Abstract
Patient: Female, 53-year-old
Final Diagnosis: Irritation fibroma
Symptoms: A 2–4 mm diastema between the lower central incisors • a firm, well-circumscribed, asymptomatic nodule on the tip of her tongue
Clinical Procedure: —
Specialty: Dentistry
Objective: Rare coexistence of disease or pathology
Background
Irritation fibroma (IF) is a benign reactive exophytic oral lesion arising from chronic trauma, most frequently found on the buccal mucosa, tongue, and lips. Its association with a diastema is a rare occurrence. While typically asymptomatic, such lesions can enlarge due to repeated irritation. This report documents a case of a tongue-tip IF in a 53-year-old woman, caused by trauma from a mandibular midline diastema.
Case Report
A 53-year-old woman presented with a 2-year history of a firm, asymptomatic nodule on the tip of her tongue that enlarged during eating. Intraoral examination revealed a 0.5–1 cm, well-circumscribed nodule and a 2–4 mm diastema between the mandibular central incisors. The lesion was attributed to the patient’s habit of repetitively rubbing her tongue against the diastema. The fibroma was completely excised using a diode laser under local anesthesia, a method chosen for its hemostatic properties and patient comfort. Histopathological examination of the excised tissue confirmed the diagnosis of irritation fibroma. Postoperative healing was uneventful, and no recurrence was observed at a 12-month follow-up visit.
Conclusions
This case shows that dental diastemas can serve as a source of chronic trauma and must be considered an etiological factor in the development of irritation fibromas. Identifying and eliminating the source of trauma is crucial to preventing recurrence. Diode laser excision proved to be an effective and minimally invasive treatment modality, ensuring precise removal and excellent healing.
Keywords: Diastema, Fibroma, Laser Therapy, Tongue
Introduction
Irritation fibroma (IF) is the most common tumor-like growth in the oral cavity [1]. The increase in the size of the tissue is due to local response of the tissue to injury or chronic irritation [2]. The fibroma develops through a chronic repair process, forming a fibrous submucosal mass composed of granulation and scar tissue [3]. IF usually presents on the buccal mucosa along the occlusal line, tongue borders, or gingiva. However, its occurrence at the tip of the tongue is relatively rare, which increases the clinical value of this case [3,4]. This highlights an important but often overlooked etiology: sharp incisal edges and spacing between anterior teeth can act as a continuous source of trauma, leading to the development of IF in unusual locations such as the tongue tip [5]. This condition has been referred to by several names, including traumatic fibroma, peripheral fibroma, fibrous nodule, focal fibrous hyperplasia, and inflammatory fibrous hyperplasia [6].
According to a population-based epidemiological study, IF was identified as the second most prevalent benign oral lesion among White adults over 35 years of age [7]. Clinically, these lesions present as broad-based masses, typically lighter in color than the surrounding tissue. Their surface often appears white due to hyperkeratosis or may exhibit ulceration caused by secondary trauma. The growth of IF usually does not exceed 10–20 mm in diameter. Surgical removal is one of the most common procedures when treatment is required in oral and maxillofacial surgery [8]. Another widely used treatment modality is diode lasers, which are more effective than other modalities such as conventional surgery, electrosurgery, and cryosurgery in reducing bleeding and pain [6]. While recurrences are rare, they typically result from repeated trauma to the site. This condition carries no risk of malignant transformation [9].
Midline diastema is a common dental malocclusion defined as a space, 0.5 mm or more, between maxillary and/or mandibular incisors [10]. Diastema has multiple etiological factors, including anatomical, dental, pathological, and habitual. Anatomical variations, such as in the case of the labial frenulum, can cause diastema. Dental malformations such as peg-shaped lateral incisors, lateral incisor agenesis, microdontia, and mesiodens, as well as pathological lesions or cysts in the midline region can contribute to diastema formation. Habits such as finger or lip sucking and tongue thrusting are among the etiological factors. Moreover, genetics and dental-skeletal discrepancies should be considered as causes of diastema formation [11].
This case report describes an irritation fibroma on the tongue tip of a 53-year-old woman, an uncommon location for this lesion. The lesion’s development was attributed to chronic trauma from a mandibular midline diastema, an under-recognized etiological factor. This report emphasizes the rarity of this presentation and aims to increase clinical awareness of diastema-related trauma as a potential cause for tongue pathology.
