Traumatic Fibroma of the Gingiva in a Child: 4-Year Follow-Up

Tülin Taşdemir; Gizem Erbas Unverdi; Zafer Çehreli

doi:10.7126/cumudj.1689299

Case Report

ÜÇ YAŞINDAKİ ÇOCUK HASTADA TRAVMATİK FİBROMA: 4 YILLIK TAKİP

Year 2025, Volume: 28 Issue: 4, 633 - 638, 29.12.2025

Tülin Taşdemir , Gizem Erbas Unverdi , Zafer Çehreli

https://doi.org/10.7126/cumudj.1689299

Abstract

Travmatik fibroma, ağız boşluğunda en yaygın görülen yumuşak doku lezyonu olarak kabul edilir. Çocuklarda meydana gelebilir ancak yaşamın ilk on yılında çok nadir görülür. Bu vaka raporu, özellikle diş etindeki olağan dışı konumu ile bir çocuk hastada travmatik bir fibroma yönetimini vurgulamayı amaçlamaktadır. Sağlıklı 3 yaşında bir çocuk, 6 aydır mevcut olan maksiller ön diş etinde sınırları belirgin, hiperplastik, saplı bir lezyon nedeniyle sevk edilmiştir. Lezyon lokal anestezi altında çıkarılmıştır ve histopatolojik inceleme travmatik fibroma tanısını doğrulamıştır. Bir yıl sonra üç küçük lezyon olarak nüks gözlenmiştir. Ancak, sonraki dört yıl içinde büyüme kaydedilmemiştir. Nadiren, diş eti travmatik fibroması yaşamın ilk on yılında gelişebilir ve tekrarlama potansiyeline sahiptir.

