Changes

==Introduction==  

==Introduction==  

[[File:Fibrous epulis.JPG|thumb|200px|right|Fibrous epulis]]

[[File:Fibrous epulis.JPG|thumb|200px|right|Fibrous epulis]]

Peripheral odontogenic fibroma is a benign tumour that arises from the [[Enamel Organ#Periodontal Ligament|periodontal ligament]]. It was previously known as a fibromatous epulis and ossifying epulis depending on the degree of mineralization.  

Peripheral odontogenic fibroma is a benign tumour that arises from the [[Tooth - Anatomy & Physiology#Periodontal Ligament|periodontal ligament]]. It was previously known as a fibromatous epulis and ossifying epulis depending on the degree of mineralization.  

They present as firm, smooth swellings of the [[Gingiva|gingiva]] and are normally indistinguishable from [[Gingival Hyperplasia|gingival hyperplasia]].

They present as firm, smooth swellings of the [[Gingiva|gingiva]] and are normally indistinguishable from [[Gingival Hyperplasia|gingival hyperplasia]].

==Diagnostic Imaging==

==Diagnostic Imaging==

Radiographs are required to differentiate this benign neoplasm from malignant or locally aggressive lesions. Skull radiographs will evaluate the oral lesion itself and thoracic radiography to evaluate for metastasies (if a malignancy is a diagnostic possibility). Radiographs typically show a soft tissue opacity in the the gingiva region with varying degrees of mineralization. Bone involvement is not a feature of this neoplasm and hence is not to be confused with [[Acanthomatous Ameloblastoma|Acanthomatous Ameloblastoma]] which often invades bone.

Radiographs are required to differentiate this benign neoplasm from malignant or locally aggressive lesions. Intra-oral radiographs will evaluate the oral lesion itself and thoracic radiography to evaluate for metastasies (if a malignancy is a diagnostic possibility). Radiographs typically show a soft tissue opacity in the the gingiva region with varying degrees of mineralization. Bone involvement is not a feature of this neoplasm and hence is not to be confused with [[Acanthomatous Ameloblastoma|Acanthomatous Ameloblastoma]] which often invades bone.

Radiography cannot be used to differentiate a peripheral odontogenic fibroma from a hyperplastic gingival lesion.

Radiography cannot be used to differentiate a peripheral odontogenic fibroma from a hyperplastic gingival lesion.

==Pathology==

==Pathology==

[[Image:epulis.gif|right|thumb|200px|<small><center>Canine Epulis(Courtesy of Alun Williams (RVC))</center></small>]]

[[Image:epulis.gif|right|thumb|200px|<small><center>Canine Epulis(Courtesy of Alun Williams (RVC))</center></small>]]

Proliferation of fibrous tissue with a variety of osteoid, [[Enamel Organ#Cementum|cementum]] or [[Enamel Organ#Dentine|dentine]] like material. Isolated strands or islands of odontogenic epithelium are always present (ie: suggesting induction of connective tissue by the epithelial cells).  

Proliferation of fibrous tissue with a variety of osteoid, [[Tooth - Anatomy & Physiology#Cementum|cementum]] or [[Tooth - Anatomy & Physiology#Dentine|dentine]] like material. Isolated strands or islands of odontogenic epithelium are always present (ie: suggesting induction of connective tissue by the epithelial cells).  

The stroma contains neoplastic fibroblasts, with varying cellularity and the overlying epitheluim is normal.

The stroma contains neoplastic fibroblasts, with varying cellularity and the overlying epitheluim is normal.

{{Learning

{{Learning

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