Buccal Fibroma

 Buccal Fibroma

Dr. Ghada Amin (Professor Of Oral and Maxillofacial)

Maryam Jameel Dental Intern 

Ghadah Alwahbi Dental Intern 

Abstract

 The fibroma, also referred to as irritation fibroma, is by far the most common of the oral fibrous tumorlike growths. While the terminology implies a benign neoplasm, most if not all fibromas represent reactive focal fibrous hyperplasia due to trauma or local irritation. Although the term focal fibrous hyperplasia more accurately describes the clinical appearance and pathogenesis of this entity, it is not commonly used. We present a case report of oral fibroma in the left side of the buccal mucosa in 35 years old 

Introduction

Fibromas are benign tumors of fibrous connective tissue Their size is usually small and their diameter is rarely larger than 1.5 centimeter . Generally, fibromas are solitary, asymptomatic, sessile lesions, affecting patients between third and sixth decade of life. They are found in 1.2% of adults and they have a 66% female predominance The association between fibromas and trauma is well established. Most of the fibromas of the oral cavity are reactive hyperplasia in response to local irritation or trauma They are common on gingiva, tongue and buccal mucosa . However, although fibromas are common in the oral cavity, their incidence on the hard palate is rare, mainly because of fewer chances of trauma or irritation

Figure 1 & 2. Intraoral examination revealed a soft nodule in the premolar left side

The intraoral examination revealed a soft nodule in the left side which was covered by normal mucosa.

 Intra orally on palpation, it was ovoid and firm in terms of consistency and is located in the premolar-molar region (Figure 1 & 2). 

Case Presentation

A 35 years old female had reported to dental clinic , with the chief complaint of growth in the left check mucosa region since 4 months. She had no relevant medical or dental history as evidenced with a comprehensive case history reported. It started initially as a small lesion four months ago which steadily increased to the current size. Chewing and normal oral function have been hampered by growth. Intraoral inspection showed a single, painless, sessile, well circumscribed mass with smooth surface. On palpation, it was firm in consistency, and lobulated swelling measuring approximately 3*3 cm 

Figure 3 & 4 &5. Surgical resection and suturing

Figure 6 Formalin solution 

Postoperative Follow-up

The patient presented for the 1-week postoperative appointment and indicated she had experienced no pain following the surgical excision of the mass

Figure 7 After 1week

Figure 7 Follow up After 4 months

Discussion

 Fibroma is the most common connective tissue tumour in oral cavity. It is also described with a term “inflammatory hyperplasia” representing inflamed fibrous and granulation tissue. These proliferative benign connective tissue tumour size varies from small to large depending on the degree to which one or more of the components of the inflammatory reaction and healing response are exaggerated in the particular lesion. If a similar lesion is present on gingiva it is been referred as “epulis”. Fibroma is also known as irritational fibroma, focal fibrous hyperplasia or fibromatous fibroma. Fibroma occurs more frequently in females than in males between third, fourth and fifth decade of life. In this case report fibroma occurred in 35 years old female 

Conclusion 

Fibroma clinically resembles as traumatic fibroma, pyogenic granuloma, peripheral ossifying fibroma, irritational fibroma, peripheral giant cell granuloma so clinical, radiographical and histological examination is very important for accurate diagnosis and treatment