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This rapid review summarizes the latest primary research in temporomandibular joint (TMJ) injection treatment. The final literature searches were conducted on 4 January 2024. Selection was performed systematically following predefined eligibility criteria. Randomized control trials concerning the treatment of TMJ disorders with intra-articular injections were included. Studies on more invasive interventions were excluded. Quality of life, joint pain and range of mandibular mobility were assessed. Ultimately, 12 studies covering a total of 603 patients qualified. They concerned: (1) arthrocentesis (AC) and the administration of, (2) injectable platelet-rich fibrin (I-PRF), (3) platelet-rich plasma (PRP), (4) hyaluronic acid (HA), (5) non-steroidal anti-inflammatory drugs (NSAIDs), and (6) hypertonic dextrose (HD) with a local anesthetic. The dominant approach was to perform arthrocentesis before administering the appropriate injection substance (I-PRF, PRP, HA, or NSAID). Two current studies on the intra-articular administration of NSAIDs, specifically tenoxicam and piroxicam, are noteworthy. A mixture of PRP and HA was injected in another two trials. These two innovative approaches may prove to be significant directions for further research on injection treatment of TMJs.
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Objectives: This systematic review was designed to summarize randomized controlled trials of intra-articular administration of non-steroidal anti-inflammatory drugs (NSAIDs) for temporomandibular disorders. Methods: Randomized controlled trials regarding intra-articular injections of non-steroidal anti-inflammatory drugs for temporomandibular disorders were included in the review. The final search was conducted on 16 June 2024 in the Bielefeld Academic Search Engine, PubMed, and Scopus databases. Results: Of the 173 identified studies, 6 were eligible for review. In trials comparing arthrocentesis alone to arthrocentesis with NSAIDs, slight differences in joint pain were noted. For tenoxicam, differences were under 1 point on a 0-10 scale after 4 weeks, with inconsistent results. Piroxicam showed no significant difference, and pain levels were minimal in both groups. For maximum mouth opening (MMO), tenoxicam showed no significant difference. Piroxicam increased MMO by nearly 5 mm, based on one small trial with bias concerns. Conclusions: Currently, there is no strong scientific evidence supporting the injection of NSAIDs into the temporomandibular joint to relieve pain or increase jaw movement. Preliminary reports on piroxicam with arthrocentesis and tenoxicam or diclofenac without rinsing justify further research.
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Background: The application of artificial intelligence (AI) is gaining popularity in modern dentistry. AI has been successfully used to interpret dental panoramic radiographs (DPRs) and quickly screen large groups of patients. This cross-sectional study aimed to perform a population-based assessment of the oral health status and treatment needs of the residents of Kielce, Poland, and the surrounding area based on DPR analysis performed by a high-accuracy AI algorithm trained with over 250,000 radiographs. Methods: This study included adults who had a panoramic radiograph performed, regardless of indications. The following diagnoses were used for analysis: (1) dental caries, (2) missing tooth, (3) dental filling, (4) root canal filling, (5) endodontic lesion, (6) implant, (7) implant abutment crown, (8) pontic crown, (9) dental abutment crown, and (10) sound tooth. The study sample included 980 subjects. Results: The patients had an average of 15 sound teeth, with the domination of the lower dental arch over the upper one. The most commonly identified pathology was dental caries, which affected 99% of participants. A total of 67% of patients underwent root canal treatment. Every fifth endodontically treated tooth presented a periapical lesion. Of study group members, 82% lost at least one tooth. Pontics were identified more often (9%) than implants (2%) in replacing missing teeth. Conclusions: DPR assessment by AI has proven to be an efficient method for population analysis. Despite recent improvements in the oral health status of Polish residents, its level is still unsatisfactory and suggests the need to improve oral health. However, due to some limitations of this study, the results should be interpreted with caution.
