Pt came to me complainting as a swelling .. He has done 2/3 times excision before ..so wht will be the permanent Rx plan???

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Consistency? Looks irritational Fibroma. Is it a cross bite there? After a through excision. Correct the bite too.

Peripheral ossifying fibroma, pyogenic granuloma and peripheral giant cell granuloma are the differential diagnoses. Do an iopa with reduced exposure parameters to diagnose peripheral ossifying fibroma. Excisional biopsy for confirmation.

Although its colour & pedunculated shape indicates more towards a fibroma, its area of presentation & frequent recurrences points more towards a pyogenic granuloma... This is quite an unusal site for an irritational fibroma.. What were the previous histopathology of previously excised lesions? The ideal thing would be to excise it again.. Preferably with a cautery... & Please see to it that the lesion is excised in enirity... Send the specimen for an HPR... I would even advise an oral phophylaxis prior to excision..as riddance from local factors would improve the prognosis..

Oral hygiene of patient looks poor Treatment should be excision under la and advice patient toward maintaining a good hygiene

Irritational fibroma.. excision...and remove the irritating factor as cusp of canine seems to be the irritating the gingival tissue....

Based on the clinical presentation and the symptoms, the differential diagnosis would be either a peripheral fibroma or a pyogenic granuloma. Excisional biopsy to obtain final diagnosis. Thorough debridement is compulsory to prevent recurrence. Any aggravating factor for the same should be determined and treated. Eg trauma from occlusion, poor oral hygiene. Patient should be kept on regular review .

Irritional fibroma

Bleeding tendency present? Confirm that first.. Pt adv to keep maintain for oral hygiene. Followed by excision n extraction of adjacent tooth

is it painful?

No any symptoms regarding pain
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Looks like irritational fibroma... check the occlusion... and I think so lower canine cusp must be impeching the gingiva...

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