Central Ossifying Fibroma and Fibrous Dysplasia of the Jaws: A Clinical, Radiographic and Histopathologic Study of 28 Cases

Abstract

Objective: To analyze radiographic and histopathologic findings of a series of cases of central ossifying fibroma (COF) and fibrous dysplasia (FD) of the jaws. Method: This study consisted of a retrospective review of cases of COF and FD of the jaws diagnosed at the Oral Pathology Service of the Department of Dentistry of UFRN, between January 1970 and January 2007. Clinical data relative to the patients’ age and gender as well as to the anatomic location of the lesions were analyzed. By the analysis of panoramic radiographs, COF and FD were evaluated as to the radiographic density and limits of the lesions compared to the circumjacent bone tissue. For the histopathological analysis, COF and FD were examined as to their morphology, degree of maturity and osteoblastic action of the mineralized tissue, as well as to the cellularization, vascularization and collagenization of the connective tissue. Results: 15 cases of COF and 13 cases of FD were retrieved, with a strong female predilection. Regarding anatomic location, 66.7% of the cases of COF occurred in the mandible and 69.2% of the cases of FD were found in the maxilla. In particular, 90% of the COF of the mandible and 66.7% of the FD of the maxilla were found in posterior regions. Radiographically, the cases of COF and FD showed predominantly mixed or radiopaque density. All cases of COF presented as circumscribed lesions and 100% of the cases of FD showed diffuse radiographic margins. Regarding cellularization, vascularization and collagenization of the connective tissue, COF and FD showed remarkable similarities, with predominance of moderate and sever degrees. Nevertheless, FD and COF exhibited important differences in the mineralized material, the cases of COF presenting greater variability in the morphology of the mineral deposits. Conclusion: There was considerable superpositioning of the microscopic aspects of COF and FD. Among the assessed clinical and radiographic parameters, the radiographic limit of the lesion in relation to the surrounding bone tissue was a key finding for differential diagnosis between COF and FD of the jaws.