Case Report
A 53-year-old Middle-Eastern woman presented with a chief concern of a mass on the tongue tip. Her medical history was significant for iron deficiency anemia. Her dental and family histories were non-contributory. She was a non-smoker and denied taking any medications.
The clinical examination revealed a firm, well-defined, sessile, and exophytic nodule on the tip of the tongue, measuring approximately 0.5–1 cm in diameter, similar in color to the surrounding normal mucosa (Figure 1). She reported the asymptomatic lesion had been present for 2 years, with a history of slight, gradual enlargement – notably during meals – but denied any pain or ulceration.
Figure 1. Intraoral views of the lesion on the tip of the tongue.
(A) Frontal view showing a well-defined exophytic sessile lesion. (B) Lateral view demonstrating the size and attachment of the lesion.
The dental examination revealed generalized tooth wear, poor oral hygiene, and a 2–4 mm midline diastema between the lower central incisors (Figure 2). This diastema was identified as a probable source of chronic trauma, based on the patient’s report of friction between the space and the lesion.
Figure 2. Dental examination demonstrating midline diastema.
(A) Frontal view showing 2–4 mm diastema between the mandibular central incisors and generalized tooth wear. (B) Occlusal view illustrating the space between the mandibular central incisors, considered a potential traumatic factor contributing to the tongue lesion.
The surgical procedure was explained to the patient, and informed consent was obtained. Local anesthesia infiltration using 2% lidocaine with 1: 100 000 epinephrine was administered, and complete excision of the lesion was carried out using a high-power diode laser (LaserHF, Hager & Werken) with a wavelength of 975 nm, following standard laser safety protocols. Bleeding was successfully controlled with the laser, and the excised specimen was immediately preserved in 10% formalin and sent for histopathological evaluation.
Postoperatively, the patient was prescribed ibuprofen 600 mg 3 times a day and amoxicillin 500 mg 3 times a day for 7 days. She was instructed to apply ice packs, maintain a soft diet, avoid spicy or sharp foods, prevent mechanical trauma to the surgical area, maintain good oral hygiene with gentle brushing, and minimize excessive movements such as wide smiling or talking during the first postoperative week.
The patient was recalled for follow-up visits and clinical photographs on days 3, 7, 14, and 30, and then every 3 months for 1 year. During the first week, she experienced episodes of pain and numbness in the excision area. By postoperative day 14, both symptoms had significantly reduced, and by the third week, she was able to eat and speak without restrictions. The surgical site healed completely, and no recurrence was observed at the 12-month follow-up (Figure 3).
Figure 3. Postoperative healing of the tongue following diode laser excision of the lesion.
(A) At 3 days after the operation, showing the excision site. (B) At 2-week follow-up, showing early mucosal healing. (C) At 3-month follow-up, demonstrating progressive resolution. (D) At 12-month follow-up, showing complete healing with no recurrence.
Histopathological examination revealed stratified squamous epithelium with hyperkeratosis, acanthosis, and elongated rete ridges. Beneath the epithelium, dilated lymph vessels and scattered blood vessels were noted, along with sparse chronic inflammatory cells, including lymphocytes and plasma cells. The lesion exhibited collagen overproduction with mature fibroblasts within a dense collagen matrix (Figure 4).
Figure 4. Photomicrograph of the histopathology of an irritation fibroma excised from the tip of the tongue.
The histology demonstrates hyperplastic keratinizing stratified squamous epithelium with elongated rete ridges overlying a dense collagenous stroma containing scattered fibroblasts. Chronic inflammatory cells, including lymphocytes and plasma cells, are sparsely present. Findings are consistent with a benign irritation fibroma. Hematoxylin and eosin [H&E] stain. Magnification ×40.
Based on the clinical and histopathological findings, a final diagnosis of irritation fibroma was established. This benign, slow-growing nodule rarely exceeds 1.5 cm in size. The diastema was identified as the likely source of chronic trauma. Differential diagnoses had included mucocele – suggested by the lesion’s mild enlargement during meals – and fibrolipoma; however, both were conclusively ruled out based on their distinct histological features.