Keywords

çocuk , diş eti , yumuşak doku lezyonu , travmatik fibroma , nüks

References

1. Wenig BM. Atlas of head and neck pathology: Elsevier Health Sciences, 2015.
2. Rathva VJ. Traumatic fibroma of tongue. BMJ Case Rep 2013;2013:bcr2012008220.
3. Buchner A, Shnaiderman A, Vared M. Pediatric localized reactive gingival lesions: a retrospective study from Israel. Pediatr Dent 2010;32:486-492.
4. Buchner A, Shnaiderman-Shapiro A, Vered M. Relative frequency of localized reactive hyperplastic lesions of the gingiva: a retrospective study of 1675 cases from Israel. J Oral Pathol Med 2010;39:631-638.
5. Lakkam BD, Astekar M, Alam S, Sapra G, Agarwal A, Agarwal AM. Relative frequency of oral focal reactive overgrowths: An institutional retrospective study. J Oral Maxillofac Pathol 2020; 24:76-80.
6. Hunasgi S, Koneru A, Vanishree M, Manvikar V. Assessment of reactive gingival lesions of oral cavity: A histopathological study. J Oral Maxillofac Pathol 2017;21:180.
7. Regezi JA, Sciubba J, Jordan RC. Oral pathology: clinical pathologic correlations: Elsevier Health Sciences, 2016.
8. Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci 2006;48:167-175.
9. Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. Fourth edition ed. St. Louis, Missouri: Elsevier, 2016.
10. Sharma S, Chandra S, Gupta S, Srivastava S: Heterogeneous conceptualization of etiopathogenesis: Oral pyogenic granuloma. Natl J Maxillofac Surg 2019;10:3-7.
11. Mortazavi H, Safi Y, Baharvand M, Rahmani S, Jafari S. Peripheral exophytic oral lesions: a clinical decision tree. Int J Dent 2017;2017:9193831.
12. Mergoni G, Meleti M, Magnolo S, Giovannacci I, Corcione L, Vescovi P. Peripheral ossifying fibroma: A clinicopathologic study of 27 cases and review of the literature with emphasis on histomorphologic features. J Indian Soc Periodontol 2015;19:83-87.
13. Effiom OA, Adeyemo WL, Soyele OO. Focal reactive lesions of the gingiva: an analysis of 314 cases at a tertiary health ınstitution in Nigeria. Niger Med J 2011;52:35-40.
14. Ritwik P, Brannon RB. Peripheral odontogenic fibroma: a clinicopathologic study of 151 cases and review of the literature with special emphasis on recurrence. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:357-363.
15. Brierley DJ, Crane H, Hunter KD. Lumps and Bumps of the Gingiva: A Pathological Miscellany. Head Neck Pathol 2019;13:103-113.
16. Bodner L, Peist M, Gatot A, Fliss DM. Growth potential of peripheral giant cell granuloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:548-551.
17. Lester SR, Cordell KG, Rosebush MS, Palaiologou AA, Maney P. Peripheral giant cell granulomas: a series of 279 cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2014;118:475-482.
18. Chrcanovic BR, Gomes CC, Gomez RS. Peripheral giant cell granuloma: An updated analysis of 2824 cases reported in the literature. J Oral Pathol Med 2018;47:454-459.
19. Bawazir M, Islam MN, Cohen DM, Fitzpatrick S, Bhattacharyya I. Gingival fibroma: an emerging distinct gingival lesion with well-defined histopathology. Head Neck Pathol 2021;15:917-922.
20. Silva-Mancera IC, Triana-Escobar FE, Soto-Llanos L. Excision of a traumatic fibroma with diode laser in a pediatric patient: case report. Rev Fac Odontol Univ Antioq 2019;31(1-2):162-170.
21. Rangeeth BN, Moses J, Reddy VK. A rare presentation of mucocele and irritation fibroma of the lower lip. Contemp Clin Dent 2010;1:111-114.
22. Veena KM, Rao PK, Prabhu RV. Focal fibrous hyperplasia: a case report. Pacific Journal of Medical Sciences 2014:21-25.
23. Rossmann JA. Reactive lesions of the gingiva: diagnosis and treatment options. Open Pathol J 2011;5:23-32.
24. Bulanda S, Ilczuk-Rypuła D, Nitecka-Buchta A, Nowak Z, Baron S, Postek-Stefańska L. Sleep bruxism in children: etiology, diagnosis, and treatment-a literature review. Int J Environ Res Public Health 2021;18(18):9544.
25. Scarpini S, Lira AO, Gimenez T, Raggio DP, Chambrone L, Souza RC, et al. Associated factors and treatment options for sleep bruxism in children: an umbrella review. Braz Oral Res 2023;37:e006.
