Abstract
Central ossifying fibroma is a rare, benign fibro-osseous lesion that arises from the periodontal ligament. Periapical cemento-osseous dysplasia is another variant of fibro-osseous lesion which occurs in the anterior region of the mandible of females. Odontoma is a benign odontogenic tumor that contains enamel, dentine cement and pulp tissue. A 46-year-old woman was referred to the Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, with two non-painful swellings on both sides of the mandible, which had been slowly growing over a period of one year. Our differential diagnosis was florid cemento-osseous dysplasia, focal cemento-osseous dysplasia for the right side, complex odontoma for the left side and periapical cement-osseous dysplasia for the anterior side. The historical feature revealed ossifying fibroma, complex odontoma and periapical cemento-osseous dysplasia. The occurrence of these three lesions in the same jaw has been rarely reported in the literature. The relationship between the occurrence of these three lesions is not obvious it could be coincidental. It seems that more case reports are needed to establish the relationship between them.
Highlights
Fibro-osseous lesions (FOL) of the jaws constitute a group of conditions which are remarkable for their clinico-pathological similarities.[1]
They differ, with the exception of fibrous dysplasia, from those found in the rest of the skeleton
The designation fibro-osseous lesion is not a specific diagnosis and describes only a process. Radiology defines their diagnosis because the pathology features on a biopsy specimen may be very similar to lesions of diverse cause, but they differ widely in their behavior and prognosis, from dysplasia, hamartoma, to benign neoplasia. These processes have been classified under the encompassing heading of benign fibroosseous lesions, a more specific diagnosis often is critical because the treatment of these pathoses varies, from review and follow-up to surgical recontouring to complete removal
Summary
Fibro-osseous lesions (FOL) of the jaws constitute a group of conditions which are remarkable for their clinico-pathological similarities.[1]. FOLs of the face and jaws include ossifying fibroma, fibrous dysplasia, cementoossifying fibroma, benign cemento-blastoma and periapical cemental dysplasia ( known as periapical fibrous dysplasia) They are characterized by the replacement of normal bone by connective tissue, with varying degrees of mineralization in the form of woven bone or cementum-like round acellular basophilic structures.[2] The designation fibro-osseous lesion is not a specific diagnosis and describes only a process. Some lesions produce painless bone deformity and facial asymmetry which on occasion reaches grotesque size.[1,2,3,4] Periapical Cemento Osseous Dysplasia (PCOD) is an asymptomatic condition that occurs in the periapical region of the anterior mandible Both radiologically and histologically, the lesion is indistinguishable from the cementifying fibroma.[5] Very often multiple teeth are involved, there appears to be a female predominance (ranging from 10:1 to 14:1), and 70% of cases affect blacks. The purpose of this paper is to report a case in which the patient presented two types of fibro-osseous lesions and odontoma complex simultaneously in the same jaw
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