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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