Irritation Fibroma of The Lower Lip

Painless Mass Lesion On The  Lower Lip: Irritation Fibroma

Irritation Fibroma of The Lower Lip

Fibroma - Definition

Fibromas are the most common lesions in the oral mucosa. Traumatic fibroma; It is a reactive lesion, usually caused by chronic trauma to the oral mucous membrane. Typically, the lower lip is often seen in traumatized areas such as the lateral edges of the tongue and the buccal mucosa. The most common treatment of traumatic fibromas is excision and removal of irritation. Case Report: In this article, traumatic fibroma cases seen in various regions of oral cavity as a result of various chronic irritations are presented and literature about fibromas is reviewed. Conclusion: Although there is no predisposing lesion for malignancy, fibromas should be excised because of poor quality of life and problems in speech and chewing due to localization in many patients and the patient should be made aware of this and irritant should be eliminated.

Traumatic fibroma

Traumatic fibroma, focal fibrous hyperplasia, irritation fibroma, also called hyperplastic scar; is a benign, localized, peripheral, tumor-like lesion arising from connective tissue. It usually develops secondary due to chronic irritation or trauma. Traumatic fibroma or irritation fibroma can be defined as the final form of inflammatory hyperplastic lesion after healing.

Fibroma incidence

It may occur after a single acute trauma or may develop after recurrent mild trauma, chronic inflammation or infection. Typically, the buccal mucosa, which is exposed to trauma, is seen laterally in the tongue and in the lower lip. However, it can be seen all over the mouth. It is one of the most common lesions of the oral mucosa and its prevalence is 1.2% in adults. It can also be seen in both sexes equally and at any age. However, it is mostly seen in adults. Clinically; round or ovoid-shaped, the surface is usually smooth, asymptomatic and the environment is seen in the same color as the healthy mucosa. The surface of the lesion can sometimes ulcerate due to hyperkeratotic or recurrent trauma. They are usually less than 1 cm in diameter. Lesions larger than 1 cm are rare. Histopathologically; lesion contained a plurality of mature fibroblasts scattered in a dense collagen matrix consisting of a mixture of type 1 and type 3 collagen.

Malignant transformation in irritation fibroma is not seen!

It shows hyperplastic epithelium with irregular surface and small superficial erosions due to excessive collagen production. Malignant transformation in irritation fibroma It is not seen. In addition, cases of squamous cell carcinoma appearing clinically as irritation fibroma have been reported in the literature.

Irritation fibroma

Irritation fibroma is a lesion with irregular surface hyperplastic epithelium and local micro-erosive regions due to excessive collagen production histopathologically. Therefore, histopathologically, these lesions have no malignant predisposing findings. However, the lesion chronic irritant factor should be eliminated to treat or prevent recurrence after treatment. In some cases, the chronic irritant agent has the habit of sucking a pencil, biting the inner lips of the lip, having intermittent tooth structure and mucous trauma during eating facilitates the development of fibroma. After surgical intervention, the patient was advised to prevent this recurrence in order to prevent recurrence of the lesion.

Symptoms of oral fibroma

Fibrous hyperplasia is the final form of inflammatory hyperplasic lesion and is generally not considered a true neoplasm. Irritation fibroma, also known as scar, is usually caused by chronic trauma and is often seen in traumatized areas such as the cheek, lateral edge of the tongue, and lower lip. Fibrous hyperplasia is generally seen more than 30 years of age and more common in women. The lesions are stalked, stemless, pale pink and hard by palpation. Gingiva is seen in the buccal mucosa, tongue and palate.

Diagnosis and differantial diagnosis for oral irritation fibroma

Irritation fibroma; The most common mass in the oral mucosa is a lesion that shows hyperplastic structure against chronic irritation rather than being neoplastic. Clinically, these lesions take the form of a pinkish nodule unless the surface is injured and ulcerated. It usually occurs on the lips, tongue, gums and palate. The clinical presentation of fibroma is similar to benign tumors, especially papilloma, lipoma, minor salivary gland tumors and primary or metastatic malignant tumors. They should be evaluated histopathologically.

Treatment of irritation fibroma

Treatment is the elimination of the factors causing irritation fibroma and surgical excision in unresolved cases.

Generally, the lesion heals spontaneously with the elimination of chronic irritant factor. However, relatively large lesions or surgical excision may be required for lesions with anterior region localization that disrupt gum aesthetics. In addition, intraoral apparatus (occlusal splint) can be applied to assist the patient to heal the lesion when necessary with surgical excision.

In some cases dental restorations in the mouth needed for prevention of irritation fibromas!
Implant restorations, incompatible dentures, broken teeth or malocclusion are predisposing factors for the development of irritation fibroma. Therefore, the compliance of dental restorations in the mouth should be checked in the clinical and radiographic examination of the patient. In the presence of such a condition, the necessary dental treatment is sufficient to prevent the formation or recurrence of irritation fibroma. Surgical excision is also indicated if irritation fibromas caused by chronic trauma affect the quality of life of the patient.

Similar links >> Oral Fibroma (Traumatic Fibroma - Irritation Fibroma)Benign Cartilage Tumor of The Mouth - Chondroma

Source links >> A rare presentation of mucocele and irritation fibroma of the lower lip / Two cases of irritation fibromas on lower lip

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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