Gingival and alveolar mucosal reactive hyperplastic lesions: a retrospective clinical and histological study of 996 cases.

BACKGROUND: gingival/alveolar mucosal reactive hyperplastic lesions (GRHL), including fibrous hyperplasia (FH), pyogenic granuloma (PG), peripheral ossifying fibroma (POF) and peripheral giant cell lesion (PGCL), are a common group of oral diseases. The aim of the present study was to access the frequency and distribution of the clinical and histological features of these disorders in a Brazilian population. MATERIAL AND METHODS: all specimens diagnosed as GRHL in three Oral Pathology laboratories were selected for the study. Clinical information was retrieved from the laboratory biopsy forms and hematoxylin and eosin stained histological slides were reviewed for analysis of the histological characteristics. RESULTS: final sample was composed of 996 specimens, including 463 FH (47%), 280 PG (28%), 183 POF (18%) and 70 PGCL (7%). Females were more affected by FH, PG, and POF, and most cases affected adults with mean ages ranging from 40 to 53 years. FH, PG, and POF were more common in the upper gingiva/alveolar mucosa. Most PG, POF and PGCL were pedunculated, in contrast with FH (p<0.001). PG, FH and POF were mostly red or normal mucosal in color, while PGCL were mostly red/purple (p<0.001). PGCL were larger, followed by POF, FH and PG (p<0.001). Some histological features were characteristically found in some conditions, but they were also encountered in other lesions with variable frequencies. CONCLUSIONS: Oral medicine specialists, oral pathologists and periodontists are usually the professionals in contact with patients presenting GRHL and it is of upmost relevance that they should be familiarized with their clinical and histological profile.

A retrospective analysis of reactive hyperplastic lesions of the oral cavity: study of 1149 cases diagnosed between 2000 and 2011, Chile / Análisis retrospectivo de lesiones reaccionales hiperplásicas en mucosa oral: estudio de 1149 casos diagnosticados entre el 2000–2011 en chile

El objetivo de este estudio fue determinar la frecuencia relativa y distribución de lesiones reaccionales hiperplásicas (LRH) de la mucosa oral, presentes en el registro de biopsias del Servicio de Anatomía Patológica de la Facultad de Odontología, Universidad de Chile. Este estudio de tipo retrospectivo consistió en 1149 biopsias con diagnóstico histopatológico de LRH, entre los años 2000-2011. Las LRH se clasificaron en 5 grupos: Hiperplasia fibrosa (HF), granuloma piogénico (GP), granuloma periférico de células gigantes (GPCG) y fibroma osificante periférico(FOP). Los datos de edad y sexo de los sujetos, y de localización y tipo de lesión, fueron obtenidos del registro de biopsias de cada caso. De las LRH, la lesión más frecuente fue HF (71,1 por ciento), seguido de GP (21,1 por ciento), GPCG (5 por ciento) y FOP (2,9 por ciento) respectivamente. Las biopsias de LRH fueron mas frecuentes en mujeres (70,7 por ciento). El rango etario más afectado fue el de 50 a 59 años (22 por ciento). La localización de mayor frecuencia de LRH fue el maxilar superior (24,7 por ciento), seguida de mejilla (20,6 por ciento), lengua (19,4 por ciento), mandíbula (18,5 por ciento), labio inferior (9,9 por ciento) y labio superior (6,7 por ciento). En este estudio, de las LRH el diagnóstico más prevalente fue FH. El sexo más afectado fue el femenino, el rango etario el de 50 a 59 años y la ubicación más frecuente, maxilar superior. Estos resultados en general son concordantes con lo descrito en otros países.

The aim of this study was to determine the relative frequency and distribution of reactive hyperplastic lesions (RHL) of the oral mucosa at the Oral Pathology Institute of the School of Dentistry at the University of Chile. This was a retrospective study of 1149 biopsies with histopathological diagnosis of RHL, performed between 2000 and 2011. The RHL were classified in 4 groups: fibrous hyperplasia (FH), pyogenic granuloma (PG), peripheral giant-cell granuloma (PGCG) and peripheral ossifying fibroma (POF). Results: the most frequent RHL was FH (71. 1%), followed by PG (21.1%), PGCG (5 %) and POF (2.9%). RHLs were more frequent in women (70.7%). The most highly affected age group was the 50- to 59-year-olds (22%). The most frequent location for RHL was maxilla (24.7%), followed by cheek (20.6%), tongue (19.4%) and jaw (18.5%). The most prevalent RHL diagnosis was FH. Themost frequently affected sex was female, the most frequent agerange was 50-59 years, and the most frequent location, maxilla.

