Cemento-ossifying fibroma resection combined with heterotopic canine autotransplantation: a case report

Cemento-ossifying fibroma (COF) is a mesenchymal benign odontogenic tumor, which may lead to impacted or ectopic permanent teeth. Autotransplantation of teeth is a surgical process, in which a tooth is transplanted from one position to another in the same individual. This method can effectively restore the patient's mastication and aesthetics and is feasible in replacing missing teeth. This study reports a case of simultaneous COF resection combined with heterotopic canine autotransplantation to repair dentition defect, which effectively promotes the restoration of bone continuity and stability and achieves immediate and long-term aesthetic function requirements.

Immunohistochemical analysis of osteoclastic and osteoblastic activity in ossifying fibroma and juvenile ossifying fibroma: A comparative study

Cemento-ossifying fibroma (COF) and juvenile ossifying fibroma (JOF) have been considered distinct entities within the category of fibro-osseous lesions. This study aimed to assess osteoblast and osteoclast activity in COF and JOF by investigating bone resorption markers, specifically receptor activator of nuclear factor-kB (RANK), RANK ligand (RANKL), and its inhibitor osteoprotegerin (OPG). A comparative analysis of these markers was performed on all lesions. Immunohistochemistry was employed to evaluate and quantify the expression of these biomarkers in a sample of 20 cases of cemento-ossifying fibroma (COF), 15 cases of psammomatoid juvenile ossifying fibroma (PsJOF), and 10 cases of trabecular juvenile ossifying fibroma (TrJOF). The expression of osteoprotegerin was significantly higher in cemento-ossifying fibroma (33.9±13.0) compared to trabecular juvenile ossifying fibroma (27.3±9.2) and psammatoid ossifying fibroma (25.2±14.9), with the COF showing the highest expression followed by the latter two (p=0.037). There was a higher percentage (80%) of stromal fibroblast cells that showed positive expression of RANKL in cemento-ossifying fibroma (COF) compared to psammomatoid juvenile ossifying fibroma (PsJOF) (33.3%) and trabecular juvenile ossifying fibroma (TrJOF) (30.0%) when considering a positive expression score of 3 (p=0.024). Cemento-ossifying fibroma demonstrated the highest expression of osteoprotegerin and RANKL-positive stromal fibroblast cells, followed by psammomatoid juvenile ossifying fibroma and trabecular juvenile ossifying fibroma. These findings provide valuable insights into the pathogenesis of these lesions.

Cemento-Ossifying Fibroid Epulis in the Posterior Maxilla

Cemento-ossifying fibroma is a benign fibro-osseous lesion arising from the periodontal ligament and has the potential to form cementum and bone in the periodontal ligament. Cemento-ossifying fibroma is a painless, pedunculated, or sessile, smooth exophytic growth arising attached to the gingival tissues. We present a case of cemento-ossifying fibroid epulis in the posterior maxilla attached to the interdental gingiva between the 26 and 27 region buccally in a 52-year-old female patient managed with surgical excision of the lesion, extraction of the involved teeth, curettage, and palatal obturator while under general anesthesia. The patient was followed up post-operatively, healing was satisfactory, there were no signs of infection, and no recurrence was noted in the six-month follow-up period.

Extraosseous cemento-ossifying fibroma beneath the left buccal mucosa: a case report

Cemento-ossifying fibroma (COF) is a benign mesenchymal odontogenic tumor that commonly occurs in the tooth-bearing areas of the maxilla and mandible. This study reports a COF case located under the left buccal mucosa. The classification and differential diagnosis of this COF case were discussed based on the diagnosis and treatment of this case and previous literature.

Cemento-Ossifying Fibroma With Cerebral Involvement

Cemento-ossifying fibroma (COF) is a rare fibro-osseous tumor. The lesion is most commonly seen in people in the third and fourth decade. There are three variants of ossifying fibroma; juvenile trabecular ossifying fibroma, juvenile psammomatoid ossifying fibroma, and COF. COF is highly cellular and contains a fibrous tissue that has different amounts of calcified tissue. Although histologically benign, it has a significant growth potential.

Transformation of Cemento-Ossifying Fibroma into Osteosarcoma after Radiotherapy and Nine Endoscopic Surgeries

Cemento-ossifying fibromas (COFs) are benign fibro-osseous tumors usually found in the mandible and maxilla that can show malignancy in rare situations. COFs usually grow slowly and asymptomatically until they produce local bulges, pain, headaches, and visual impairment, and have a Ki-67 index within 3%, even in aggressive and recurrent cases. Surgical resection can usually provide a satisfactory prognosis. However, no cases of COF transforming into osteosarcoma have been reported. We present a case of COF involving a 58-year-old woman whose initial symptom was hearing loss in the right ear accompanied by tinnitus. Enhanced magnetic resonance imaging revealed a 3.1 cm x 3.2 cm mass centered on the right pterygoid process of the sphenoid bone. Postoperative pathology revealed a COF with a high Ki-67 index (8%-10%). Over the next two years, the tumor relapsed repeatedly. The patient underwent nine endoscopic surgeries and radiotherapy. The sixth postoperative biopsy showed that the COF had transformed into an osteosarcoma. The patient subsequently experienced respiratory and cardiac arrests and was receiving treatment in the intensive care unit with a poor prognosis at the time of writing this manuscript. Thus, a high Ki-67 index may be a risk factor for malignant transformation for COFs.

