Central odontogenic fibroma (simple type) in a four-year-old boy: atypical cone-beam computed tomographic appearance with periosteal reaction

Central Odontogenic Fibroma of the Mandible in a 9-year-old Child: A Case Report with 24-month Follow-up

Background

Central odontogenic fibroma (COF) is a rarely benign tumor with an incidence of only 0.1% among all odontogenic tumors, which commonly involve the mandible.

Case description

A 9-year-old child reported with asymptomatic bony expansion of the mandible, showing an unilocular radiolucency on an orthopantomogram. The tumor was managed surgically by enucleation, and the surgical stent was placed, which was later modified as a removable functional space maintainer. The patient was followed up for 24 months with the complete healing of periapical radiolucency and the eruption of displaced permanent tooth to the proper position.

Conclusion

This case report discusses the importance of the dentist in assessing and diagnosing COF, especially in the pediatric age group.

Radiological evaluation of the periosteal reactions in the jaws: a retrospective CBCT study

OBJECTIVES

The objective of this study is to evaluate the relationship between the radiological features of periosteal reactions (PR) and histopathological features of the lesions.

METHODS

A total of 4605 CBCT images were evaluated and they were classified according to their radiological differential diagnosis. Images with pathologies were listed according to their histopathological examinations as cystic lesions, benign tumours, malignant tumours, fibro-osseous lesions and osteonecrosis, while images without pathologies were listed as traumas and others. All groups were reclassified as with or without the presence of detected PR.

RESULTS

Pathologies and traumas were detected in 1801 of 4605 patients. There were 3 PR in 1140 cystic lesions, 4 PR in 102 benign tumours, 16 PR in 43 malignant tumours, 67 PR in 156 osteonecrosis/osteomyelitis cases and 3 PR in 262 trauma cases. As a result of the chi-square test between groups, there was a significant relationship between histopathologic diagnoses and periosteal reaction patterns (p = 0.000).

CONCLUSIONS

Although there is a significant overlap between the patterns of PRs, PRs can be used to narrow the possibilities in the differential diagnosis. However, PRs alone are not sufficient variables for differential diagnosis in the absence of cortical bone destruction, localization, clinical and systemic findings.

Central Odontogenic Fibroma: characteristics and management

Introduction: Central Odontogenic Fibroma (COF) is a rare benign odontogenic tumour of the jaws. Until its recent change in classification by the WHO in 2017, this entity has gone without an agreed upon definition for many years. For this reason, COF would remain largely unknown to practitioners. Corpus: The pedagogical objectives of this article are, through a systematic review of the literature using the PRISMA methodology, to list the epidemiological, aetiological, clinical, radiological, histological, therapeutic and prognostic characteristics of COF. All the data collected made it possible to establish a COF management summary for practitioners in order to optimize it. Conclusion: Based on the 135 cases listed, it appears that surgical enucleation is the treatment of choice for COF. The recurrence rate is low and malignant transformation has never been reported. However, regular clinical and radiological follow-up of patients over several years seems to be a justified precaution.

Atypical periosteal reaction and unusual bone involvement of ameloblastoma: A case report with 8-year follow-up

Unusual radiographic findings of intraosseous ameloblastoma have been reported and discussed. In the case discussed herein, cone-beam computed tomography (CBCT) clearly showed many radiographic features that were ambiguous on conventional radiographs, including an ill-defined periphery, extensive superficial buccal extension with minimal lingual extension, obvious bucco-crestal expansion, and multiple triangular (Codman's triangle-like) areas of periosteal reaction. Based on the above-mentioned findings, the differential diagnosis was a long-term infected benign or low-grade malignant lesion. An incisional biopsy was performed, and the histopathologic diagnosis was acanthomatous ameloblastoma. Recurrence of the lesion was clearly detected on CBCT images at 4 and 8 years after surgery. These unusual radiographic findings have never been reported to be associated with ameloblastoma, and thus may contribute to novel concepts in radiographic interpretation in the future. This report also underscores the important role played by CBCT as a comprehensive diagnostic tool and for definite confirmation of recurrence.