Cemento-ossifying fibroma of mandible mimicking complex composite odontome

Abstract

Cemento-ossifying fibroma (COF) is a fibro-osseous lesion or non-odontogenic tumour that affects craniofacial bones. These lesions are included in the spectrum of fibro-osseous lesions arising from periodontal ligament cells, which can deposit combination of cementum and bone surrounded by fibrous tissue. It clinically, macroscopically and radiologically resembles complex composite odontome and can be differentiated only on the basis of histopathology. They usually occur solitarily as a painless and expansile spherical or ovoid jawbone mass that may displace the roots of adjacent teeth. They predominantly occur in females in third and fourth decades of life. We present a case report of a 20-year-old man, with a mildly painful swelling in the mandible which was successfully treated with enucleation and diagnosed as COF. Its resemblance to complex composite odontome and unique surgical approach are highlighted in this paper.

Cemento-Ossifying Fibroma of the Mandible: A Case Report

“…A metaplastic process that emerges in the connective tissue fibers and unregulated growth of periodontal ligament cells are the two potential sources of the large amounts of mesenchymal cellular induction into bone and cementum that result in odontogenesis [ 3 ]. According to Dewan et al's hypotheses, the periodontal membrane may be stimulated by infection-induced inflammation and fibrosis of the periapical region [ 9 ].…”

“…Although it grows slowly, it can occasionally appear as juvenile aggressive ossifying fibroma (JAF), a form of OF that manifests more vascularity and aggression in people aged between 5 and 15 years [ 3 ]. Overall, COF is well-defined, encapsulated, and asymptomatic and may eventually cause facial distortion as a result of expansion, requiring surgical intervention [ 9 , 11 ]. Teeth displacement may be the only clinical feature of the ensuing facial asymmetry.…”

A Painless Bump: A Case Report of Cemento-Ossifying Fibroma of the Anterior Maxilla

“…In the clinical setting, COF appears as a painless, slowly expanding mass in the mandible rather than the maxilla, often located apical to posterior teeth, and more prevalent in females than males [ 9 ]. It is possible that the sole early clinical sign is the displacement of teeth, and the teeth in proximity to the lesion generally remain vital [ 10 ].…”