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Objectives: This overview was conducted following the Preferred Reporting Items for Overviews of Reviews guidelines and aimed to collect and compare the results of systematic reviews on temporomandibular joint injection treatment. Methods: Systematic reviews of randomized clinical trials on temporomandibular disorders treated with lavage or intra-articular administrations were qualified for syntheses. The final searches were conducted on 27 February 2024, without time frame restrictions. Results: Of the 232 identified records, 42 systematic reviews were selected. The most evidence-based conclusions call into question the clinical differences between many therapeutic approaches, including the following: (1) injectable selection for the treatment of pain and hypomobility; (2) the method of performing arthrocentesis; (3) the use of imaging when rinsing the TMJ cavity; (4) the supplementation of the extracapsular administration of unprocessed blood with intracapsular deposition in the treatment of TMJ hypermobility. Conclusions: Systematic reviews based solely on randomized clinical trials proved the following differences: (1) in painful temporomandibular hypomobility, a better therapeutic effect is observed with arthrocentesis followed by I-PRF administration compared to lavage alone; (2) in painful temporomandibular hypomobility, inferior- or double-compartment injection leads to better results than superior-compartment injection; (3) in temporomandibular joint recurrent dislocation, hypertonic dextrose administration is superior to placebo, although (4) unprocessed blood has a better effect than hypertonic dextrose. PROSPERO registration number: CRD42024496142.
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The injection of autologous blood (AB) is one of the methods of treatment of recurrent dislocations in the temporomandibular joints (TMJs). Due to the low invasiveness of this technique, it is reasonable to evaluate it in accordance with the standards of evidence-based medicine. The purpose of this systematic review is to identify primary studies on AB injection for the treatment of TMJ hypermobility and assess the therapy for effectiveness. This systematic review was conducted in accordance with the current "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines. Controlled randomized trials comparing dislocation episode rates, range of motion in the TMJ, or articular pain intensity were adopted as the eligibility criteria. Final searches were conducted on 11 June 2023 using Bielefeld Academic Search Engine, Elsevier Scopus, and the National Library of Medicine: PubMed. Trials were assessed using the "Oxford Center for Evidence-Based Medicine 2011 Levels of Evidence" scale and "A revised Cochrane risk-of-bias tool for randomized trials". The results of the individual studies were tabulated, syntheses were illustrated in graphs. Twenty two studies involving 982 patients were included in the qualitative analysis, of which seven studies involving 390 patients were subject to quantitative analysis. None of the included randomized controlled trials presented a high risk of bias, 75% of them raised some concerns. In a three-month observation, administration of AB was more efficient in limiting temporomandibular dislocations than hypertonic dextrose (1 study, 32 patients, relative risk = 0.33, odds ratio = 0.29) and no difference in outcomes was observed between intracavitary and pericapsular administration compared to pericapsular injection alone (2 studies, 70 patients, relative risk = 1.00, odds ratio = 1.00). Injections of AB into the temporomandibular joints are effective in preventing further TMJ dislocation episodes in 75-94% of patients. This study received no funding.
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OBJECTIVES: This overview of systematic reviews aimed to establish the current state of knowledge on the suitability of artificial intelligence (AI) in dental panoramic radiograph analysis and illustrate its changes over time. METHODS: Medical databases covered by the Association for Computing Machinery, Bielefeld Academic Search Engine, Google Scholar, and PubMed engines were searched. The risk of bias was assessed using ROBIS tool. Ultimately, 12 articles were qualified for the qualitative synthesis. The results were visualized with timelines, tables, and charts. RESULTS: In the years 1988-2023, a significant development of information technologies for the analysis of DPRs was observed. The latest analyzed AI models achieve high accuracy in detecting caries (91.5%), osteoporosis (89.29%), maxillary sinusitis (87.5%), periodontal bone loss (93.09%), and teeth identification and numbering (93.67%). The detection of periapical lesions is also characterized by high sensitivity (99.95%) and specificity (92%). However, due to the small number of heterogeneous source studies synthesized in systematic reviews, the results of this overview should be interpreted with caution. CONCLUSION: Currently, AI applications can significantly support dentists in dental panoramic radiograph analysis. As systematic reviews on AI become outdated quickly, their regular updating is recommended. PROSPERO registration number: CRD42023416048.
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Perda do Osso Alveolar , Cárie Dentária , Humanos , Inteligência Artificial , Radiografia Panorâmica , Revisões Sistemáticas como AssuntoRESUMO
This mapping review aims to identify and discuss current research directions on intracavitary temporomandibular joints (TMJs) injections. The inclusion criteria allowed studies published in the last full six years, based on patients diagnosed with temporomandibular joint disorders (TMDs), treated by TMJ intra-articular injections. Medical databases covered by the Association for Computing Machinery, Bielefeld Academic Search Engine, PubMed, and Elsevier Scopus engines were searched. The results were visualized with tables, charts, and diagrams. Of the 2712 records identified following the selection process, 152 reports were qualified for review. From January 2017, viscosupplementation with hyaluronic acid (HA) was the best-documented injectable administered into TMJ cavities. However, a significant growing trend was observed in the number of primary studies on centrifuged blood preparations administrations that surpassed the previously leading HA from 2021.
