Abstract
Cemento-ossifying fibroma is a benign fibro-osseous lesion belonging to the same category as fibrous dysplasia and cementifying dysplasia. These are slow-growing lesions that are seen in the third and fourth decades of life. Both the ossifying fibroma and cemento-ossifying fibroma represent two extremes of the same disease process since histologically both contain bone and cementum. However, the term cemento-ossifying fibroma is justified on the basis of clinical and radiological correlation. Radiographs have become an essential tool in the diagnosis of lesions in the jaw, where the anatomy is complex. Nowadays, CT provides information for diagnosis as well as treatment planning. In this case series, we report three cases of cemento-ossifying fibroma that were histologically confirmed and discuss the imaging findings.
Highlights
Cemento-ossifying fibroma (COF) is a rare, benign fibroosseous lesion of the jaws exhibiting well-circumscribed, unilocular radiolucency mixed with radiopacity based on the type of mineralized tissue it contains.[1]
The origin of COF has been associated with the periodontal membrane that has multipotent cells capable of forming cementum, lamellar bone, and fibrous tissue
We report a case series of three COF, two of which are seen in the maxilla and one in the mandible
Summary
Cemento-ossifying fibroma (COF) is a rare, benign fibroosseous lesion of the jaws exhibiting well-circumscribed, unilocular radiolucency mixed with radiopacity based on the type of mineralized tissue it contains.[1]. Intra-oral periapical radiograph of teeth 13 to 16 revealed a mixed radiopaque and radiolucent lesion with more areas of dense radiopacities. Clinical examination revealed a single diffuse swelling measuring about 4 × 3 cm in size in relation to buccal and lingual aspect of mandibular premolar to molar region on the right side. Mandibular occlusal radiograph [Figure 8] of the right side revealed a lesion expanding both the buccal and lingual cortical plates in the posterior mandible in relation to mandibular first premolar to molar region. Orthopantomograph [Figure 9] and right lateral skull [Figure 10] view revealed a well-defined lesion extending from mesial surface of mandibular first premolar to distal part of mandibular second molar. Figure 12: 3D CT reveals abnormality in the right mandible with expansion of the buccal (white arrow) and lingual cortical plates (black arrow). Correlating with the clinical and radiological features, a final diagnosis of cement-ossifying fibroma was arrived
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