Discussion
This case emphasizes important clinical and therapeutic insights in the diagnosis and management of irritation fibroma [IF], complementing previous reports in the literature. Thorough clinical and pathological evaluation remains essential for accurate diagnosis and optimal treatment. Although IF is a benign entity, it frequently causes functional or esthetic discomfort, necessitating surgical excision. In the present case, excision via diode laser was highly effective. The technique provided superior intraoperative visibility and precise tissue control due to concomitant hemostasis, which minimized bleeding. These factors contributed to an efficient procedure under local anesthesia and enhanced patient comfort. Postoperative outcomes at 1-year follow-up were excellent, with no reports of pain, scar formation, or recurrence, thereby affirming the safety and efficacy of this modality when standard protocols are adhered to. Notably, the patient declined adjunctive orthodontic treatment for diastema closure. Consequently, counseling was provided on the persistent etiological factor (chronic irritation) and the associated potential risk of future recurrence, underscoring the importance of patient education in long-term preventive management.
Rathva et al [3] reported a rare case of a pedunculated irritation fibroma [IF] on the tongue tip of a 44-year-old man, attributed to chronic trauma from sharp, attrited mandibular anterior teeth and treated successfully with conventional scalpel excision. In a parallel but distinct presentation, the current case involves a 53-year-old woman with a sessile, well-circumscribed IF at the same site, resulting from repetitive friction against a mandibular midline diastema. While both cases underscore the tongue tip’s susceptibility to mechanically induced fibrous hyperplasia despite its rarity, they also demonstrate divergent therapeutic philosophies. The present case was managed using a diode laser, which facilitated precise ablation, minimal intraoperative bleeding, and accelerated wound healing, contrasting with the traditional surgical approach used by Rathva et al. Histopathological examination in both instances confirmed characteristic features of IF, including hyperplastic stratified squamous epithelium with elongated rete ridges and dense, avascular collagenous bundles. However, the current lesion exhibited additional foci of dilated lymphatic channels, proliferating capillaries, and mild chronic inflammation, suggesting a more dynamic and active tissue response to persistent low-grade irritation.
These observations not only reinforce the spectrum of clinicopathological variations possible in irritation fibromas but also highlight the critical role of tailored treatment selection based on lesion size, location, and patient-specific factors. The favorable outcome achieved with diode laser excision in this case supports its growing adoption as a minimally invasive, efficacious alternative to conventional surgery for managing such reactive oral lesions.
A comparative analysis of another 4 reported cases and the present case underscores both the unifying features and the clinical variability of oral fibromas. In all instances, the lesions were reactive fibrous proliferations triggered by chronic local irritation, consistent with the well-documented pathogenesis of irritation and traumatic fibromas [7,9,12–15]. Histopathological findings across cases uniformly demonstrated hyperkeratinized or parakeratinized epithelium with underlying fibrous connective tissue, confirming the benign and reactive nature of these lesions [16]. Treatment in each case involved complete surgical excision – whether by scalpel or diode laser – along with removal of local irritants, resulting in uneventful healing and absence of recurrence during follow-up, in line with prior reports that fibromas rarely recur if adequately excised [17].
Despite these similarities, the cases differed markedly in terms of demographic profile, etiological factors, anatomical location, clinical presentation, and management.
Padmanabhan et al [14] described a 37-year-old woman with a rare posterior mandibular gingival fibroma reaching 5×4×3 cm, which interfered with function and required conventional surgical excision combined with tooth extractions. On the other hand, 2 cases – an 11-year-old boy [9] and a middle-aged woman [15] – presented with small (<1 cm) lateral tongue lesions that were largely asymptomatic and were managed conservatively using diode laser excision following cuspal adjustments, highlighting the advantages of laser-assisted approaches in terms of hemostasis, minimal postoperative discomfort, and patient acceptance.
Jiang et al [7] reported the case of a 53-year-old male chronic smoker with a tongue-tip fibroma unrelated to mechanical malocclusion, treated via conventional surgical excision, with no recurrence at 6 months. Similarly, the present case involved a 53-year-old woman with a tongue-tip fibroma associated with mandibular midline diastema, successfully treated using diode laser excision, with uneventful healing and no recurrence at 12 months. Together, these 2 cases demonstrate how different irritative stimuli – chronic smoking or mechanical trauma – can lead to similar pathological outcomes, and how both conventional and laser-based surgical approaches can achieve predictable, recurrence-free results when local factors are addressed.
Taken together, these cases illustrate the broad clinical spectrum of oral fibromas, ranging from small, innocuous tongue lesions in pediatric and adult patients to unusually large, functionally debilitating gingival growths. They emphasize the importance of tailoring management strategies not only to the biological behavior of the lesion but also to size, site, etiological factors, and functional impact, with contemporary laser techniques offering distinct benefits in selected scenarios [12,18]. These findings align with the existing literature, reinforcing the importance of prompt diagnosis and appropriate surgical modality to optimize functional and esthetic outcomes [17,19].
