Fibroma cementoossificante bilateral mandibular apresentando diferentes estágios de maturação: relato de caso clínico / Bilateral ossifying fibroma of the jaw with different maturation stages: a case report

Abstract

The ossifying fibroma (OF) is characterized as a benign neoplasm originated from the mesenchymal periodontal membrane, being composed of different amounts of mineralized material and fibrocellular stroma, leading to a mixed aspect. More commonly found as solitary lesions, the OF can be multiple in rare cases, normally associated with hyperparathyroidism-jaw tumor syndrome (HPT-JT). The aim of this study is to report a case of bilateral OF in the mandible with different stages of maturation, not associated with HPT-JT. This case shows a 20-year-old female patient with asymptomatic intraoral hard swelling in both sides of the mandible, presenting a slight expansion in the buccal bone cortex, near to the molars, hard to palpation. CBCT showed a unilocular, well-circumscribed hypodense image, with calcified masses only on the right side. Incisional biopsies were performed and a diagnosis of bilateral OF was reached. Due to the different stages of maturation of the lesions, two different surgical approaches were performed, curettage in the left side and surgical resection in the right side with extraction of the lower second premolar and lower first molar. These areas were restored with bone grafts and the left first molar was unresponsive to the pulp vitality test and endodontic treatment was performed. The patient is undergoing periodic clinical and radiographic follow-up, and after 12 months no signs or evidence of recurrence were observed.