Brazilian Journal of Dentistry and Oral Radiology. 2023, 2, 1, bjd23. www.bjdentistry.com.br
Case Report
Surgical Strategies and Monitoring in the Treatment of Oral Fibroma:
Case Report
Luiza Clertiani Vieira Alves
1, *
, Paulo Henrique Rodrigues Carvalho
2
1
Master's student in Dentistry Graduate Program (PPGO/UFC), Federal University of Ceará, Fortaleza, CE, Brazil.
2
Dentist specialized in Oral and Maxillofacial Surgery and Traumatology, Fortaleza, CE, Brazil.
* Correspondence: clertiani@gmail.com.
Abstract: The present study reports a clinical case of fibroma on the oral mucosa of a 45-year-old patient,
addressing the diagnostic and therapeutic steps taken, as well as the outcomes achieved. Fibromas are com-
mon benign lesions in the oral cavity, requiring precise clinical management to avoid discomfort and com-
plications to the patient. In this case, the patient reported social discomfort due to the pedunculated and
painless lesion on her labial mucosa. An excisional biopsy was performed under local anesthesia, followed by
suturing, with a postoperative recovery free of complications. Histopathological analysis confirmed the diag-
nosis of fibroma, and periodic follow-up showed no signs of recurrence, improving the patient's comfort and
aesthetics. This case underscores the im-portance of clinical and histopathological diagnosis, as well as careful
follow-up for successful resolution of oral lesions, highlighting the need for multidisciplinary and evidence-
based practices in dentistry.
Keywords: Oral Fibroma; Excisional Biopsy; Clinical Management of Oral Lesions.
1. Introduction
Oral lesions pose a significant diagnostic challenge in dental practice, given their
etiological diversity ranging from variations of normality to malignant conditions. Fibro-
mas, in particular, are benign lesions commonly found in the oral mucosa, characterized
by slow growth and firm consistency [1]. Proper identification and management of these
lesions are crucial not only for eliminating potential discomforts or complications but also
for ensuring the patient's oral aesthetics and functionality [2]. The diagnosis of oral fibro-
mas is usually made through a detailed clinical ex-amination, followed by histopatholog-
ical confirmation after performing an excisional biopsy [3]. This procedure not only pro-
vides a definitive diagnosis but also represents the primary treatment for the lesion. The
surgical technique involves the complete removal of the lesion, with care to preserve the
integrity of adjacent tissues, thus minimizing the risk of recurrence and ensuring better
healing [4].
The multidisciplinary approach to the diagnosis and treatment of benign oral le-
sions, such as fibromas, emphasizes the importance of a personalized treatment plan that
considers both clinical needs and patient expectations. This includes not only surgical
intervention, but also periodic follow-up aimed at monitoring the treated area and pre-
venting possible recurrences [5]. The successful treatment of fibroma in the oral mucosa,
as discussed, highlights the essentiality of a precise and personalized diagnostic and ther-
apeutic approach. This case highlights the importance of multidisciplinary collaboration
and close follow-up to ensure not only effective removal of the lesion, but also long-term
patient satisfaction and well-being. Furthermore, the relevance of continuous education
and evidence-based practice is highlighted to improve clinical results in dentistry, em-
phasizing the need for careful diagnoses and appropriate management of oral lesions to
Citation: Alves LCV, Carvalho
PHR. Surgical Strategies and Mon-
itoring in the Treatment of Oral Fi-
broma: Case Report. Brazilian Jour-
nal of Dentistry and Oral Radiol-
ogy. 2023 Jan-Dec;2:bjd23.
doi: https://doi.org/10.52600/2965-
8837.bjdor.2023.2.bjd23
Received: 27 March 2023
Accepted: 17 May 2023
Published: 10 July 2023
Copyright: This work is licensed
under a Creative Commons Attrib-
ution 4.0 International License
(CC BY 4.0).
Surgical Strategies and Monitoring in the Treatment of Oral Fibroma: Case Report 2 of 4
prevent recurrences and promote recovery. aesthetic and functional. Thus, this article
aims to present a case report of a fibroma in the oral mucosa, discussing the diagnostic
and therapeutic steps adopted, as well as the results obtained. Through this study, we seek
to contribute to the existing literature on the clinical management of benign oral lesions,
reinforcing the importance of evidence-based practices in the field of dentistry.
2. Case Report
A 45-year-old non-smoking female patient with no history of systemic alterations
was referred to the same dental school as the previous case with the main complaint of a
"hard nodule on the lip." During the initial anamnesis, a fibrous lesion was found on the
upper lip mucosa, presenting as painless, pink-colored, firm consistency, pedunculated
shape, and sessile base. According to the patient, the presence of the lesion caused social
discomfort, although there were no reports of taste alterations or difficulties during eating.