Ossifying Fibroma in the Maxilla and Mandible: A Case Report With a Brief Literature Review

Fibro-osseous lesions in the jaw bones include fibrous dysplasia, ossifying fibroma (OF), cemento-ossifying fibroma, florid osseous dysplasia, and focal osseous dysplasia. OF is the most common fibro-osseous tumor that presents as a slow-growing well-encapsulated benign neoplasm composed of varying amounts of bone or cement-like tissue in a fibrous stroma well-demarcated from the adjacent normal bone. OF is most common in the jaw bones, with a predilection for the mandible. OF usually occur as solitary lesions and rarely as multiple lesions in a patient. We present clinical and radiologic features, histopathology, and surgical management of a rare case with large synchronous OFs in the mandible and maxilla and a brief review of the literature.

Cemento-Ossifying Fibroma of Upper Lip in a Female Child

Cemento-ossifying fibroma (COF) is a benign tumor classified under fibro-osseous lesions characterized by the proliferation of fibrous tissue associated with the presence of osteoid or cementicle-like masses. COF of bony origin is highly neoplastic in nature compared to their soft tissue counterparts which are relatively rare. The authors here present a case report of COF arising from the left upper lip in a 10-year-old female patient. The lesion was initially asymptomatic, slow-growing in nature, and later turned painful over a period of eight months. A medical CT was taken to elicit a calcified mass seen at the left subcutaneous plane of the upper lip. The lesion was surgically treated by complete excision under local anaesthesia and sutured. Follow-up was done for a period of one year to assess for recurrence which was not evident in this case. This case report, being a peculiar case of COF arising from the soft tissue of the upper lip, describes the clinical presentation, diagnostic imaging, histopathological evidence, and brief surgical management of the lesion.

Bringing benign ectomesenchymal odontogenic tumours to the lab: An in vitro study using an organotypic culture model

BACKGROUND

Benign neoplasms exhibit most of the cellular phenomena considered hallmarks of cancer, except the capacity to metastasize. Thus, the elucidation of the mechanisms associated with the progression of benign neoplasms may complement and clarify the mechanisms involved in carcinogenesis. Benign odontogenic tumours often result in facial deformities and morbidities, and have complex pathogenesis, mainly due to the diversity of interactions between the odontogenic epithelium and the ectomesenchyme. Primary cell culture of such tumours is not only difficult to be established and maintained, but also tumour cells lose characteristic cellular morphology. Considering gene expression, growth, migration, proliferation and cellular morphology are controlled by cell-cell interactions and cell-extracellular matrix interactions, cell culture in 3D substrates has gained space as a way to overcome some of the limitations of traditional monolayer cell culture systems.

METHODS

In this study, fragments obtained from mesenchymal odontogenic tumours were cultured in type I collagen scaffolds. Invasion tests were performed in these models, as well as phenotypic characterization of the cultured tumours.

RESULTS

The results obtained for the odontogenic myxoma and the cemento-ossifying fibroma demonstrate a good reproduction of the growth pattern of these tumours under ex vivo conditions. Microscopic evaluation showed maintenance of cell viability in the explants for more than 30 days, without the presence of necrosis.

CONCLUSION

This is the first study involving long-term 3D primary cultures of benign odontogenic tumours, which is expected to support complex approaches to cell and molecular biology, and to serve as an experimental model for testing molecular therapies.

Crouzon with Acanthosis Nigricans and Odontogenic Tumors: A Rare Form of Syndromic Craniosynostosis

Crouzon syndrome with acanthosis nigricans (CAN) is caused by a mutation in the fibroblast growth factor receptor ( FGFR) 3 gene that presents clinically as Crouzonoid craniofacial features in association with other anomalies such as acanthosis nigricans and benign odontogenic tumors. Diagnosis through the use of genetic mutational analysis is critical, as it alerts the surgeon to the need for careful screening for jaw tumors so that timely treatment in the form of curettage or segmental resection can be provided.