Benign fibro-osseous lesions: clinicopathologic features from 143 cases diagnosed in an oral diagnosis setting.

OBJECTIVE: The aim of this study was to report the clinicopathologic and radiologic features of 143 benign fibro-osseous lesions (BFOLs). STUDY DESIGN: Clinical and radiologic information were retrieved from the patients files, and histologic features were reviewed from hematoxylin and eosin-stained histologic slides. RESULTS: There were 22 ossifying fibromas (OFs), 21 fibrous dysplasias (FDs) and 100 osseous dysplasias (ODs; 65 florid, 18 focal, and 17 periapical). The mean age of the FD/OF patients was a decade lower than those with OD. The mandible was more affected than the maxilla, except in FDs. All FDs and OFs presented local swelling, whereas this was observed in <40% of the ODs. Radiologic images of the florid/periapical ODs and OFs were predominantly mixed, whereas FDs and focal ODs were predominantly radiopaque. CONCLUSIONS: Florid OD, OF, and FD were the most common diagnoses, and the clinicopathologic and radiologic features were somewhat distinct from the characteristics of other populations.

Fibroma ossificante periférico: um levantamento clínico e epidemiológico / Peripheral ossyfying fibroma: a clinical epidemiological survey

Este artigo aborda 18 casos de fibroma ossificante periférico (FOP) diagnosticados no Centro de Referência de Lesões Bucais da Universidade Estadual de Feira de Santana/Bahia, no período de 2002 a 2008. Para descrever a relação entre as variáveis sociodemográficas com o FOP, utilizou-se o Statistical Package for Social Science (SPSS), versão 10.0 for Windows (1998). Observou-se maior acometimento desta doença na quarta década de vida, sexo feminino e cor não branca. A gengiva superior anterior foi a região de maior prevalência. Faz-se importante que os cirurgiões-dentistas conheçam as características do FOP para o correto diagnóstico.

Estudo comparativo da atividade proliferativa celular do fibroma ossificante periférico e da lesão de células gigantes periférica / Comparative study of the proliferative activity of the peripheral giant cells lesion and of peripheral ossifying fibroma

Foi realizado um estudo clínico retrospectivo descritivo e histoquímico de casos do fibroma ossificante periférico (FOP) e da lesão de células gigantes periférica (LCGP), coletados aleatoriamente no arquivo do Serviço de Diagnóstico Histopatológico da Universidade de Passo Fundo. O objetivo do trabalho foi comparar as atividades proliferativas celulares dessas lesões, visando o estabelecimento de uma conduta terapêutica adequada para cada uma das enfermidades. Os dados referentes ao sexo, idade, raça, localização da lesão e ocorrência de recidiva foram analisados e, o número de regiões organizadoras nucleolares (NORs) por núcleo de células ovóides foi determinado por meio do método de impregnação pela prata (Ag-NOR). Os resultados obtidos para o FOP foram de prevalência da lesão em mulheres (70%) da raça branca (60%) com média de idade de 28,11 anos, maior ocorrência da lesão na maxila anterior e índice de recidiva de 30%. O número médio de NORs foi de 1,72 para cada núcleo. Já para a LCGP, o sexo feminino também atingiu 70%, porém a média de idade foi de 42,90 anos e 100% dos pacientes pertenciam à raça branca. A ocorrência da lesão foi maior na região mandibular anterior e apresentou um índice de 20% de recidiva. Nesta lesão, o número médio de NORs foi de 1,93 por núcleo. Contudo, nos testes de correlação, nenhuma das características clínicas apresentou associação com o número médio de NORs por núcleo e a comparação desse número médio por núcleo nas LCGPs e nos FOPs não mostrou diferença significativa entre os grupos.

A retrospective clinical descritive and histochemical study envolving cases of periferic bone fibroma and of periferic giant cell lesion, randomly collected from the archives of Histophatologic Diagnostic Service of University of Passo Fundo was made. The objective of this work was to compare the proliferating cellular activities of these lesions, aiming the establishment of an adequate therapeutic conduct to each one of the disorders. The datas referring to the gender, age, race, position of the lesion and recurrence occurrence were analized and considered and the NORs’ numbers by egg-shaped cells’ nucleus were analized through the impregnation of silver method (Ag-NOR), getting as a result of periferic bone fibroma, 70% women, with an age average of 28.11 years old, where 60% of the pacients were white, and with the lesion’s position more often being on the front upper jaw, with the recurrence’s index up to 30%. The NORs’ average number was of 1.72 to each nucleus. On the periphery giant cell lesion, the female gender had also achieved 70%, however the age’s average was of 42.90 and 100% were white. The occurrence of the lesion was higher on the front inferior jaw and had showed a recurrence’s index of 20%. The NORs’ average of this lesion was 1.93 to each nucleus. Nevertheless, on the correlation’s tests none of these clinic characteristics showed a connection with the higher average’s number of NORs by nucleus and the comparison of NORs average’s number by nucleus on periphery bone fibroma and periphery giant cell lesion did not show a significant difference between the groups.