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The aim of this review was to systematically map the research on the intra-articular administration of injectable platelet-rich fibrin (I-PRF) to the temporomandibular joints (TMJs). Medical databases covered by the ACM, BASE, Google, NLM, and ResearchGate were searched on 23 February 2023. The assessment of the level of evidence was based on the Oxford Center for Evidence-Based Medicine 2011 scale. The risk of bias was assessed for randomized controlled trials with the RoB2 tool. Extracted data were tabulated, and the changes in effect values were calculated. A total of eight studies qualified, of which five trials on 213 patients were randomized and controlled (RCTs). In each of the RTC study groups, arthrocentesis was performed, and 1-2 mL per joint of I-PRF (700 rpm/3 min/60 g centrifugation) was administered. Articular pain in three months decreased to 0-25% of the initial pre-interventional values in the study and 38-50% in the control groups. Mandible mobility increased to 121-153% and 115-120% in the I-PRF groups and controls, respectively. The main limitations of the evidence were the small number of RCTs and the lack of any RCT study groups receiving I-PRF without prior arthrocentesis. In conclusion, supplementing the temporomandibular joint rinsing with I-PRF administration further relieves pain and improves mandible mobility. The lack of RCTs on the intra-articular administration of I-PRF as a stand-alone procedure encourages further research. This research received no external funding. The review protocol has not been previously published.
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This systematic review and meta-analysis aimed to validate the hypothesis that intra-articular injections into the inferior temporomandibular joint compartment are more efficient than analogous superior compartment interventions. Publications reporting differences between the above-mentioned techniques in the domains of revealing articular pain, decreasing the Helkimo index, and abolishing mandibular mobility limitation were included. Medical databases covered by the Bielefeld Academic Search Engine, Google Scholar, PubMed, ResearchGate, and Scopus engines were searched. The risk of bias was assessed using dedicated Cochrane tools (RoB2, ROBINS-I). The results were visualized with tables, charts, and a funnel plot. Six reports describing five studies with a total of 342 patients were identified. Of these, four trials on a total of 337 patients were qualified for quantitative synthesis. Each eligible report was at moderate risk of bias. From 19% to 51% improvement in articular pain, 12-20% lower Helkimo index, and 5-17% higher maximum mouth opening were observed. The evidence was limited by the small number of eligible studies, discrepancies regarding the substances used, possible biases, and the differences in observation times and scheduled follow-up visits. Despite the above, the advantage of inferior over superior compartment temporomandibular joint intra-articular injections is unequivocal and encourages further research in this direction.
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This systematic review with meta-analysis was conducted to evaluate the effectiveness of local anesthetic administration into temporomandibular joint cavities in relieving pain and increasing mandibular mobility. Randomized controlled trials were included with no limitation on report publication dates. Final searches were performed on 15 October 2023, using engines provided by the US National Library, Bielefeld University, and Elsevier Publishing House. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Articular pain and mandible abduction values and their mean differences were summarized in tables and graphs. Eight studies on a total of 252 patients evaluating intra-articular administration of articaine, bupivacaine, lidocaine, and mepivacaine were included in the systematic review. None of the eligible studies presented a high risk of bias in any of the assessed domains. An analgesic effect of intra-articular bupivacaine was observed for up to 24 h. In the long-term follow-up, there were no statistically significant changes in quantified pain compared to both the baseline value and the placebo group, regardless of the anesthetic used (articaine, bupivacaine, and lidocaine). There is no scientific evidence on the effect of intra-articular administration of local anesthesia on the range of motion of the mandible. Therefore, in the current state of knowledge, the administration of local anesthetics into the temporomandibular joint cavities can only be considered as a short-term pain relief measure.
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Thiazolidinediones (TZDs) are a group of diabetes medications currently being investigated for anti-arthritis effectiveness, one of which is pioglitazone. The purpose of this scoping review is to evaluate the potential use of pioglitazone in the treatment of temporomandibular joint (TMJ) arthritis. The criteria of eligibility were studies with the diagnosis of arthritis and pioglitazone treatment with a change in any inflammation index as an outcome. Of the 1169 records initially identified following the selection process, two animal studies and four clinical studies were included in the review. Improvements from the baseline were observed in each treatment group for each inflammation indicator. The results of the animal studies on the temporomandibular joints and on patients with rheumatoid and psoriatic arthritis indicate that the drug in question may have potential to treat arthritis, including within the temporomandibular joint.
