Conventional surgical excision for the treatment of Peripheral Cemento-Ossifying Fibroma Posterior Maxilla: Case report

Background: Peripheral Cemento-Ossifying Fibroma (PCOF) usually presents as epulis, represents 3.1% of all oral tumors and 9.6% of gingival lesions, is difficult to distinguish clinically and radiographically, requires anatomic histopathological confirmation, peaking in the 2nd and 3rd decades, high recurrence 8-20%.
Objective: To report the case management of Peripheral Cemento-Ossifying Fibroma in posterior maxilla with conventional surgery excision surgery, curettage, extraction, and ostectomy.
Case: A 42-year-old woman came to the Oral Surgery Clinic at RSUD Haji East Java Province Hospital, complaining of a lump in left maxillary gingiva since 2 years ago, with discomfort, often bitten, initially small, gradually enlarged and never shrinking, does not bleed easily, no lumps elsewhere, with sharp remnants of roots, loose teeth, and a history of vertigo.
Discussion: The results of FNAB is Fibromatous Epulis, panoramic radiographic view of the loose periodontal ligament of tooth 27, radiolucent mixed radiopaque clearly demarcated in the distal portion of 27, no visible image of tooth 28. Calculus was cleaned before surgery. Treatments with conventional surgery were excision using a scalpel, curettage, ostectomy, and tooth extraction 27, 38. Histopathological results of postoperative anatomy showed bone trabeculae and “cementum like” tissue in accordance with cemento-ossifying fibroma. The patient was evaluated within 6 months, with no recurrence.
Results: Treatment of peripheral cemento-ossifying fibroma with conventional surgery with excision, curettage, ostectomy, and extraction of the causative tooth was successful.