Surgical Management of Ossifying Fibroma in Maxilla: Report of Two Cases

Ossifying fibroma is a rare benign osteogenic neoplasm arising from undifferentiated cells of the periodontal ligament. Ossifying fibroma have a well-defined border that differentiates it from fibrous dysplasia clinically, these tumors manifest as a round or ovoid, expansile, painless, slow-growing mass may displace the roots of adjacent teeth and also cause root resorption. They occur at second to fourth decade of life. Radiologically the lesion appears as a dense radiopaque mass surrounded by a thin, well-defined regular radiolucent rim. Patient underwent thorough history taking and complete face, ear, nose, and throat examination. Computed tomography maxilla, orthopantomogram, paranasal sinus reveals entire maxillary sinus involved in one case. Nasal septum deviated to the opposite side, airway reduced on the side of swelling seen in one case. Root resorption seen in two cases and missing teeth in seen in case 1. In our study in case 1, the tumor involved maxillary sinus, medial wall of the nose. The tumors were excised by Weber-Fergusson and in case 2 the tumor was excised by maxillary vestibular approach. Overall recurrence rates after resection is reported to range from 30 to 56%.

Giant cemento-ossifying fibroma of the mandible: a rare case

The World Health Organization classifies cemento-ossifying fibroma (COF) as a fibro-osseous neoplasm included among the nonodontogenic tumors derived from the mesenchymal blast cells of the periodontal ligament, with a potential for forming fibrous tissue, cementum and bone, or a combination of such elements. These are slow-growing lesions, and are more frequent in women, between the third and fourth decades of life. Case reports of massive expansile COFs (measuring more than 10 cm) are rarely reported in the literature. This article aims to describe a case of giant cemento-ossifying fibroma with radiographic and 3D CT features in a 34 year old female patient, who came with the complaint of progressive swelling of the face which had started 6 years earlier.

Reconstruction of maxillary cemento-ossifying fibroma defect with buccal pad of fat

A cemento-ossifying fibroma (COF) is a rare benign neoplasm of maxilla when compared with mandible (World Health Organization, 1992). COF of maxilla may be quite large and locally very aggressive lesion. These tumor mass was peeled out by en-bloc excision using gentle blunt dissection. This paper presents 35-year-old male patient who had a gradually expanding lobular mass in the left maxillary posterior region for past 1 year. He has been treated successfully by surgical en-bloc resection. Various techniques were used to reconstruction the defect. Buccal pad of fat is a simple technique having advantages like good vascularity, adaptability, good closure of the defect with favorable prognosis.

Imaging in the diagnosis of cemento-ossifying fibroma: a case series

Cemento-ossifying fibroma is a benign fibro-osseous lesion belonging to the same category as fibrous dysplasia and cementifying dysplasia. These are slow-growing lesions that are seen in the third and fourth decades of life. Both the ossifying fibroma and cemento-ossifying fibroma represent two extremes of the same disease process since histologically both contain bone and cementum. However, the term cemento-ossifying fibroma is justified on the basis of clinical and radiological correlation. Radiographs have become an essential tool in the diagnosis of lesions in the jaw, where the anatomy is complex. Nowadays, CT provides information for diagnosis as well as treatment planning. In this case series, we report three cases of cemento-ossifying fibroma that were histologically confirmed and discuss the imaging findings.

Recurrent bimaxillary radiopacities: A rare case report

Cemento-ossifying fibroma (COF) is considered a benign osseous tumor. Herewith, we present a case of multiple central ossifying fibroma in a 35-yeaold woman. Intraorally, there was swelling in the left upper posterior teeth region and another diffused swelling in the fourth quadrant. Radiographs revealed the presence of well-defined mixed radiolucent–radiopaque area having thin radiolucent rim followed by thick sclerotic margin. No genetic correlation could be established. As bilateral COF is a rare entity, we present such a case with different radiographic appearance, using various radiographic techniques.

Ossifying fibroma of maxilla in a male child: Report of a case and review of the literature

Ossifying fibroma is a rare benign fibro-osseous neoplasm of the jaw characterized by substitution of normal bone by fibrous tissues and newly formed calcified products such as bone, cementum or both. It is a well-demarcated lesion that differentiates it from fibrous dysplasia. This case report describes a rare case of ossifying fibroma arising in the maxilla of an 11-year-old child treated with enucleation. The clinical, radiographical, surgical and histological findings are presented. Controversies regarding the terminology and classification along with the differential diagnosis are discussed and a review is provided of the literature on the subject.

Psammomatoid and trabecular variants of juvenile ossifying fibroma-two case reports

Juvenile ossifying fibroma (JOF) is an uncommon fibro-osseous lesion occurring in the facial bones. It is highly aggressive and has a strong tendency to recur. It has been recognized as a separate histopathological entity among the fibro-osseous group of lesions. Surgical resection is the preferred line of treatment. Here we report two cases of JOF who reported to the oral medicine and radiology department; the two cases had different clinical features, history, radiological appearance, and aggressiveness. Under the recent classification system, both cases were recognized as histopathological variants of JOF: one psammomatoid and the other trabecular.