Ossifying fibroma in a Hong Kong community: the clinical and radiological features and outcomes of treatment

Abstract

OF in this community predominantly affects females. Although gynaecological history was not included in the clinical notes, there is a clear possibility of reactivation of OF growth at the menopause. Other potentially important contributing factors are "traditional Chinese medicine" and the progressive reduction in the degree of water fluoridation. Although most patients were followed up, this was only for a few years. Nevertheless, one case actually recurred during follow-up. Therefore, patients with OF should be encouraged to maintain follow-up for a longer period.

A multilocular radiolucency with spindle cell proliferation in a case of ossifying fibroma: a potential pitfall

“…lesions found in older adults show a mixed pattern while a radiolucent pattern is frequently found with younger patients. 2 A similar observation was also espoused by Liu et al 5 in a recurrent case of OF, with the radio-graphic pattern changing from unilocular to multilocular and then to a radio-opaque lesion. Of the 20 cases examined separately by MacDonald-Janowski and Li 2 and Liu et al, 5 only a single case in each study showed a multilocular but radiolucent lesion: in a 26-year-old female and 12-year-old female, respectively.…”

“…4 Liu et al, 5 in an analysis of 20 Chinese patients with OF, found no gender significance compared with exclusive female involvement in 24 patients of Hong Kong Chinese descent. 2 The mean age also differed between these two Chinese groups, being 28 years (range 6-57 years) for Chinese and 38 years (range 10-80 years) for Hong Kong Chinese for both the maxillary and mandibular locations. However, both studies observed that patients with maxillary lesions were a decade younger at presentation than those with mandibular lesions.…”

“…Other radiographic features such as cortical expansion, absent lamina dura, involvement of both sides of the jaw, bowing of the lower border of the mandible and downward displacement of the mandibular canal are in accordance with the previous established reports. 2 To differentiate the present lesion from more common odontogenic lesions, such as keratocystic odontogenic tumour and ameloblastoma, based on conventional radiography may be difficult owing to the nature of multilocular radiolucency and scalloped margins, but central giant cell granuloma is more common in the paediatric population. Simple bone cyst, although unlikely to be extensive as in the present case, may simulate the invagination between the roots of the teeth and lack of displacement of the involved teeth.…”

“…However, both studies observed that patients with maxillary lesions were a decade younger at presentation than those with mandibular lesions. 2,5 Radiographically, OF may present as radiolucent, radio-opaque or both. The radiographic appearance is related to age at presentation, i.e.…”

“…1 Diagnosis of fibro-osseous lesions is troublesome, not only among themselves, but also with diagnosis of other jaw lesions, including those which are odontogenic and non-odontogenic in origin. 1,2 In the jaws, the mandible is more frequently affected than the maxilla, with a preponderance of lesions diagnosed between the premolar-molar region in the mandible and the posterior region of the maxilla, [2][3][4] with or without involving the maxillary sinus. 2 We report an OF with predominantly spindle cell proliferation and purely radiolucent lesion with bilateral involvement of the mandible in a middle-aged woman.…”