Pyogenic granuloma, peripheral giant cell granuloma and peripheral ossifying fibroma: retrospective analysis of 138 cases.

AIM: The present study examined retrospectively the clinical and radiographic characteristics of pyogenic granuloma (PG), peripheral giant cell granuloma (PGCG) and peripheral ossifying fibroma (POF), located in the gingiva and alveolar ridge. METHODS: Biopsy records of the Stomatology Service of São Lucas Hospital-PUCRS were reviewed between 1980 and 2006. The medical charts of patients with histopathologic diagnosis of PG, PGCG and POF were selected. The data obtained were evaluated by means of descriptive statistics, analysis of variance (ANOVA), and the chi-squared test (chi-squared), considering the 5% level of significance. RESULTS: Of the 138 cases analyzed, 57.2% corresponded to PG, 22.5% to PGCG and 20.3% to POF. PG and POF exhibited a predilection for females and PGCG for males. PG occurred in younger individuals and showed a greater tendency for bleeding (P=0.018). PG showed a greater frequency of reddish color (P<0.001), PGCG purplish (P<0.001) and POF pinkish (P<0.001). In the radiographic examination, the presence of radiopaque foci was greater in POF (P<0.001), and resorption of the subjacent alveolar bone was found more often in PGCG (P<0.001). POF exhibited a longer evolution. There was no difference in lesions with respect to local irritating factors, ulceration, size, site and recurrence. Pregnancy was a factor linked to PG. CONCLUSION: Despite the lesions investigated exhibit similar clinical characteristics, the present study demonstrated that aspects such as age of the patient and evolution, color, bleeding and radiographic characteristics can help in the differential diagnosis of these lesions.

Benign fibro-osseous lesions of the jaw bones in Jamaica: analysis of 32 cases.

OBJECTIVE: It is intended to analyse all the cases of benign fibro-osseous lesions seen at the two major public hospitals in Jamaica over a 15-year period and to compare our result with what has been previously documented by other authors. No such analysis has been carried out in Jamaica or elsewhere in the English-speaking Caribbean. MATERIALS AND METHODS: The case files of patients histologically diagnosed to have a fibro-osseous lesion at both the Kingston Public Hospital and the Cornwall Regional Hospital in Jamaica from 1980 to 1995 were retrieved and information about these lesions was documented. The WHO classification for benign fibro-osseous lesions was used. RESULTS: A total of 32 cases of benign fibro-osseous lesions were recorded over the 15-year period. Of these, 15 were histologically reported as fibrous dysplasia, 10 as ossifying fibroma, three as gigantiform cementoma, one each as periapical cemental dysplasia and cementoblastoma, and two cases of recurrent fibrous dysplasia. With the exception of gigantiform cementoma the age at presentation for these lesions is not consistent and this can be particularly noted for ossifying fibroma and fibrous dysplasia, both of which occurred between the age of 10 and 68 years. CONCLUSION: These lesions are more common in females, furthermore it is suggested that the inconsistent age at presentation for some of these lesions may be peculiar to Jamaica, and may be due to delay in reporting a lesion by the patient, as routine dental examination is not a common practice.

Fibroma cemento-osificante: estudio retrospectivo de 91 casos para determinar sus características clínicas y radiológica / Cemento-ossifying fibroma. A retrospective study of 91 cases to establish clinical and radiological characteristics

Actualmente se define el fibroma cemento-osificante como una sola lesión, uniendo a las pre-existentes fibroma osificante y fibroma cementificante, ya que no se encuentran diferencias de comportamiento y de origen entre ellas. Se revisaron los casos diagnósticados como fibromas osificantes, fibroma cementificante y fibroma cemento-osificante del Instituto de Referencia de Patología Oral de la Facultad de Odontología, Unniversidad de Chile, para determinar sus características clínicas, obteniéndose una muestra de 91 casos. Se observó mayor frecuencia en mujeres de la 4ta. década de vida, siendo el maxilar inferior la zona más afectada. Las características clínicas se resumen como una lesión con aumento de volumen de crecimiento lento, asintomático y con porcentaje de recidiva. Radiográficamente lo más frecuente es encontrar una lesión de densidad radiopaca con límites netos.