Open AccessFibrous Epulis Misdiagnosed for Combined Periodontic-Endodontic Lesion
Author(s) -
Nabil Khzam,
Reza Shah Mansouri,
Alexander Poli,
Mahmoud M. Bakr
Publication year - 2017
Publication title -
international journal of medical and dental sciences
Language(s) - English
Resource type - Journals
eISSN - 2454-8952
pISSN - 2320-1118
DOI - 10.18311/ijmds/2017/18849
Subject(s) - medicine , lesion , epulis , irritation , periodontium , dentistry , root canal , pathology , immunology
Fibrous epulis or peripheral ossifying fibroma is a reactive non-neoplastic condition that affects the gingiva as a result of chronic irritation. A case of a 44 year old female is presented in this study with a gingival swelling related to the maxillary central incisors. The Patient reported a history of trauma ten years ago and a recent root canal treatment of tooth 21, followed by referral to a specialist with a misdiagnosis for a combined periodontic-endodontic lesion affecting the maxillary central incisors. Excisional biopsy of the lesion revealed a diagnosis of ulcerated fibrous epulis with osseous metaplasia also known as peripheral ossifying fibroma. Periodontal debridement was performed to eliminate supra and subgingival plaque and calculus as well as gingival inflammation that could have been the source of irritation. The clinical and histopathological pictures and the surgical procedures associated with management of the periodontal disease are described. The etiological factor behind the development of the gingival reactive lesion remains unknown and could be the history of trauma, the chronic irritation induced by the plaque and calculus associated with the periodontal disease or a combination of both. We endeavour to follow up the case in order to report any recurrence.