Peripheral ossifying fibroma--a clinical evaluation of 134 pediatric cases.

PURPOSE Reported clinicopathologic studies on the peripheral ossifying fibroma (POF), a reactive gingival lesion, have not addressed the pediatric population in specific detail. This study, the first devoted to children, investigated the clinical features of a large number of POFs and compared the findings to cases reported in the English language literature. METHODS Detailed clinical and historical information of 134 surgically removed POFs in patients aged 1-19 formed the basis of this study. Clinical manifestations, histogenesis, treatment rationale with pediatric considerations, and biologic behavior were emphasized. RESULTS The POF was found more frequently in females (60%). It had a predilection for the maxillary gingiva (60%) and for the incisor/cuspid region. The average patient age was 14 years. Only 2 (1%) POFs were found to be unequivocally associated with primary teeth. The clinician seldom included the POF in the differential diagnosis. The recurrence rate after surgical excision was 8%. CONCLUSIONS This study revealed that a POF arising from the periodontal ligament of a primary tooth is most likely a rare event. However, the pediatric patient with a POF has special management considerations compared to the adult. Because of the POF behavior pattern, a proper treatment protocol is warranted with close postoperative follow-up.