Many studies in the current literature reported different IF cases in terms of their locations in the oral cavity, the causes of the lesion, and their management [1,3,5–7,9,14,21,22,28–45] (Table 1). The demographic data of the present case – a woman in her fifth decade – is consistent with the established epidemiology of irritation fibroma [IF]. Silva-Mancera et al [22] report that while IF can occur in any demographic, it has a higher prevalence among females between the fourth and sixth decades of life. This predisposition may be influenced by hormonal factors, a correlation further supported by Jain et al [2]. In our patient, aging and poor oral hygiene, which resulted in multiple tooth losses, were potential contributing factors to the development of a mandibular diastema. This diastema, in conjunction with possible forward tongue pressure due to the altered dentition, created a site of chronic mechanical trauma on the tongue tip. This etiological pathway explains the late-onset formation of the IF in this case.
Table 1.
Clinical data of studies reporting irritation fibroma in the oral cavity.
| Author | Location | Cause | Management |
|---|---|---|---|
| Dhanai et al [27] | Maxillary mucosa | Inflammation | Surgical excision |
| Srivastava et al [28] | Palate | Betel chewing and low-grade trauma | Surgical excision |
| Asundaria et al [19] | Lateral border of the tongue | Trauma by sharp cusps | Laser excision |
| Diwan et al [29] | Maxillary mucosa, buccal mucosa | Calculus deposits, traumatic occlusion, and traumatic biting due to orthodontics | Laser excision |
| Lapitskayab et al [30] | Palate | N/A | Surgical excision |
| Cohen [31] | Lower labial mucosa | Self-biting | Surgical excision |
| Tsikopoulos et al [5] | Palate | Trauma from dentures | Surgical excision |
| Ware et al [20] | Maxillary mucosa | Trauma | Surgical excision |
| Salaria et al [32] | Mandibular mucosa | N/A | Surgical excision |
| Lalchandani et al [24] | Maxillary mucosa | Deep bite | Surgical excision |
| Padmanabhan et al [14] | Lateral border of the tongue | N/A | Laser excision |
| Park et al [33] | Mandibular mucosa | N/A | Surgical excision |
| Mahawar et al [34] | Maxillary mucosa | Trauma from dentures | Surgical excision |
| Nascimento et al [35] | Palate | Self-biting | Surgical excision |
| Silva-Mancera et al [22] | Buccal mucosa | Self-biting | Laser excision |
| Jiang et al [7] | Tip of the tongue | N/A | Surgical excision |
| Patait et al [36] | Buccal mucosa | Self-biting, sharp tooth, and trauma from dentures | Laser excision |
| Yadav et al [37] | Mandibular mucosa | Trauma | Surgical excision |
| Jain et al [38] | Mandibular mucosa | N/A | Surgical excision |
| Pinali et al [39] | Maxillary mucosa | N/A | Surgical excision |
| Prasanna et al [40] | Buccal mucosa | Trauma from dentures | Surgical excision |
| Saharan et al [41] | Maxillary mucosa | N/A | Surgical excision |
| Kohli et al [21] | Lower labial mucosa | N/A | Laser excision |
| Jeong et al [42] | Upper labial mucosa | N/A | Surgical excision |
| Practice et al [1] | Buccal mucosa | Self-biting | Laser excision |
| Sabino et al [43] | Buccal mucosa | Self-biting | Surgical excision |
| Bakhtiari et al [6] | Lingual surface of retromolar pad | N/A | Combination of surgical and laser excision |
| Zhao et al [44] | Dorsal surface of the tongue | N/A | N/A |
| Jain et al [45] | Lower labial mucosa | N/A | Surgical excision |
| Rathva et al [3] | Tip of the tongue | Trauma from lower attrided anterior | Surgical excision |
According to the reviewed literature (2013–2024), the tongue tip is an exceptionally rare site for irritation fibroma, identified in only 2 cases (6.25%). This makes it the second rarest location, surpassed only by the dorsal tongue and mandibular lingual mucosa (1 case each, 3.13%). In contrast, the most common location was the maxillary labial/buccal mucosa, representing 21.88% of cases (n=7) (Table 2).
Table 2.
