Mandibular ossifying fibroma

Findings

Bubbly, expansile lesion centered at the inferior aspect of the midline and right parasymphyseal mandible. Contains internal cystic regions and areas of coarse calcified matrix or septation with expansile margin predominantly involving the buccal cortex. There is mild remodeling of the lingual cortex. There is no bony dehiscence or significant soft tissue component.

Differential diagnosis:
- Ossifying fibroma
- Odontoma
- Fibrous dysplasia
- Odontogenic myxoma
- Ameloblastoma
- Hemangioma
- Cementoma


Diagnosis: Mandibular ossifying fibroma


Key points

Ossifying fibromas are one of the fibro-osseous lesions, which also include cementifying ossifying fibroma, cementifying fibroma and fibrous dysplasia.
Distinction is difficult because of overlapping clinical, radiological and pathological criteria.
Usually arise from the periodontal ligament, and are most commonly found in the mandible.
Presents in middle age, often asymptomatic. Can cause paresthesia from nerve compression.
Round or oval periapical lesion with variable lucency and matrix calcification depending on spectrum. Usually no cortical disruption.
Conservative curettage is the treatment.