Abstract
A 15-year-old male presented with an incidentally discovered radiopacity above an unerupted wisdom tooth of the right mandible. A biopsy 2 years prior was inconclusive. Light microscopy of the biopsy revealed proliferating cords of odontogenic epithelium with a moderately cellular mesenchymal matrix enclosing loose stellate reticulum-like areas. There was associated new enamel and dentine formation with the structure of a complex odontoma. These features are of an ameloblastic fibro-odontoma. Ameloblastic fibro-odontoma is a rare, slowing growing, mixed odontogenic neoplasm which is usually diagnosed before the age of 20. They involve the posterior mandible or maxilla and can be associated with unerupted teeth. Radiographically the ameloblastic fibroma component appears as a well defined radiolucent area with the odontomatous component appearing as irregular radiopacities. Radiological differential diagnoses include calcifying odontogenic cyst and odontoma. Ameloblastic fibro-odontomas are generally not aggressive and can be treated with surgical curettage without removal of adjacent teeth. Recurrences have been reported. The risk of developing an amelobastic fibrosarcinoma is less than for an ameloblastic fibroma. However, follow-up is recommended.
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