Percentages of reported locations of irritation fibroma 2013–2024.
| Location | Percentage |
|---|---|
| Maxillary buccal/labial mucosa | 21.875% |
| Buccal mucosa of the inner cheek | 18.75% |
| Palate | 12.50% |
| Mandibular labial/buccal mucosa | 15.625% |
| Lips | 12.50% |
| Lateral border of the tongue | 6.25% |
| Tip of the tongue | 6.25% |
| Dorsal surface of the tongue | 3.125% |
| Mandibular lingual mucosa | 3.125% |
Management of IF typically involves complete surgical excision. In recent years, diode lasers have gained attention as a promising alternative to conventional surgical methods. Silva-Mancera et al [22] demonstrated the advantages of diode lasers, showing superior intraoperative control due to effective hemostasis, reduced bleeding, and enhanced visibility during the procedure. Additionally, their study emphasized postoperative benefits such as minimal pain, reduced swelling, faster healing, and the elimination of sutures, making lasers particularly advantageous in soft tissue management. Bakhtiari et al [6] supported these findings, reporting that diode lasers minimize tissue damage by sealing blood vessels during excision, resulting in quicker recovery and reduced scarring. In pediatric dentistry, some studies have argued in favor of traditional surgical methods. Wininger et al [23] noted that conventional surgery remains a reliable option due to its simplicity and cost-effectiveness, particularly in resource-limited settings. However, it is associated with increased intraoperative bleeding, the need for sutures, and longer recovery times. Furthermore, the risk of postoperative complications, such as infection and scarring, is comparatively higher with conventional surgical techniques.
In this case, using a diode laser effectively excised the lesion, ensured rapid healing, and prevented recurrence, aligning with most literature supporting lasers as a superior treatment modality for IF. Nevertheless, the decision to utilize diode lasers should be tailored to individual cases, considering their factors. The treatment of IF typically focuses on addressing etiological factors, such as diastema, and ensuring the complete removal of the lesion to reduce the risk of recurrence. Lalchandani et al [24] emphasized the importance of these measures, noting their effectiveness in preventing recurrence. However, Sundaram et al [25] reported cases of recurrence, attributing them to insufficient surgical excision or failure to eliminate local aggravating factors following surgery. Similarly, Richtsmeier et al [26] reported that continued exposure to irritants could lead to recurrence even after successful excision, underscoring the need for comprehensive management of underlying causes.
Treating IF requires a thorough clinical and pathological diagnosis to ensure accurate management. Although these lesions are benign, they can cause significant discomfort and often need surgical removal. In the present case, diode laser excision proved to be a successful and effective technique, providing excellent visualization of the surgical site, better control during the operation, and increased patient comfort. The procedure was performed using only local anesthesia, with no bleeding during surgery. After a year of follow-up, the patient reported no pain, scarring, or recurrence, showing the effectiveness and safety of the diode laser approach when protocols are carefully followed. Although the patient declined orthodontic treatment for diastema closure, she was informed about the possibility of lesion recurrence in the future.
The high level of patient cooperation, acceptance, and satisfaction further underscores the benefits of this minimally invasive treatment method, which continues to be a preferred choice for managing various oral lesions.
Conclusions
This case report shows that a dental diastema can be a source of chronic mechanical trauma, serving as a significant etiological factor in the development of irritation fibromas, even on uncommon sites like the tongue tip. Addressing and removing this causative factor is crucial to preventing recurrence. Furthermore, diode laser excision proved to be an effective and minimally invasive treatment choice, ensuring precise removal, excellent hemostasis, and favorable healing outcomes when protocols are carefully followed.
Footnotes
Conflict of interest: None declared
Department and Institution Where Work Was Done: Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
Patient Consent: Patient permission/consent was obtained.
Declaration of Figures’ Authenticity: All figures submitted have been created by the authors who confirm that the images are original with no duplication and have not been previously published in whole or in part.
