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Peripheral ossifying fibroma is a relatively rare, benign, unencapsulated, exophytic gingival mass of fibrous connective tissue. Odontogenic epithelium is found within the gingival mass, but usually appears to play a minor role when compared to the fibrous component. It manifests as a firm, slow-growing, sessile nodular growth of the gingiva, most often on the mandibular buccal or labial aspect. It occurs in persons of a wide age range, and affects both sexes equally. Treatment consists of conservative excision performed with care to maintain or re-establish the gingival architecture and periodontal integrity. Recurrence is rare.

Figures 1: Peripheral ossifying fibroma. Note the pale, pink, non-tender sessile growth on the upper left gingiva.
Figure 2: Intraoral periapical radiograph of the left maxillary premolar and molar region showing spacing between the premolars due to their displacement. Note the radiopacity of the soft tissues between the premolars.
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