Epithelium Rich Type Central Odontogenic Fibroma in Maxilla a Case Report and Review of Literature

Abstract

Central Odontogenic Fibroma (COF) is a rare, benign neoplasm of mesenchymal origin that makes up less than 5% of odontogenic tumors commonly found in women in ratio 2.8:1. For many years there was considerable confusion concerning the criteria by which the lesion should be diagnosed and as a result, a verity of different conditions were being reported as odontogenic fibroma (OF). In this article reporting a case of COF (Epithelium Rich-type) in the maxilla radiographically presented as a well-defined radiolucent and radiopaque lesion retarding the first premolar from erupting plus reviewing the literature about COF including its variants.

Central odontogenic fibroma, hyperplastic dental follicle, or dentigerous cyst? A diagnostic dilemma: A case report

“…DF may also have similar features like COF such as odontogenic rests and some calcifications but differ in absence of fibroblastic connective tissue arranged in interwoven strands, which is a characteristic of COF 6,7 . In histopathologic view of our case, interwoven collagen strands that are the characteristics of COF were seen.…”

“…Polarization colors of the thick collagen fibers of COF showed small percentage of orange and yellowish-orange colors, while they were found in high percentage in HDF. 6 Radiographically, HDF is usually symmetrical unlike COF. 6,7 The pericoronal radiolucency around the impacted canine tooth in our case was asymmetric.…”

“…Epidemiologic data related to odontogenic lesions have been associated with a variety of results due to the change in the classification of lesions over the years 11 . In the same way, at first, the term “COF” was given to every enlarged DF until Gardner separated between those different types although difficulties persisted in distinguishing between HDF and COF 6 …”

“…6 Radiographically, HDF is usually symmetrical unlike COF. 6,7 The pericoronal radiolucency around the impacted canine tooth in our case was asymmetric. The radiolucent space in mesial portion of the impacted tooth was very wider than distal portion; thus, according to this, the lesion was a COF rather than a HDF.…”

“…Smaller lesions are usually asymptomatic, but larger ones may be associated with localized bony expansion or loosening of teeth. 6 , 7 Radiographically, smaller tumors are well‐defined unilocular radiolucent lesions. Approximately 12% of COFs will show radiopaque flecks within the lesion.…”