Moreover, confusion exists regarding its relationship to other similar entities with various definitions and debate as to whether it is of odontogenic or nonodontogenic osseous origin , although the WHO classification currently lists it as a "bone-related tumor" 7. Occasionally, they are identified in children, in which case they are a more aggressive variant and are known as juvenile aggressive cemento-ossifying fibromas discussed separately 3,5. Teeth are often displaced by the growing mass. Other locations within the head and neck have been described 1. However, in most cases both features are present, warranting the generic term cemento-ossifying fibromas 1.
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Cemento-ossifying fibroma of the mandible A clinicopathological report Tapas K. E-mail: moc. Abstract Cemento-ossifying fibromas are rare fibro-osseous benign neoplasms that affect the jaws. They are included in the group of mesodermal odontogenic tumors and commonly present as a progressively growing lesion that might attain enormous size with resultant deformity, if left untreated.
A confusion prevails on the terminology, which can only be confirmed by histopathologic evaluation. A case of cemento-ossifying fibroma involving the right mandible is described in a 30 year-old female patient. The clinical, radiographic, histologic features are presented and the various differential diagnosis are discussed. Cemento-ossifying fibroma COF is a distinct form of a benign fibro-osseous tumor, affecting predominantly the craniofacial region. Their resemblance to ossifying fibroma and cemento-osseous dysplasias give evidence for an odontogenic origin.
Cemento-ossifying fibroma has always been surrounded by controversy regarding the terminology and criteria of diagnosis. Even then, the differences between the broad spectrum of ossifying fibromas remains unclear. The following case report attempts to differentiate between lesions presenting with similar clinical, radiographic and histologic presentations; as well as describe the varying manifestations of COF, with reference to previous literature.
Case Report A 30 year old female patient with no other relevant medical history, reported to the department with a swelling on the right side of the face since the last 2 years with occasional pain Figure 1. The swelling seemed to be gradually increasing in size, reaching its present size in the last 6 months.
No history of previous similar swelling, toothache, or numbness could be elicited. Extra-oral examination revealed a well-defined, dome-shaped swelling extending over the right body of the mandible up to the lower border of the mandible inferiorly. There was no erythema or surface ulceration of the swelling. On palpation, a bony hard consistency of the swelling was elicited, with no evident tenderness or increase in temperature.
Expansion of the buccal cortical plate was evident. Intraorally, the swelling was observed in the lower buccal vestibule leading to obliteration of the mucobuccal fold with respect to lower right molars and measured approximately 3cm x 4cm in size. Tooth mobility and mild tenderness on percussion was observed in the teeth associated with the lesion namely, lower right molars and root stump. Digital panoramic radiograph taken revealed a well-defined multilocular radiolucent lesion in the right mandibular body region extending up to the ramus Figure 2.
The lesion was seen extending beyond the lower border of the mandible with expansion and thinning of the cortical plates. The internal structure of the lesion was mainly radiolucent, with diffuse scattered radiopacity. Root resorption of lower right first and second molars was evident. Occlusal radiograph showed well-defined expansion of both the buccal and lingual cortical plates arising from lower right first molar region, with evidence of ill-defined diffuse septa, suggesting a multi-locular appearance with diffuse irregular radiopacity within the largely radiolucent lesion Figure 3.
Cemento-Ossifying fibroma (2nd stage)
E-mail: moc. Abstract The purpose of this article is to report 20 cases of ossifying fibroma involving the jaw bone and to review the literature of this lesion. All the cases had adequate radiographs and clinical information. Varying shapes of the lesion including cystic lesion and mixed density lesion are presented, including two massive expansile lesions, which measured more than 10 cm.
Cemento-ossifying fibroma of the mandible A clinicopathological report Tapas K. E-mail: moc. Abstract Cemento-ossifying fibromas are rare fibro-osseous benign neoplasms that affect the jaws. They are included in the group of mesodermal odontogenic tumors and commonly present as a progressively growing lesion that might attain enormous size with resultant deformity, if left untreated. A confusion prevails on the terminology, which can only be confirmed by histopathologic evaluation. A case of cemento-ossifying fibroma involving the right mandible is described in a 30 year-old female patient.
Peripheral cemento-ossifying fibroma of maxilla
E-mail: moc. This article has been cited by other articles in PMC. Abstract Peripheral cemento-ossifying fibroma is a reactive gingival overgrowth occurring frequently in anterior maxilla. It is a slow-growing benign tumor which may lead to pathologic migration and other periodontal problems, so it should be excised as soon as possible. Herein, we are reporting a similar case of peripheral cemento-ossifying fibroma in the maxillary anterior region. Keywords: Fibroma, gingival overgrowth, peripheral cemento-ossifying fibroma INTRODUCTION Ossifying fibroma is a benign neoplasm arising in craniofacial bones, composed of proliferating fibroblasts with osseous products that include bone and ovoid calcifications; these lesions are well demarcated from the adjacent bone. The central type arises from the endosteum or the periodontal ligament adjacent to the root apex and causes expansion of medullary cavity.