenic Granuloma Pink to red to purple in color. Highly vascular in appearance. Gingiva- most common site. 2. Peripheral Ossifying Fibroma Exclusively occurs on gingiva ( interdental papilla). Red to pink. Migration and loosening of teeth. Formation of mineralized product in H/P. 3. Peripheral Giant Cell Granuloma Exclusively occurs on gingiva. Red-blue nodular mass. Giant cells seen in H/P. 4. Giant cell fibroma Etiology not known. H/P: large, stellate -shaped, multinucleated cells present.

11. TREATMENT AND PROGNOSIS Conservative surgical excision of the lesion. Recurrence is extremely rare.

12. REFERENCES Neville, Damm , Allen, Bouquot . Oral and Maxillofacial Pathology. 3 rd ed. Philadelphia: Elsevier; 2002. Shafer, Hine, Levy. Shafer’s Textbook of Oral Pathology. 7 th ed. Churchill Livingstone: Elsevier; 2005. Greenberg MS, Glick M, Ship JA. Burket’s oral medicine. 11 th ed. Hamilton: CBS Publishers and Distributors; 2008. Differential diagnosis of oral and maxillofacial lesions by Norman K Wood & Paul W Goaz . V edition.