Central odontogenic fibroma current concepts

Abstract

The author reviews current knowledge concerning the central odontogenic fibroma, which at present in incompletely understood, and reaches the following conclusions. 1) The separation of this lesion into simple and WHO types remains valid because they exhibit different histologic features. However, more care should be taken in rendering the diagnosis of the WHO type than in the past; unlike the simple type, it is a fibroblastic lesion. 2) Complex central odontogenic fibroma is a more appropriate term than the WHO type because the WHO does not use the latter term in its 1992 manual. 3) The microscopic distinction of simple odontogenic fibroma from desmoplastic fibroma remains difficult in some cases. 4) The granular cell odontogenic tumor, which has sometimes been referred to as a type of odontogenic fibroma, is a separate entity, although some simple odontogenic fibromas exhibit scattered granular cells. 5) The separation of lesions that have been reported recently as odontogenic fibromas with giant cell reactions from central giant cell granulomas that exhibit foci of odontogenic epithelium requires further study.

So-called Hybrid Central Odontogenic Fibroma/Central Giant Cell Lesion of the Jaws. A Report on Seven Additional Cases, Including an Example in a Patient with Cherubism, and Hypotheses on the Pathogenesis

“…Central odontogenic fibroma (COF) is a benign neoplasm of the jaws that represents less than 5% of all odontogenic tumors [1][2][3][4]. It is characterized by fibroblastic proliferation that ranges from poorly cellular and myxoid without significant odontogenic epithelial component, to cellular, featuring interlacing collagen fascicles with abundant odontogenic epithelium and occasional foci of calcifications resembling dysplastic dentin or cementum [1][2][3][4].…”

“…It is characterized by fibroblastic proliferation that ranges from poorly cellular and myxoid without significant odontogenic epithelial component, to cellular, featuring interlacing collagen fascicles with abundant odontogenic epithelium and occasional foci of calcifications resembling dysplastic dentin or cementum [1][2][3][4]. The terms simple type or epithelium-poor type and WHO type or complex or epithelium-rich type, have been, respectively, designated to those lesions.…”

“…COF is usually slow-growing and may progressively cause painless bone expansion and displacement or root resorption of adjacent teeth [1][2][3][4]. From the approximately 70 cases of central odontogenic fibroma reported in the English-language literature up to 2004, a predilection for young females is evident [1][2][3].…”

Desmoplastic Fibroma Primarily Originating in the Maxillary Alveolus: A Case Report

“…Furthermore, the tumor cells were positive for anti-desmin, and negative for anti-S-100 protein and anti-NSE antibodies, indicating that the cells originated not in neurogenic cells but in fibroblastic cells. Since the present case primarily arose in the jaw bone, an odontogenic tumor, for example, a variant of odontogenic fibroma, would also have to be considered in a differential diagnosis, as previously proposed by Slootweg & Miiller (13), Drebber et al (14) and Gardner (15). The present case did not resemble any of the mesenchymal tumors, such as hyperplastic dental follicles, odontogenic fibroma into simple and WHO types, odontogenic fibroma exhibiting pleomorphic fibroblasts or central odontogenic fibroma, which were proposed by Gardner (15).…”

“…Since the present case primarily arose in the jaw bone, an odontogenic tumor, for example, a variant of odontogenic fibroma, would also have to be considered in a differential diagnosis, as previously proposed by Slootweg & Miiller (13), Drebber et al (14) and Gardner (15). The present case did not resemble any of the mesenchymal tumors, such as hyperplastic dental follicles, odontogenic fibroma into simple and WHO types, odontogenic fibroma exhibiting pleomorphic fibroblasts or central odontogenic fibroma, which were proposed by Gardner (15). An immunohistochemical discrimination between the present case and odontogenic tumors was attempted using the odontogenic fibrous cell-specific antisera, such as anti-FGF and anti-FGF-R (7).…”