References
- 1.Practice P, Apt V, Sok K, Bostanci N. Removal of irritation fibroma by 810-nm diode laser. Indian J Appl Res. 2016;6(10):213–14. [Google Scholar]
- 2.Jain G, Arora R, Sharma A, et al. Irritation fibroma: report of a case. J Curr Res Sci Med. 2017;3(2):118–21. [Google Scholar]
- 3.Rathva VJ. Traumatic fibroma of tongue. BMJ Case Rep. 2013;2013;2013:bcr2012008220. doi: 10.1136/bcr-2012-008220. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.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;18(Suppl 1):S86–S89. doi: 10.4103/0973-029X.141328. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Tsikopoulos A, Festas C, Fountarlis A, et al. Large irritation fibroma of hard palate: A case report of a rare clinical entity. Pan Afr Med J. 2021;38:61. doi: 10.11604/pamj.2021.38.61.27662. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Bakhtiari S, Taheri JB, Sehhatpour M, et al. Removal of an extra-large irritation fibroma with a combination of diode laser and scalpel. J Lasers Med Sci. 2015;6(4):182–84. doi: 10.15171/jlms.2015.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Jiang M, Bu W, Chen X, Gu H. A case of irritation fibroma. Postepy Dermatol Alergol. 2019;36(1):125–26. doi: 10.5114/ada.2019.82834. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Patait M, Kulkarni P, Bezalwar A, et al. Management of oral mucosal irritational fibroma with laser therapy: A case report. J Oral Med Oral Surg Oral Pathol Oral Radiol. 2018;4(1):61–63. [Google Scholar]
- 9.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(1):166–69. doi: 10.5005/jp-journals-10005-2492. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Kamath M, Arun A. Midline diastema. Int J Orthod Rehabil. 2016;7(3):101. [Google Scholar]
- 11.Tanaka OM, Morino AYK, Machuca OF, Schneider NÁ. When the midline diastema is not characteristic of the ‘ugly duckling’ stage. Case Rep Dent. 2015;2015:924743. doi: 10.1155/2015/924743. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Esmeili T, Lozada-Nur F, Epstein J. Common benign oral soft tissue masses. Dental Clin North Am. 2005;49(1):223–40. doi: 10.1016/j.cden.2004.07.001. [DOI] [PubMed] [Google Scholar]
- 13.Kfir Y, Buchner A, Hansen LS. Reactive lesions of the gingiva: A clinicopathological study of 741 cases. J Periodontol. 1980;51(11):655–61. doi: 10.1902/jop.1980.51.11.655. [DOI] [PubMed] [Google Scholar]
- 14.Padmanabhan AK. Management of irritational fibroma of the tongue with diode laser: A case report. Scholarly J Otolaryngol. 2020;4(4):390–92. [Google Scholar]
- 15.Lanjekar A, Kulkarni S, Akhade S, et al. An unusually large irritation fibroma associated with gingiva of lower left posterior teeth region. Case Rep Dent. 2016;2016:5202181. doi: 10.1155/2016/5202181. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Mathur RM, Ramesh V, Sankar V. Reactive lesions of the oral cavity: A clinicopathological study of 154 cases. J Indian Soc Pedod Prev Dent. 2010;28(2):79–83. [Google Scholar]
- 17.Rossmann JA. Reactive lesions of the gingiva: Diagnosis and treatment options. Open Pathology Journal. 2011;5(1):23–32. [Google Scholar]
- 18.Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: A review. J Oral Sci. 2006;48(4):167–75. doi: 10.2334/josnusd.48.167. [DOI] [PubMed] [Google Scholar]
- 19.Barker DS, Lucas RB. Localized fibrous overgrowths of the oral mucosa. Br J Oral Surg. 1967;5(2):86–92. doi: 10.1016/s0007-117x(67)80031-3. [DOI] [PubMed] [Google Scholar]
- 20.Ware RYZ, Gan YJ, Karandikar AA, et al. An unusually aggressive irritation fibroma: A diagnostic dilemma. J Case Rep. 2021;11(2):135–38. [Google Scholar]
- 21.Kohli A, Gupta K, Pandey M, Dwivedi A. Excision of irritation fibroma using a diode laser. J Dent Med Sci. 2016;3(3):26–29. [Google Scholar]
- 22.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. 2019;31(1–2):162–70. [Google Scholar]
- 23.Boj JR, Poirier C, Hernandez M, et al. Review: Laser soft tissue treatments for paediatric dental patients. Eur Arch Paediatr Dent. 2011;12(2):100–5. doi: 10.1007/BF03262788. [DOI] [PubMed] [Google Scholar]
