Abstract

A fibroepithelial polyp is a benign reactive exophytic lesion of the oral mucosa resulting from an exaggerated tissue response to low-grade mechanical or inflammatory irritation. When localized to the gingiva, its clinical presentation frequently mimics other focal reactive overgrowths, requiring definitive clinicopathological correlation. A 21-year-old female presented with a painless, firm, pedunculated, pink labial gingival mass associated with the maxillary right central incisor (#11). The lesion emerged 6 months following the completion of a 2-year course of fixed orthodontic therapy. Detailed periodontal parameters revealed stable baseline tissues with an isolated localized plaque-retentive field. A complete conventional excisional biopsy was executed down to the attached gingiva, combined with root surface debridement. Histopathological examination confirmed hyperplastic stratified squamous epithelium overlying dense, mature collagenized fibrous connective tissue with mild chronic inflammatory cell infiltration, lacking any evidence of cellular atypia, mineralized structures, or multinucleated giant cells. Surgical excision was completed successfully with uneventful healing by secondary intention, fully preserving the local soft tissue architecture without postoperative complications. A 3-year follow-up period demonstrated exceptional stability of the gingival contour, ideal aesthetic restoration, and a complete absence of localized recurrence. This case is particularly noteworthy due to the uncommon manifestation of a mature fibroepithelial polyp localized within the highly sensitive maxillary anterior aesthetic zone, presenting unique diagnostic and aesthetic management challenges. A long-term follow-up validates the clinical therapeutic approach and establishes long-term resolution.