Fibromas

Question 1

What is the most common tumor of the oral cavity?

Answer 1

Fibroma

Question 2

What is fibroma?

Answer 2

Reactive hyperplasia of fibrous CT in response to local irritation or trauma

Question 3

What is the most common location of a fibroma?

Answer 3

Buccal mucosa along the bite line

Other sites include the labial mucosa, tongue and gingiva

Question 4

Gingival fibromas represent a fibrous maturation of what lesion?

Answer 4

Fibrous maturation of a pre-existing pyogenic granuloma

Question 5

Clinical appearance of fibromas

Answer 5

Smooth surfaced pink nodule that is similar in color to the surrounding mucosa .

Surface may appear white as a result of hyperkeratosis from continued irritation

Question 6

How may the appearance of fibromas differ in blacks?

Answer 6

gray-brown pigmentation

Question 7

Are fibromas normally sessile or pedunculated?

Answer 7

Most are sessile but some are pedunculated

Question 8

Where do frenal tags occur?

Answer 8

Maxillary labial frenum

Question 9

What is the histopathologic feature of fibromas?

Answer 9

Exophytic, nodular mass of dense fibrous CT covered by stratified squamous epithelium

CT is usually dense and collagenized

Question 10

Are fibromas encapsulated?

Answer 10

No, fibrous tissue blends gradually into the surrounding CT

Question 11

Tx for fibromas?

Answer 11

Conservative surgical excision

Question 12

Why is it necessary to submit excised tissue for microscopic examination?

Answer 12

Other benign and malignant tumors may mimic the clinical appearance of a fibroma

Question 13

Is recurrence common in fibroma excisions?

Answer 13

No, they are rare

Question 14

Is tx necessary for frenal tags?

Answer 14

No, because they are small and easily diagnosed

Question 15

a retrocuspid papilla is what kind of fibroma?

Answer 15

giant cell fibroma

Question 16

Where do retrocuspid papilla occur?

Answer 16

developmental lesion that occurs on the gingiva, lingual to the mandibular cuspid

Question 17

Are retrocuspid papilla commonly unilateral or bilateral?

Answer 17

Bilateral

Question 18

What’s the normal size of retrocuspid papilla?

Answer 18

Small pink papule less than 5mm in diameter

Question 19

What is the histopathologic appearance of giant cell fibroma?

Answer 19

Mass of vascular fibrous CT that is loosely arranged and covered by stratified squamous epithelium

Numerous larger multi nucleated stellate fibroblasts exist within the superficial CT

Rete ridges are narrow and elongated

Covering epithelium is thin and atrophic

Question 20

Tx for giant cell fibroma

Answer 20

Conservative surgical excision

Question 21

Why do retrocuspid papilla not need to be excised?

Answer 21

Characteristic appearance allows clinical recognition

Question 22

What is peripheral ossifying fibroma?

Answer 22

A relatively common reactive (rather than neoplastic) gingival growth

Question 23

What is the origin of mineralized products in peripheral ossifying fibroma?

Answer 23

Origin from cells of the periosteum or PDL

Question 24

Where does the peripheral ossifying fibroma exclusively occur?

Answer 24

gingiva

Question 25

What is the clinical presentation of peripheral ossifying fibroma lesion?

Answer 25

nodular mass emanating from the interdental papilla

sessile or pedunculated

Question 26

What is peripheral ossifying fibroma easily mistaken with?

Answer 26

pyogenic granuloma

Question 27

what is the histopathologic appearance of peripheral ossifying fibroma?

Answer 27

fibrous proliferation associcated with the formation of a mineralized product (central bone formation)

Question 28

Tx for peripheral ossifying fibroma

Answer 28

Tx of choice = local surgical excision

Mass should be excised down to periosteum

Adjacent teeth should be carefully scaled down to remove any source of irritation