WHERE DO AMELOBLASTIC fiBROMA AND AMELOBLASTIC fiBRO-ODONTOMA fiT IN THE CLASSIfiCATION OF ODONTOGENIC TUMOURS?

Abstract

The 4th edition of the World Health Organization's Classification of Head and Neck Tumours was published in January 2017. In this edition ameloblastic fibroma, ameloblastic fibro-dentinoma and ameloblastic fibro-odontoma have been grouped under odontomas as developing odontomas rather than inclusion as mixed odontogenic neoplasms. BRAFV600E mutations and low frequency of fractional allelic loss of tumour suppressor gene loci have been reported in ameloblastic fibroma and ameloblastic fibro-odontoma, indicative of a neoplastic process, however the prevailing view is that once dental hard tissues are produced, these lesions are more likely maturing into odontomas rather than true neoplasms, a view which has some support in the literature. Not withstanding some of these lesions reach significant size prior to diagnosis and management with bone expansion suggesting a neoplastic process. In addition lesions may recur and malignant transformation has been reported. The purpose of this paper is to present a case of ameloblastic fibro-odontoma, a case of ameloblastic fibroma and discuss the merits of the current classification of these lesions.