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Artrite Reumatoide , Transtornos da Articulação Temporomandibular , Animais , Pioglitazona/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/tratamento farmacológico , InflamaçãoRESUMO
Temporomandibular disorders, often manifested by articular pain, limitation of the mouth opening range, and unpleasant acoustic symptoms originating from inside the joint, have been associated with reduced quality of life. These symptoms, among others, can be treated with intra-articular injections of various substances, including repeated platelet-rich plasma (PRP) administration. The reported study was designed as an uncontrolled open-label clinical trial of consecutive cases. The participants completed a Fonseca questionnaire and evaluated acoustic symptoms, and spontaneous and provoked pain on VAS, and were subjected to a physical examination before, during, and after PRP therapy. The total Fonseca questionnaire results were statistically significantly (p < 0.05) correlated with 340 out of 348 (98%) other variables. The fully subjective assessment of the presence and intensity of acoustic symptoms coming from the temporomandibular joints was correlated with the physical examination results (0.45-0.63) and the maximum mouth opening with the maximum pain-free mouth opening (0.73-0.87). There were no correlations observed between the patient's and the physician's assessment of mandibular mobility. The Fonseca questionnaire seems to cover the entire spectrum of temporomandibular disorders, making it a balanced tool for assessing the quality of life in TMDs. However, it is worth considering extending the standard 3-point response scale to an 11-point one. The patient is somewhat able to perform a self-diagnosis with regard to the acoustic symptoms, but it is not possible for them to determine without measurement whether the range of mandibular mobility is appropriate..
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Plasma Rico em Plaquetas , Transtornos da Articulação Temporomandibular , Humanos , Medidas de Resultados Relatados pelo Paciente , Exame Físico , Plasma Rico em Plaquetas/fisiologia , Qualidade de Vida , Transtornos da Articulação Temporomandibular/terapia , Transtornos da Articulação Temporomandibular/tratamento farmacológico , Resultado do TratamentoRESUMO
This systematic review aims to analyze the outcomes of the treatment of temporomandibular joint (TMJ) articular pain (AP) and restricted maximum mouth opening (MMO) with intra-articular administration of mesenchymal stem cells (MSCs). The inclusion criteria allowed primary studies involving AP and/or MMO pre-treatment and post-intervention values. Medical databases that were covered by ACM Digital, BASE, EBSCOhost, Google Scholar, PubMed, Scopus, and Web of Science engines were searched. The risk of bias was assessed with RoB 2 and ROBINS-I tools. The results were tabulated, plotted, and analyzed for regression. A total of 5 studies involving 51 patients/69 TMJs were identified, and 4 studies on 50 patients/67 TMJs were synthesized. Interventions were each time effective in decreasing AP and increasing MMO in a 6-month follow-up period by an average of about 85% and over 40%, respectively. Regression analysis showed a good fit of the logarithmic model for AP relief (5.8 - 0.8 ln x; R2 = 0.90) and MMO increase (33.5 + 2.4 ln x; R2 = 0.89). The results for AP and MMO were based on 3 studies in 39 patients and 4 studies in 50 patients, respectively, all at high risk of bias. The intra-articular administration of MSCs to TMJs, based on weak evidence, may be highly effective in reducing AP and improving MMO. This study received no funding.
