Page 53 - MDA SCATE 2024 Programme Book
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ORAL PRESENTATION

                                                                                         ABSTRACTS



                       Calcifying Fibroblastic Granuloma: A case report in a 14-year-old boy
       Abstract 5
                       NMRR Registration Number: RSCH ID-23-06273-9ZF

                       Ismail, N. I., & Chan, Y. P.
                       Department of Paediatric Dentistry, Hospital Kuala Lipis


                       Background: Growths on the gingiva can be reactive or neoplastic in nature.
                       Many lesions appear similar clinically and can only be identified through
                       histopathological examination. It is hypothesized that calcifying fibroblastic
                       granuloma is a reactive gingival growth arising from periodontal ligament
                       fibres.
                       Case  Presentation:  A  14-year-old  boy  presented  with  a  mass  over  the
                       palatal  region.  The  boy  who  has  learning  difficulties  was  unaware  of  the
                       painless growth and denies any history of trauma. The lesion did not resolve
                       with antibiotics prescribed by a general medical practitioner and gradually
                       increased in size. Clinically, a lobulated and pedunculated mass was present
                       on  the  palate  with  a  thin  stalk  attached  interdentally  to  tooth  21  and  22,
                       measuring approximately 20 mm x 24 mm x 10 mm. The surface of the lesion
                       appeared  reddish-pink  with  speckles  of  white,  and  a  tendency  to  bleed.
                       Radiographically, no bony pathology was seen although the adjacent teeth
                       showed increased mobility. MRI findings were suggestive of a benign gingival
                       vascular tumour. Excisional biopsy was performed under general anesthesia
                       and  scaling  was  done  to  remove  any  local  irritants.  Histopathological
                       examination  showed  a  fibrocellular  stroma  and  fibrovascular  connective
                       tissue  with  some  trabeculae  and  spherules  of  metaplastic  calcifications,
                       consistent  with  calcifying  fibroblastic  granuloma.  Histological  studies
                       suggest that the lesion may be confused with pyogenic granuloma in early
                       stages  when  areas  of  dystrophic  calcification  are  less  apparent,  and  the
                       lesion has yet to undergo fibrous maturation with ossification. Controversy
                       exists over the nomenclature of this lesion, with several terms being used to
                       describe it, such as peripheral ossifying fibroma.
                       Conclusion:  Reactive  gingival  lesions  in  children  may  show  exuberant
                       growth rates in a short period. Early detection can prevent alveolar erosion or
                       tooth displacement. Due to high recurrence rates, close follow-up is advised
                       in addition to complete surgical excision and elimination of local irritants.
























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