Cemento-Ossifying Fibroma of the Mandible: A Case Report

Abstract

Benign osseous tumors of mesodermal origin that are included within the group of fibro-osseous lesions include cemento-ossifying fibromas (COFs). The fibrocellular component of these diseases originates from the periodontal ligament, which deposits bone and cementum encased in fibrous tissue. It typically appears in the mandible and presents as a solitary, nonaggressive, slowly developing, asymptomatic, expansile lesion, rarely occurring in the maxilla. The only intervention that proved to be successful in producing excellent outcomes and that may be regarded as a final therapeutic option is the complete surgical removal of COFs. Presenting herein is a case report describing a painless and expansile mass in the left mandibular region, histopathologically diagnosed as COF.

Keywords: cemento-ossifying fibroma; cementum; excision; expansile lesion; psammoma bodies.

Figure 1. Painless spherical expansile mass observed in the mandibular lingual premolar region between teeth 33 and 35, as per FDI notation.

FDI, Fédération Dentaire Internationale

Figure 2. Lingual cortical expansion observed in the mandibular premolar region.

Figure 3. IOPA revealing a unilocular mixed lesion with an internal ground-glass appearance, a thin radiopaque margin, and concentric expansion of the affected bone involving teeth 34-35.

IOPA, Intraoral Periapical Radiograph

Figure 4. Mucoperiosteal flap elevated followed by curettage in the premolar region, exposing the lesion along with the extraction of teeth 34 and 35.

Figure 5. Primary closure achieved with simple interrupted sutures with silk 3-0.

Figure 6. The histopathological specimen presented with a highly cellular fibroblast field with dispersed areas of calcifications, similar to cementum-like material.