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Transplante de Células-Tronco , Transtornos da Articulação Temporomandibular , Transplante Autólogo , Humanos , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/terapiaRESUMO
BACKGROUND: Temporomandibular joint disorders (TMDs) are manifested, inter alia, by pain and limited scope of the mandibular abduction. Among the treatment strategies for these ailments, intra-articular injections of autologous blood preparations, including platelet-rich plasma (PRP), are administered. This prospective case series was aimed at assessing the effectiveness of repeated platelet-rich plasma (PRP) administration to the TMJ cavities in terms of reducing articular pain and increasing the mobility of the mandible. MATERIAL AND METHODS: 40 consecutive patients diagnosed with TMJ pain qualified for the case series. The entire treatment program consisted of five PRP administrations and a summary appointment. Regression was analyzed for (1) intensity of spontaneous pain; (2) effectiveness of spontaneous pain relief; (3) mastication efficiency values; (4) painless mandibular abduction; (5) maximum mouth opening. The correlations between the abovementioned variable series were analyzed. RESULTS: The mean spontaneous pain decreased consistently with successive PRP administrations in line with the regression model: -0.4x + 4.2 (R2 = 0.98). Articular pain improvement was reported in 71% of joints treated. Improvement in chewing quality at the end of the entire injection cycle was found in 63% of patients. The equations for the linear regression models for painless mandibular abduction (five applications of PRP) and maximum mouth opening (the first four applications of PRP) were x + 34 (R2 = 0.89) and 0.6x + 43.6 (R2 = 0.96), respectively. Improvement in these domains was found in 78% and 53% of patients, respectively. The strongest correlations were found between pain and chewing efficiency (-0.95), pain and painless mandible abduction (-0.96), and painless mandibular abduction and mastication efficiency (0.94). CONCLUSION: PRP injections into TMJ cavities should be considered as a low invasive, highly accessible form of treatment for various TMDs causing pain and mandible movement limitation.
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One of the possible alternatives for creating materials for the regeneration of bone tissue supporting comprehensive reconstruction is the incorporation of active substances whose controlled release will improve this process. This systematic review aimed to identify and synthesize in vitro studies that assess the suitability of polyphenolics as additives to polymer-ceramic composite bone regeneration materials. Data on experimental studies in terms of the difference in mechanical, wettability, cytocompatibility, antioxidant and anti-inflammatory properties of materials were synthesized. The obtained numerical data were compiled and analyzed in search of percentage changes of these parameters. The results of the systematic review were based on data from forty-six studies presented in nineteen articles. The addition of polyphenolic compounds to composite materials for bone regeneration improved the cytocompatibility and increased the activity of early markers of osteoblast differentiation, indicating a high osteoinductive potential of the materials. Polyphenolic compounds incorporated into the materials presumably give them high antioxidant properties and reduce the production of reactive oxygen species in macrophage cells, implying anti-inflammatory activity. The evidence was limited by the number of missing data and the heterogeneity of the data.
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Materiais Biocompatíveis , Polifenóis , Antioxidantes/farmacologia , Materiais Biocompatíveis/farmacologia , Regeneração Óssea , Cerâmica/farmacologia , Polifenóis/farmacologia , Engenharia Tecidual/métodosRESUMO
INTRODUCTION: Hyaluronic acid, steroids and blood products are popularly injected into the temporomandibular joint (TMJs) to relieve pain and increase the extent of mandibular abduction. The purpose of this review is to identify other injectable substances and to evaluate them in the above-mentioned domains. MATERIAL AND METHODS: The review included articles describing clinical trials of patients treated with intra-articular injections with or without arthrocentesis. RESULTS: The following emerging substances were initially evaluated to be effective in treating TMJ pain and increasing the amplitude of mandibular abduction: analgesics, dextrose with lidocaine, adipose tissue, nucleated bone marrow cells and ozone gas. DISCUSSION: Better effects of intra-articular administration are achieved by preceding the injection with arthrocentesis. CONCLUSIONS: The most promising substances appear to be bone marrow and adipose tissue.
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OBJECTIVES: The purpose of this systematic review with meta-analysis is to identify clinical studies concerning the impact of intra-articular administration of hyaluronic acid (HA) on mandibular mobility and to make an attempt at determining the efficacy of HA in this indication. METHODS: The review included primary studies involving groups of at least 10 patients who were diagnosed with pain in the temporomandibular joint and who were injected with hyaluronic acid as the only intervention. The outcomes pursued were changes in mandibular mobility and pain intensity. Four databases of medical articles were searched, including PubMed and BASE. The risk of bias was assessed using the Cochrane methodology tools. The therapy's efficacy was calculated in the domains of mandibular abduction, protrusive movement, lateral mobility, and pain relief. For these values, the regression and correlation with variables characterizing the interventions were analyzed. RESULTS: In total, 16 reports on 20 study groups with a total of 1007 patients qualified for the review. The mean effectiveness in the domain of mandibular abduction over the 6-month follow-up period was 122% of the initial value, and the linear regression model can be expressed as 0.5x + 36. The level of pain in the same time frame decreased to an average of 29%. The severity of pain 6 months after the beginning of treatment positively correlates with the number of injections per joint (0.63), the total amount of drug administered in milliliters (0.62), and the volume of drug administered monthly per joint (0.50). LIMITATIONS: In some studies, the patient groups were heterogeneous in terms of diagnosis. The studies varied depending on the joint into which the HA was administered. The synthesized studies differed with regard to the method of measuring the mandible abduction amplitude. CONCLUSIONS: The increase in the amplitude of mandibular abduction was expressed as the quotient of the mean values during the observation periods, and the initial value was achieved in all study groups, and in the linear regression model, it was 0.5 mm on average per month. Multiple administrations of the drug may reduce the analgesic effectiveness of the treatment.