- 24.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(3):306–9. doi: 10.5005/jp-journals-10005-1769. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25.Sundaram G, Ramakrishnan T, Parthasarathy H, et al. Disease: A cross-link of sorts! J Indian Soc Periodontol. 2018;22(2):113–18. doi: 10.4103/jisp.jisp_322_17. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 26.Richtsmeier WJ. Case report. Arch Otolaryngol Head Neck Surg. 2016;119(9):926. doi: 10.1001/archotol.1993.01880210014001. [DOI] [PubMed] [Google Scholar]
- 27.Dhanai A, Bagde HS, Gera R, Mukherjee K, et al. Case report on irritational fibroma. J Pharm Bioallied Sci. 2024;16(Suppl 1):S960–S62. doi: 10.4103/jpbs.jpbs_650_23. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.Srivastava A, Bhati P, Khanna V, et al. A large irritation fibroma of the hard palate: A rare clinical entity. Cureus. 2024;16(6):e62244. doi: 10.7759/cureus.62244. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 29.Diwan B, Shirbhate U, Bajaj P, et al. Conventional scalpel and diode laser approach for the management of traumatic fibroma. Cureus. 2023;15(10):e47810. doi: 10.7759/cureus.47810. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 30.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(3):e249369. doi: 10.1136/bcr-2022-249369. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 31.Cohen PR. Biting fibroma of the lower lip: A case report and literature review on an irritation fibroma occurring at the traumatic site of a tooth bite. Cureus. 2022;14(12):e32237. doi: 10.7759/cureus.32237. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32.Salaria SK, Kalra P, Belkhede SG, Vinnakota G. Successful management of recurrent irritational fibroma and associated residual soft tissue defect in the posterior teeth through single-stage surgery: A rare case report. J Indian Soc Periodontol. 2021;25(3):258–61. doi: 10.4103/jisp.jisp_182_20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 33.Park SH, Song YW, Jung UW, et al. Histopathological analysis of irritation fibroma occurred in young male gingiva: A case report. J Korean Dent Sci. 2020;13(1):35–41. [Google Scholar]
- 34.Mahawar P, Reddy S, Bhasin M, Kakkad A. Traumatic fibroma: A case report. IOSR J Dent Med Sci. 2020;19(3):37–40. [Google Scholar]
- 35.Nascimento LHA, Pinheiro TN, Junior JM, et al. Leaf-like traumatic fibroma in a dentate patient: An unusual case. CODS J Dent. 2020;12(2):45–47. [Google Scholar]
- 36.Patait M, Kulkarni P, Bezalwar A, et al. Management of oral mucosal irritational fibroma with laser therapy: A case report. J Oral Med Oral Surg Oral Pathol Oral Radiol. 2018;4(1):61–63. [Google Scholar]
- 37.Yadav N, Kumar A, Manohar B, Makhijani B. Irritational gingival fibroma: A case report. Int J Dent Med Spec. 2017;4(2):7–9. [Google Scholar]
- 38.Jain D, Mohan R, Sinha S, Singh VD, Singh A. Irritational fibroma of lower labial mucosa: A case report. Int J Dent Med Spec. 2016;3(1–2):16–19. [Google Scholar]
- 39.Pinali D, Shayari N, Kumar S, Ruchi B. Basal cell adenoma of the buccal mucosa masquerading as irritation fibroma: A rare case report. Oncology Journal of India. 2018;2(3):55–57. [Google Scholar]
- 40.Prasanna S, Nandhini G, Rajkumar K. Traumatic fibroma in buccal mucosa: A case report and literature review. Danipal J Dent Sci. 2018;1(1):44–46. [Google Scholar]
- 41.Saharan K, Shivaprasad S, Poornima R, Ashok L. Irritational fibroma of gingiva in a young female: A case report. J Med Radiol Pathol Surg. 2017;4(1):15–17. [Google Scholar]
- 42.Jeong Y, Kang C, Kim S, Lee J. Irritation fibroma associated with ectopic eruption of the maxillary incisor. J Korean Acad Pediatr Dent. 2016;43(2):207–14. [Google Scholar]
- 43.Sabino NAR, Gaetti-Jardim EC, Gaetti-Jardim E, Jr, De Melo RL. Fibroma: Case report. Arch Health Investig. 2016;5(4):214–16. [Google Scholar]
- 44.Zhao X, Liu DJ, Xu CX, et al. Multiple irritation fibromas after dorsum linguae biopsy. J Craniofac Surg. 2014;25(2):524–16. doi: 10.1097/SCS.0000000000000686. [DOI] [PubMed] [Google Scholar]
- 45.Jain K, Singh BD, Dubey A, Avinash A. Fibro-epithelial hyperplasia mimicking mucocele. Kathmandu Univ Med J. 2014;12(46):146–48. doi: 10.3126/kumj.v12i2.13663. [DOI] [PubMed] [Google Scholar]