26. Storari M, Serri M, Aprile M, Denotti G, Viscuso D. Bruxism in children: What do we know? Narrative review of the current evidence. Eur J Paediatr Dent 2023;24:207-210.
27. Casian Romero A, Trejo Quiroz P, De León Torres C, Carmona Ruiz D. Hiperplasia fibrosa inflamatoria: reporte de un caso. Rev Clin Periodoncia Implantol Rehabil Oral 2011;4:74-79.
28. Jeong Y, Kang C-M, Kim S, Lee J. Irritation fibroma associated with ectopic eruption of the maxillary ıncisor. J Korean Acad Pediatr Dent 2016;43:207-212.
29. Mishra R, Khan TS, Ajaz T, Agarwal M. Pediatric palatal fibroma. Int J Clin Pediatr Dent 2017;10:96-98.
30. Kandya A, Verma M, Pitale U, Goyal S, Vijayvargiya N. Localized fibrous overgrowth-traumatic fibroma: a case report. Int J Prev Clin Dent Res 2018;5(2)110-112.
31. Lalchandani CM, Tandon S, Rai TS, Mathur R, Kajal A. Recurrent irritation fibroma-"what lies beneath": a multidisciplinary treatment approach. Int J Clin Pediatr Dent 2020;13:306-309.
32. Bhayade S, Chandak S, Bhondey A, Atulkar M, Sawarkar P. Traumatic fibroma -a rare soft tissue entity in a paediatric patient. Int J Oral Health Med Res 2015;2(4):52-54.
33. Lapitskaya A, Cahuana-Bartra P, Brunet-Llobet L, Miranda-Rius J. Oral irritation fibroma associated with the pathological migration of a primary tooth. BMJ Case Rep 2022;15:e249369.
34. Asundaria RR, Tavargeri A. Excision of traumatic fibroma of the tongue in a pediatric patient: a case report. Int J Clin Pediatr Dent 2023;16:166-169.
35. Saad I, Jokhadar M, Rkab MS, Al Manadili A, Al-Raeei M, Azmeh C, et al. Pedunculated oral fibroma in an 11-year-old patient: A case study. Oral Oncol Rep 2024;9:100143.
36. Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, et al. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil 2018;45:837-844.
37. Machado E, Dal-Fabbro C, Cunali PA, Kaizer OB. Prevalence of sleep bruxism in children: a systematic review. Dental Press J Orthod 2014;19:54-61.
38. Manfredini D, Restrepo C, Diaz-Serrano K, Winocur E, Lobbezoo F. Prevalence of sleep bruxism in children: a systematic review of the literature. J Oral Rehabil 2013;40:631-642.
39. Castroflorio T, Bargellini A, Rossini G, Cugliari G, Rainoldi A, Deregibus A. Risk factors related to sleep bruxism in children: A systematic literature review. Arch Oral Biol 2015;60:1618-1624.
40. Guo H, Wang T, Niu X, Wang H, Yang W, Qiu J, et al. The risk factors related to bruxism in children: A systematic review and meta-analysis. Arch Oral Biol 2018;86:18-34.
41. Restrepo C, Gómez S, Manrique R. Treatment of bruxism in children: a systematic review. Quintessence Int 2009;40:849-855.
42. Ierardo G, Mazur M, Luzzi V, Calcagnile F, Ottolenghi L, Polimeni A. Treatments of sleep bruxism in children: A systematic review and meta-analysis. Cranio 2021;39:58-64.
43. Chisini LA, San Martin AS, Cademartori MG, Boscato N, Correa MB, Goettems ML. Interventions to reduce bruxism in children and adolescents: a systematic scoping review and critical reflection. Eur J Pediatr 2020;179:177-189.
44. Firmani M, Reyes M, Becerra N, Flores G, Weitzman M, Espinosa P. Sleep bruxism in children and adolescents. Rev Chil Pediatr 2015;86:373-379.
45. Guaita M, Högl B. Current treatments of bruxism. Curr Treat Options Neurol 2016;18:10.
46. Zain RB, Khoo SP, Yeo JF. Oral pyogenic granuloma (excluding pregnancy tumour)--a clinical analysis of 304 cases. Singapore Dent J 1995;20:8-10.
47. Bornstein MM, Winzap-Kälin C, Cochran DL, Buser D. The CO2 laser for excisional biopsies of oral lesions: a case series study. Int J Periodontics Restorative Dent 2005;25:221-229.
48. Rossmann JA, Cobb CM. Lasers in periodontal therapy. Periodontol 2000 1995;9:150-164.
49. Shalawe WS, Ibrahim ZA, Sulaiman AD. Clinical comparison between diode laser and scalpel incisions in oral soft tissue biopsy. Al-Rafidain Dent J 2012;12(2):337-343.
50. Zieliński G, Pająk A, Wójcicki M. Global prevalence of sleep bruxism and awake bruxism in pediatric and adult populations: a systematic review and meta-analysis. J Clin Med 2024;13(14):4259.

