Difference between revisions of "Peripheral Odontogenic Fibroma"

Revision as of 10:37, 21 August 2009

Typical Signalment

Most common benign tumour found in the oral cavity in dogs
Less common in cats
Seen in dogs of any age but more common in those > 6years old

Description

Peripheral odontogenic fibroma is a benign tumour that arises from the 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 and are normally indistinguishable from gingival hyperplasia.

Diagnosis

Clinical Signs

halitosis
oral bleeding
dental disruption or loss
facial or mandibular deformity
excessive salivation
growth protruding from the mouth
dysphagia occurs rarely

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

Biopsy

An incisional biopsy is required to obtain a definitive diagnosis

Treatment

An excision of the neoplasm should be performed. The depth of the excision is determined by the location of the origin of the neoplasm at the periodontal ligament. Excision may be at the gingival level or a deep resection involving the extraction of the affected tooth and curettage of the alveolar socket.

Prognosis

Good following surgical resection. Recurrence is common following incomplete surgical resection.

References

Tutt, C., Deeprose, J. and Crossley, D. (2007) BSAVA Manual of Canine and Feline Dentistry (3rd Edition) BSAVA

Merck & Co (2008) The Merck Veterinary Manual

@@ Line 1: / Line 1: @@
-{{OpenPagesTop}}
+{{unfinished}}
-Also known as: ''''' Fibromatous epulis of periodontal ligament — Epulis — Ossifying Epulis
+{{dog}}
-==Introduction==
+{{cat}}
-[[File:Fibrous epulis.JPG|thumb|200px|right|Fibrous epulis]]
-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]].
 ==Typical Signalment==
-Most common benign tumour found in the oral cavity in dogs but is less common in cats. Is seen in dogs of any age but more common in those older than 6 years. .
+*Most common benign tumour found in the oral cavity in dogs
+*Less common in cats
-==Clinical Signs==
+*Seen in dogs of any age but more common in those > 6years old
-Include halitosis, oral bleeding, dental disruption or loss, facial or mandibular deformity, excessive salivation, growth protruding from the mouth and rarely dysphagia.
+==Description==
+Peripheral odontogenic fibroma is a benign tumour that arises from the [[Periodontal ligament - Anatomy & Physiology|periodontal ligament]]. It was previously known as a fibromatous epulis and ossifying epulis depending on the degree of mineralization.
-==Diagnostic Imaging==
+They present as firm, smooth swellings of the [[Oral Cavity - Teeth & Gingiva - Anatomy & Physiology|gingiva]] and are normally indistinguishable from [[Gingival Hyperplasia - WikiClinical|gingival hyperplasia]].
-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.
+==Diagnosis==
-Radiography cannot be used to differentiate a peripheral odontogenic fibroma from a hyperplastic gingival lesion.
-==Biopsy==
-An incisional biopsy is required to obtain a definitive diagnosis.
-==Pathology==
+===Clinical Signs===
-[[Image:epulis.gif|right|thumb|200px|<small><center>Canine Epulis(Courtesy of Alun Williams (RVC))</center></small>]]
+*halitosis
-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).
+*oral bleeding
-The stroma contains neoplastic fibroblasts, with varying cellularity and the overlying epitheluim is normal.
+*dental disruption or loss
+*facial or mandibular deformity
+*excessive salivation
+*growth protruding from the mouth
+*dysphagia occurs rarely
+===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 [[Oral Cavity - Teeth & Gingiva - Anatomy & Physiology|gingiva]] region with varying degrees of mineralization. Bone involvement is '''not''' a feature of this neoplasm.
+Radiography cannot be used to differentiate a peripheral odontogenic fibroma from a [[Gingival Hyperplasia - WikiClinical|hyperplastic gingival lesion]].
+===Biopsy===
+An incisional biopsy is required to obtain a definitive diagnosis
 ==Treatment==
-A surgical excision of the neoplasm should be performed. The depth of the excision is determined by the location of the origin of the neoplasm at the periodontal ligament.
+An excision of the neoplasm should be performed. The depth of the excision is determined by the location of the origin of the neoplasm at the [[Periodontal ligament - Anatomy & Physiology|periodontal ligament]].
 Excision may be at the gingival level or a deep resection involving the extraction of the affected tooth and curettage of the alveolar socket.
-They do not recur if adequately excised.
 ==Prognosis==
 Good following surgical resection. Recurrence is common following incomplete surgical resection.
-{{Learning
-|literature search = [http://www.cabdirect.org/search.html?q=title%3A%28%22Peripheral+Odontogenic+Fibroma%22%29+OR+%28title%3A%28epulis%29+AND+%28title%3A%28fibromatous%29+OR+title%3A%28ossifying%29%29%29 Peripheral Odontogenic Fibroma publications]
-|Vetstream = [https://www.vetstream.com/felis/Content/Disease/dis60094.asp Odontoclastic tooth resorption]
-}}
 ==References==
-Tutt, C., Deeprose, J. and Crossley, D. (2007) '''BSAVA Manual of Canine and Feline Dentistry (3rd Edition)''' ''BSAVA''
+*Tutt, C., Deeprose, J. and Crossley, D. (2007) '''BSAVA Manual of Canine and Feline Dentistry (3rd Edition)''' ''BSAVA''
-Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''
-Verstraete, F.J.M., Ligthelmf, A.J. and Weber, A,(1992) '''The Histological Nature of Epulides in Dogs'''. Journal of comparative Pathology. (106) 169-182.
-With thanks to Andrew Jefferies (Cambridge) and Alun Williams (RVC) for providing access to their lecture materials
-{{review}}
-{{OpenPages}}
-[[Category:Teeth_-_Proliferative_Pathology]]
+*Merck & Co (2008) '''The Merck Veterinary Manual'''
-[[Category:Neoplasia]]
-[[Category:Expert_Review - Small Animal]]
-[[Category:Oral Diseases - Dog]]
-[[Category:Oral Diseases - Cat]]
-[[Category:Bones - Pathology]]
-[[Category:Oral Proliferations]]
-[[Category:LisaM reviewing]]