Based on the clinical examination, it was decided to perform an excisional biopsy of the
lesion, a procedure carried out under local anesthesia. The surgical technique adopted
involved careful incision and dissection of the lesion, preserving the integrity of adjacent
tissues. After complete removal of the lesion, the area was sutured with stitches that were
removed after 7 days, without complications in the postoperative period. The obtained
material was sent for histopathological analysis, which confirmed the diagnosis of fi-
broma, a common benign lesion in the oral mucosa. The surgical margins were free of
lesion, indicating complete removal. Postoperative recommendations included local oral
hygiene care and periodic follow-up for monitoring. During follow-up visits, the patient
reported significant improvement in lip comfort and aesthetics, with no recurrence of the
lesion. This case highlights the importance of a multidisciplinary approach in the diag-
nosis and treatment of oral lesions, aiming not only for lesion removal but also for func-
tional and aesthetic recovery of the patient (Figure 1).
Figure 1: A. Preoperative panoramic radiograph displaying osteoma in the region of the
right mandibular angle. B. Radiograph detailing the location and extent of the osteoma.
C. Postoperative panoramic radiograph showing the mandible after surgical removal of
the osteoma.
Surgical Strategies and Monitoring in the Treatment of Oral Fibroma: Case Report 3 of 4
3. Discussion
The importance of appropriate diagnosis and management of oral lesions, as il-lus-
trated by the fibroma in the oral mucosa, is widely recognized in the literature. Alawi and
Freedman emphasize the uniqueness of oral sclerotic fibroma and its differentiation from
other benign fibrous lesions, reinforcing the need for careful approach in identifying and
treating these lesions [1]. De Santana Santos et al. provide a comprehensive review of
focal fibrous hyperplasia, highlighting the frequency of these lesions in clinical practice
and the importance of distinguishing such benign conditions from more serious ones [2].
The reported case also underscores the relevance of postoperative follow-up and his-
topathological evaluation, as observed in studies examining the diversity of oral and max-
illofacial biopsies and the importance of confirming the diagnosis for effective treatment
[3]. Ulaganathan et al.'s retrospective analysis of oral and maxillofacial biopsies in a spe-
cific institution highlights the variety of lesions found and the essentiality of histopathol-
ogy for clinical management [4]. The complexity of diagnosing and treating oral lesions
and the need for a multidisciplinary approach are evident. Collaboration among special-
ists and the use of evidence-based practices are crucial for achieving the best outcomes
for patients, ensuring not only effective removal of lesions but also functional and aes-
thetic recovery [5, 6].
4. Conclusion
The successful treatment of fibroma in the oral mucosa, as discussed, highlights the
essentiality of a precise and personalized diagnostic and therapeutic approach. This case
highlights the importance of multidisciplinary collaboration and close follow-up to ensure
not only effective removal of the lesion, but also long-term patient satisfaction and well-
being. Furthermore, the relevance of continuous education and evidence-based practice
is highlighted to improve clinical results in dentistry, emphasizing the need for careful
diagnoses and appropriate management of oral lesions to prevent recurrences and promote
recovery. aesthetic and functional.
Funding: None.
Research Ethics Committee Approval: We affirm that the participant consented to the
research by endorsing a clear consent document, and the investigation adhered to the
ethical standards outlined in the Helsinki Declaration.
Acknowledgments: None.
Conflicts of Interest: None.
Supplementary Materials: None.
References
1. Alawi F, Freedman PD. Sporadic sclerotic fibroma of the oral soft tissues. Am J Dermatopathol. 2004
Jun;26(3):182-7. doi: 10.1097/00000372-200406000-00002. PMID: 15166503.
2. de Santana Santos T, Martins-Filho PR, Piva MR, de Souza Andrade ES. Focal fibrous hyperplasia: A
review of 193 cases. J Oral Maxillofac Pathol. 2014 Sep;18(Suppl 1):S86-9. doi: 10.4103/0973-
029X.141328. PMID: 25364187; PMCID: PMC4211246.
3. Kim TE, Lee JY. Sclerotic Fibroma Presenting as an Axillary Mass: A Case Report with Imaging Features.
Taehan Yongsang Uihakhoe Chi. 2021 Jul;82(4):977-981. doi: 10.3348/jksr.2020.0145. Epub 2021 Apr
14. PMID: 36238068; PMCID: PMC9514397.
4. Ulaganathan G, Babu SS, Senthilmoorthy M, Prasad V, Kalaiselvan S, Kumar RSA. Retrospective Anal-
ysis of Oral and Maxillofacial Biopsies: An Institutional Study. J Pharm Bioallied Sci. 2020 Aug;12(Suppl
1):S468-S471. doi: 10.4103/jpbs.JPBS_141_20. Epub 2020 Aug 28. PMID: 33149507; PMCID:
PMC7595515.