Traumatic Fibroma of the Gingiva in a Child: 4-Year Follow-Up

Year 2025, Volume: 28 Issue: 4, 633 - 638, 29.12.2025

Tülin Taşdemir , Gizem Erbas Unverdi , Zafer Çehreli

https://doi.org/10.7126/cumudj.1689299

Abstract

Traumatic fibroma is considered the most common soft tissue lesion in the oral cavity. While it can occur in children, it is very rare during the first decade of life. This case report aims to highlight the management of a traumatic fibroma in a young patient, particularly with its unusual location in the gingiva. A healthy 3-year-old child was referred due to a well-defined, hyperplastic, pedunculated lesion in the maxillary anterior gingiva, which had been present for 6 months. The lesion was removed under local anesthesia, and histopathological examination confirmed the diagnosis of traumatic fibroma. A recurrence was observed after a year as three small lesions. However, no additional growth was noted over the following four years. While uncommon, traumatic fibroma of the gingiva can develop during the first decade of life and has the potential to recur.

Keywords

gingiva , recurrence , soft tissue lesion , traumatic fibroma , children

References

1. Wenig BM. Atlas of head and neck pathology: Elsevier Health Sciences, 2015.
2. Rathva VJ. Traumatic fibroma of tongue. BMJ Case Rep 2013;2013:bcr2012008220.
3. Buchner A, Shnaiderman A, Vared M. Pediatric localized reactive gingival lesions: a retrospective study from Israel. Pediatr Dent 2010;32:486-492.
4. Buchner A, Shnaiderman-Shapiro A, Vered M. Relative frequency of localized reactive hyperplastic lesions of the gingiva: a retrospective study of 1675 cases from Israel. J Oral Pathol Med 2010;39:631-638.
5. Lakkam BD, Astekar M, Alam S, Sapra G, Agarwal A, Agarwal AM. Relative frequency of oral focal reactive overgrowths: An institutional retrospective study. J Oral Maxillofac Pathol 2020; 24:76-80.
6. Hunasgi S, Koneru A, Vanishree M, Manvikar V. Assessment of reactive gingival lesions of oral cavity: A histopathological study. J Oral Maxillofac Pathol 2017;21:180.
7. Regezi JA, Sciubba J, Jordan RC. Oral pathology: clinical pathologic correlations: Elsevier Health Sciences, 2016.
8. Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci 2006;48:167-175.
9. Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. Fourth edition ed. St. Louis, Missouri: Elsevier, 2016.
10. Sharma S, Chandra S, Gupta S, Srivastava S: Heterogeneous conceptualization of etiopathogenesis: Oral pyogenic granuloma. Natl J Maxillofac Surg 2019;10:3-7.
11. Mortazavi H, Safi Y, Baharvand M, Rahmani S, Jafari S. Peripheral exophytic oral lesions: a clinical decision tree. Int J Dent 2017;2017:9193831.
12. Mergoni G, Meleti M, Magnolo S, Giovannacci I, Corcione L, Vescovi P. Peripheral ossifying fibroma: A clinicopathologic study of 27 cases and review of the literature with emphasis on histomorphologic features. J Indian Soc Periodontol 2015;19:83-87.
13. Effiom OA, Adeyemo WL, Soyele OO. Focal reactive lesions of the gingiva: an analysis of 314 cases at a tertiary health ınstitution in Nigeria. Niger Med J 2011;52:35-40.
14. Ritwik P, Brannon RB. Peripheral odontogenic fibroma: a clinicopathologic study of 151 cases and review of the literature with special emphasis on recurrence. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:357-363.
15. Brierley DJ, Crane H, Hunter KD. Lumps and Bumps of the Gingiva: A Pathological Miscellany. Head Neck Pathol 2019;13:103-113.
16. Bodner L, Peist M, Gatot A, Fliss DM. Growth potential of peripheral giant cell granuloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:548-551.
17. Lester SR, Cordell KG, Rosebush MS, Palaiologou AA, Maney P. Peripheral giant cell granulomas: a series of 279 cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2014;118:475-482.
18. Chrcanovic BR, Gomes CC, Gomez RS. Peripheral giant cell granuloma: An updated analysis of 2824 cases reported in the literature. J Oral Pathol Med 2018;47:454-459.
19. Bawazir M, Islam MN, Cohen DM, Fitzpatrick S, Bhattacharyya I. Gingival fibroma: an emerging distinct gingival lesion with well-defined histopathology. Head Neck Pathol 2021;15:917-922.
20. Silva-Mancera IC, Triana-Escobar FE, Soto-Llanos L. Excision of a traumatic fibroma with diode laser in a pediatric patient: case report. Rev Fac Odontol Univ Antioq 2019;31(1-2):162-170.
21. Rangeeth BN, Moses J, Reddy VK. A rare presentation of mucocele and irritation fibroma of the lower lip. Contemp Clin Dent 2010;1:111-114.
22. Veena KM, Rao PK, Prabhu RV. Focal fibrous hyperplasia: a case report. Pacific Journal of Medical Sciences 2014:21-25.
23. Rossmann JA. Reactive lesions of the gingiva: diagnosis and treatment options. Open Pathol J 2011;5:23-32.
24. Bulanda S, Ilczuk-Rypuła D, Nitecka-Buchta A, Nowak Z, Baron S, Postek-Stefańska L. Sleep bruxism in children: etiology, diagnosis, and treatment-a literature review. Int J Environ Res Public Health 2021;18(18):9544.
