Ameloblastic fibrodentinoma: report on two new cases

Mixed odontogenic tumors: A review of the clinicopathological and molecular features and changes in the WHO classification

BACKGROUND

Ameloblastic fibromas and ameloblastic fibrosarcomas are rare odontogenic tumors, and controversy exists in the classification of cases presenting hard-tissue production: Ameloblastic fibrodentinoma (AFD) and ameloblastic fibro-odontoma (AFO). These cases are currently considered “developing odontomas” (hamartomatous lesions).

AIM

To analyze the clinicopathologic features of these lesions and discuss the changes in the 2017 World Health Organization classification.

METHODS

An electronic literature search was performed in the PubMed/MEDLINE database. An electronic search of the English language literature was performed and last updated in September 2020 in the PubMed/MEDLINE database using the following terms: “ameloblastic fibroma”, “ameloblastic fibrodentinoma”, “ameloblastic fibro-odontoma”, “ameloblastic sarcoma”, “ameloblastic fibrosarcoma”, “ameloblastic fibrodentinosarcoma”, “ameloblastic fibroodontosarcoma” and “odontogenic carcinosarcoma”. The inclusion criteria were odontogenic tumor series, case reports and systematic reviews that provided sufficient clinical, radiological and microscopic documentation to confirm the diagnosis.

RESULTS

The database search strategy resulted in 947 papers. Articles focusing on other topics, articles that were not in English, duplicate articles, and articles without fulfilling the inclusion criteria were excluded. Finally, 96 publications were included in this review to describe and discuss the main features of the searched entities. Several aspects of AFO and AFD, such as biological behavior, age of occurrence, amount of hard tissue, and potential for malignant transformation into odontogenic sarcomas, support the neoplastic nature in most of the reported cases. Considering the clinical, radiographic, histopathological and molecular characteristics of odontogenic lesions with hard tissue production, we suggest that these types of lesions should continue to be recognized as odontogenic tumors by maintaining the classically used terms.

CONCLUSION

This recommendation will be relevant for future clinical, microscopic, and molecular studies to better understand the biology of these interesting odontogenic tumors.

Mature form of ameloblastic fibrodentinoma: a case report

Ameloblastic fibrodentinoma (AFD) is classified as a rarely seen benign mixed odontogenic tumor. Ameloblastic fibrodentinoma is common in children and young adults with painless swelling and mostly seen at the mandibular posterior region and usually associated with unerupted tooth. In this clinical report, an 11-year-old-boy referred to Ankara University, Faculty of Dentistry, with the complaint of pain and swelling at the mandibular posterior region, diagnosed as AFD, is presented. Extraoral examination showed swelling at the affected side. In intraoral examination, a rough painful swelling was invincible with a delayed eruption of deciduous second molar tooth. Panoramic radiography revealed well-defined radiolucency with large radiopacity above the crown of unerupted permanent second molar in the left mandible. The provisional diagnosis was complex odontoma. Biopsy resulted as AFD. The treatment achieved with total excision of the tumor and the second premolar tooth. Resorbable fixation plates were used for strengthening the excised region of the mandible. No recurrence or clinical complaints were noted during 1-year follow-up.

Ameloblastic fibrodentinoma: report of a rare case

AIM

This is to report a rare case of ameloblastic fibrodentinoma (AFD), including detailed history, histopathologic as well as radiographic findings. Her condition, a mixed odontogenic tumor, has rarely been reported in publications. We also included the gist of theories put forward regarding the histogenesis of this lesion.

BACKGROUND

AFD is a rare and controversial entity; it boasts a variety of classifications and terminology based on its unique biological nature as well as histopathological features.

CASE DESCRIPTION

The patient was a 13-year-old girl with a chief complaint of central unerupted tooth on the left mandible. Cone beam computed tomographic images revealed a mixed pericoronal and multilocular lesion surrounding the crown of the aforementioned tooth, displacing it apically to a large extent.

CONCLUSION

It is important to differentiate AFD from other benign mixed odontogenic tumors with similar radiographic appearance because of different therapeutic approaches in some of these tumors.

CLINICAL SIGNIFICANCE

From the clinical point of view, it is of paramount significance for dental practitioners to assess any delayed tooth eruption (more than 6 months and in comparison with its counterpart on the opposite side) radiographically to ascertain or rule out any such similar lesions.

Ameloblastic fibrodentinoma. Report of two cases

Two cases of ameloblastic fibrodentinoma localized in the posterior mandibular area are presented. The clinical and histological findings are discussed.