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The number of studies on the subject of effects of zirconium dioxide (ZrO2) nanoparticles addition on the mechanical parameters of polymethyl methacrylate (PMMA) is still very limited. Therefore, in this research, the authors wanted to assess PMMA modified with the nano-ZrO2 additive in terms of changes in flexural, impact and tensile strength values in relation to PMMA without such component. A systematic review and meta-analysis were performed to evaluate the effect of incorporating nano-ZrO2 into PMMA on individual types of material strength. The obtained numerical data were tabulated and analyzed in the search for percentage changes in those parameters. It was then calculated for each set and the procured model was examined using residual sum of squares (RSS) to assess the discrepancy between the data and the estimation model whilst mean absolute deviation (MAD) was employed to determine robustness. The results of the systematic review were composed of data obtained from individual studies presented in eight independent articles. Overall, the addition of nano-ZrO2 increases the flexural strength of the composite with the PMMA matrix depending on the size of the ZrO2 grains administered. Unfortunately, these conclusions are based on a very limited amount of research and require further verification, especially regarding tensile strength.
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BACKGROUND: Myofascial pain is an important cause of disability among the whole population, and it is a common symptom of temporomandibular joint disorders (TMDs). Its management techniques vary widely; however, in recent years, there has been a growing interest especially in needling therapies within masticatory muscles, due to their simplicity and effectiveness in pain reduction. METHODS: The construction of the following study is based on PICOS and PRISMA protocols. A systematic literature search was conducted based on the PubMed and BASE search engines. Searching the abovementioned databases yielded a total of 367 articles. The screening procedure and analysis of full texts resulted in the inclusion of 28 articles for detailed analysis. RESULTS: According to analyzed data, clinicians manage myofascial pain either with wet or dry needling therapies. The most thoroughly studied approach that prevails significantly within the clinical trials is injecting the botulinum toxin into the masseter and temporalis. Other common methods are the application of local anesthetics or dry needling; however, we notice the introduction of entirely new substances, such as platelet-rich plasma or collagen. In the analyzed articles, the target muscles for the needling therapies are most commonly localized by manual palpation although there are a variety of navigational support systems described: EMG, MRI or EIP electrotherapy equipment, which often aid the access to located deeper lateral and medial pterygoid muscle. CONCLUSIONS: Needling therapies within masticatory muscles provide satisfactory effects while being simple, safe and accessible procedures although there still is a need for high quality clinical trials investigating especially injections of non-Botox substances and needling within lateral and medial pterygoid muscles.
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Agulhamento Seco , Síndromes da Dor Miofascial , Ensaios Clínicos como Assunto , Humanos , Injeções Intramusculares , Músculos da Mastigação , Síndromes da Dor Miofascial/terapia , DorRESUMO
Peripheral ossifying fibroma (POF) is a reactive lesion that originates in the gingiva. Morphological similarity to other epulides and similar nomenclature to neoplastic tumors give rise to obvious problems both at the stage of diagnosis and treatment of POF. Although POF is one of the less common gingival lesions, it accounts for up to 2% of all oral lesions, which means that most general dentists will encounter POF in their practice. This paper aims to present the case of a 56-year-old woman diagnosed with POF. In the described case, POF most likely resulted from chronic periodontal irritation due to the presence of prosthetic crowns. The applied treatment in the form of total excision of POF, removal of irritants and gingivoplasty brought the expected therapeutic effect, i.e. no recurrence in the period of the hitherto follow-up. Terminological difficulties, the basics of differentiating typical gingival tumors, therapeutic options with suggested management of POF, and recurrence rate with the follow-up scheme were discussed. Despite the reactive nature of POF, this lesion recurs up to 20% and can transform to giant POF. For this reason, POF should not be underestimated, and proper diagnosis, treatment, and follow-up are critical to the success of therapy.