25. Scarpini S, Lira AO, Gimenez T, Raggio DP, Chambrone L, Souza RC, et al. Associated factors and treatment options for sleep bruxism in children: an umbrella review. Braz Oral Res 2023;37:e006.
26. Storari M, Serri M, Aprile M, Denotti G, Viscuso D. Bruxism in children: What do we know? Narrative review of the current evidence. Eur J Paediatr Dent 2023;24:207-210.
27. Casian Romero A, Trejo Quiroz P, De León Torres C, Carmona Ruiz D. Hiperplasia fibrosa inflamatoria: reporte de un caso. Rev Clin Periodoncia Implantol Rehabil Oral 2011;4:74-79.
28. Jeong Y, Kang C-M, Kim S, Lee J. Irritation fibroma associated with ectopic eruption of the maxillary ıncisor. J Korean Acad Pediatr Dent 2016;43:207-212.
29. Mishra R, Khan TS, Ajaz T, Agarwal M. Pediatric palatal fibroma. Int J Clin Pediatr Dent 2017;10:96-98.
30. Kandya A, Verma M, Pitale U, Goyal S, Vijayvargiya N. Localized fibrous overgrowth-traumatic fibroma: a case report. Int J Prev Clin Dent Res 2018;5(2)110-112.
31. Lalchandani CM, Tandon S, Rai TS, Mathur R, Kajal A. Recurrent irritation fibroma-"what lies beneath": a multidisciplinary treatment approach. Int J Clin Pediatr Dent 2020;13:306-309.
32. Bhayade S, Chandak S, Bhondey A, Atulkar M, Sawarkar P. Traumatic fibroma -a rare soft tissue entity in a paediatric patient. Int J Oral Health Med Res 2015;2(4):52-54.
33. Lapitskaya A, Cahuana-Bartra P, Brunet-Llobet L, Miranda-Rius J. Oral irritation fibroma associated with the pathological migration of a primary tooth. BMJ Case Rep 2022;15:e249369.
34. Asundaria RR, Tavargeri A. Excision of traumatic fibroma of the tongue in a pediatric patient: a case report. Int J Clin Pediatr Dent 2023;16:166-169.
35. Saad I, Jokhadar M, Rkab MS, Al Manadili A, Al-Raeei M, Azmeh C, et al. Pedunculated oral fibroma in an 11-year-old patient: A case study. Oral Oncol Rep 2024;9:100143.
36. Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, et al. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil 2018;45:837-844.
37. Machado E, Dal-Fabbro C, Cunali PA, Kaizer OB. Prevalence of sleep bruxism in children: a systematic review. Dental Press J Orthod 2014;19:54-61.
38. Manfredini D, Restrepo C, Diaz-Serrano K, Winocur E, Lobbezoo F. Prevalence of sleep bruxism in children: a systematic review of the literature. J Oral Rehabil 2013;40:631-642.
39. Castroflorio T, Bargellini A, Rossini G, Cugliari G, Rainoldi A, Deregibus A. Risk factors related to sleep bruxism in children: A systematic literature review. Arch Oral Biol 2015;60:1618-1624.
40. Guo H, Wang T, Niu X, Wang H, Yang W, Qiu J, et al. The risk factors related to bruxism in children: A systematic review and meta-analysis. Arch Oral Biol 2018;86:18-34.
41. Restrepo C, Gómez S, Manrique R. Treatment of bruxism in children: a systematic review. Quintessence Int 2009;40:849-855.
42. Ierardo G, Mazur M, Luzzi V, Calcagnile F, Ottolenghi L, Polimeni A. Treatments of sleep bruxism in children: A systematic review and meta-analysis. Cranio 2021;39:58-64.
43. Chisini LA, San Martin AS, Cademartori MG, Boscato N, Correa MB, Goettems ML. Interventions to reduce bruxism in children and adolescents: a systematic scoping review and critical reflection. Eur J Pediatr 2020;179:177-189.
44. Firmani M, Reyes M, Becerra N, Flores G, Weitzman M, Espinosa P. Sleep bruxism in children and adolescents. Rev Chil Pediatr 2015;86:373-379.
45. Guaita M, Högl B. Current treatments of bruxism. Curr Treat Options Neurol 2016;18:10.
46. Zain RB, Khoo SP, Yeo JF. Oral pyogenic granuloma (excluding pregnancy tumour)--a clinical analysis of 304 cases. Singapore Dent J 1995;20:8-10.
47. Bornstein MM, Winzap-Kälin C, Cochran DL, Buser D. The CO2 laser for excisional biopsies of oral lesions: a case series study. Int J Periodontics Restorative Dent 2005;25:221-229.
48. Rossmann JA, Cobb CM. Lasers in periodontal therapy. Periodontol 2000 1995;9:150-164.
49. Shalawe WS, Ibrahim ZA, Sulaiman AD. Clinical comparison between diode laser and scalpel incisions in oral soft tissue biopsy. Al-Rafidain Dent J 2012;12(2):337-343.
50. Zieliński G, Pająk A, Wójcicki M. Global prevalence of sleep bruxism and awake bruxism in pediatric and adult populations: a systematic review and meta-analysis. J Clin Med 2024;13(14):4259.

There are 50 citations in total.

Details

Primary Language	English
Subjects	Paedodontics
Journal Section	Case Report
Authors	Tülin Taşdemir 0000-0003-4884-4715 Gizem Erbas Unverdi 0000-0002-8916-5949 Zafer Çehreli 0000-0003-0332-8653
Submission Date	May 2, 2025
Acceptance Date	August 20, 2025
Publication Date	December 29, 2025
Published in Issue	Year 2025 Volume: 28 Issue: 4

Cite

EndNote	Taşdemir T, Erbas Unverdi G, Çehreli Z (December 1, 2025) Traumatic Fibroma of the Gingiva in a Child: 4-Year Follow-Up. Cumhuriyet Dental Journal 28 4 633–638.

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