5. El Toum S, Cassia A, Bouchi N, Kassab I. Prevalence and Distribution of Oral Mucosal Lesions by Sex
and Age Categories: A Retrospective Study of Patients Attending Lebanese School of Dentistry. Int J
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Brazilian Journal of Dentistry and Oral Radiology. 2023, 2, 1, bjd23. www.bjdentistry.com.br
Relato de Caso
Estratégias Cirúrgicas e Acompanhamento no Tratamento de
Fibromas Orais: Caso ClÃnico
Luiza Clertiani Vieira Alves
1, *
, Paulo Henrique Rodrigues Carvalho
2
1
Mestrando Programa de Pós-graduação em Odontologia (PPGO/UFC), Universidade Federal do Ceará, Fortaleza, CE,
Brasil.
2
Cirurgião-dentista especialista em Cirurgia e Traumatologia Bucomaxilofacial, Fortaleza, CE, Brasil.
* Correspondência: clertiani@gmail.com.
Resumo: O presente trabalho relata um caso clÃnico de fibroma na mucosa oral de uma paciente de 45 anos,
abordando as etapas diagnósticas e terapêuticas conduzidas, bem como os resultados alcançados. Fibromas são
lesões benignas comuns na cavidade oral, exigindo um manejo clÃnico preciso para evitar desconforto e com-
plicações ao paciente. Neste caso, a paciente relatou desconforto social devido à lesão pediculada e indolor
em sua mucosa labial. Foi realizada uma biópsia excisional sob anestesia local, seguida de sutura, com uma
recuperação pós-operatória livre de complicações. A análise histopatológica confirmou o diagnóstico de fi-
broma, e o acompanhamento periódico não mostrou sinais de recorrência, melhorando o conforto e estética
da paciente. Este caso sublinha a importância do diagnóstico clÃnico e histopatológico, bem como de um
acompanhamento cuidadoso para uma resolução bem-sucedida de lesões orais, destacando a necessidade de
práticas multidisciplinares e baseadas em evidências na odontologia.
Palavras-chave: Fibroma Oral; Biópsia Excisional; Manejo ClÃnico de Lesões Bucais.
1. Introdução
Lesões orais representam um desafio diagnóstico significativo na prática odontoló-
gica, dada a sua diversidade etiológica que abrange desde variações da normalidade até
condições malignas. Fibromas, particularmente, são lesões benignas frequentemente en-
contradas na mucosa oral, caracterizando-se por um crescimento lento e uma consistência
firme [1]. A identificação e manejo adequado dessas lesões são cruciais, não só para a
eliminação de potenciais desconfortos ou complicações, mas também para assegurar a es-
tética e a funcionalidade oral do paciente [2]. O diagnóstico de fibromas orais geralmente
é realizado mediante exame clÃnico detalhado, seguido de confirmação histopatológica
após a realização de uma biópsia excisional [3]. Este procedimento não apenas fornece um
diagnóstico definitivo, como também representa o tratamento primário para a lesão. A
técnica cirúrgica envolve a remoção completa da lesão, com cuidado para preservar a in-
tegridade dos tecidos adjacentes, minimizando assim o risco de recorrência e garantindo
uma melhor cicatrização [4].
A abordagem multidisciplinar no diagnóstico e tratamento das lesões orais benignas,
como os fibromas, enfatiza a importância de um plano de tratamento personalizado, que
considere tanto as necessidades clÃnicas quanto as expectativas do paciente. Isso inclui
não só a intervenção cirúrgica, mas também o acompanhamento periódico, visando mo-
nitorar a área tratada e prevenir possÃveis recorrências [5]. Desta forma, este artigo tem
como objetivo apresentar um relato de caso de fibroma na mucosa oral, discutindo as eta-
pas diagnósticas e terapêuticas adotadas, bem como os resultados obtidos. Através deste
estudo, busca-se contribuir para a literatura existente sobre o manejo clÃnico das lesões
Citação: Alves LCV, Carvalho
PHR. Estratégias Cirúrgicas e
Acompanhamento no Tratamento
de Fibromas Orais: Discussão de um
Caso ClÃnico. Brazilian Journal of
Dentistry and Oral Radiology. 2023
Jan-Dec;2:bjd23.
doi: https://doi.org/10.52600/2965-
8837.bjd.2023.2.bjd23
Recebido: 25 Março 2023
Aceito: 17 Maio 2023
Publicado: 10 Julho 2023
Direitos autorais: Este trabalho está
licenciado sob uma Licença Inter-
nacional Creative Commons Atri-
buição 4.0 (CC BY 4.0).