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Zhang AB, Zhao JR, Wang S, Xue J, Zhang JY, Sun ZP, Sun LS, Li TJ. CT-based radiomics analysis of different machine learning models for differentiating gnathic fibrous dysplasia and ossifying fibroma. Oral Dis 2024. [PMID: 38813877 DOI: 10.1111/odi.14984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/15/2024] [Accepted: 04/24/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVE In this study, our aim was to develop and validate the effectiveness of diverse radiomic models for distinguishing between gnathic fibrous dysplasia (FD) and ossifying fibroma (OF) before surgery. MATERIALS AND METHODS We enrolled 220 patients with confirmed FD or OF. We extracted radiomic features from nonenhanced CT images. Following dimensionality reduction and feature selection, we constructed radiomic models using logistic regression, support vector machine, random forest, light gradient boosting machine, and eXtreme gradient boosting. We then identified the best radiomic model using receiver operating characteristic (ROC) curve analysis. After combining radiomics features with clinical features, we developed a comprehensive model. ROC curve and decision curve analysis (DCA) demonstrated the models' robustness and clinical value. RESULTS We extracted 1834 radiomic features from CT images, reduced them to eight valuable features, and achieved high predictive efficiency, with area under curves (AUC) exceeding 0.95 for all the models. Ultimately, our combined model, which integrates radiomic and clinical data, displayed superior discriminatory ability (AUC: training cohort 0.970; test cohort 0.967). DCA highlighted its optimal clinical efficacy. CONCLUSION Our combined model effectively differentiates between FD and OF, offering a noninvasive and efficient approach to clinical decision-making.
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Affiliation(s)
- Ao-Bo Zhang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
| | - Jun-Ru Zhao
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Shuo Wang
- Department of stomatology, Shandong Public Health Clinical Center, Jinan, Shandong, China
| | - Jiang Xue
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
| | - Jian-Yun Zhang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
| | - Zhi-Peng Sun
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Li-Sha Sun
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Tie-Jun Li
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
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Nnko KA, Pima RT, Damas S, Mremi A. Management of ossifying fibroma of the bone of the maxilla: a case report and review of the literature. J Surg Case Rep 2024; 2024:rjae198. [PMID: 38572287 PMCID: PMC10984833 DOI: 10.1093/jscr/rjae198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Abstract
Ossifying fibroma (OF) is a slow-growing benign fibro-osseous neoplasm. It is mostly odontogenic in origin, and it arises in the jaws, particularly the mandible. OF is characterized by the production of bone and cementum-like calcifications in a fibrous stroma. OF reports of the bone of the maxilla are uncommon. Diagnosing OF can be challenging due to the considerable overlap of clinico-pathological characteristics with those of other neoplasms. Herein, the authors describe a case report OF in a 26-year-old male who presented with a huge fibro-osseous tumor of the maxilla. Histopathology established the diagnosis of maxillary OF. The tumor was surgically removed via a Weber-erguson approach with satisfactory functional and cosmetic results. No recurrence has been found after one year of follow-up. Clinical, radiological, and pathological characteristics, as well as surgical treatment approaches, are further discussed. This is one of a few documented cases of maxillary OF in our setting.
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Affiliation(s)
- Kanankira A Nnko
- Department of Dental Surgery, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania
| | - Raphael T Pima
- Department of Dental Surgery, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania
| | - Sosthenes Damas
- Department of Dental Surgery, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania
| | - Alex Mremi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania
- Department of Pathology, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania
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Alsufyani N, Alzahrani A. Imaging of Fibro-osseous Lesions and Other Bone Conditions of the Jaws. Dent Clin North Am 2024; 68:297-317. [PMID: 38417992 DOI: 10.1016/j.cden.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This review directs the focus on the imaging features of various fibro-osseous lesions and other bone lesions that can be of similar presentation. Broad diagnosis of "fibrous osseous lesion" may culminate in improper treatment and management. Radiographic discriminating factors between these entities are highlighted and summarized to improve the diagnostic process when encountering these lesions.
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Affiliation(s)
- Noura Alsufyani
- Department of Oral Medicine and Diagnostic Sciences, Oral & Maxillofacial Radiology, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Kingdom of Saudi Arabia; Department of Medicine and Dentistry, School of Dentistry, University of Alberta, 5-522, Edmonton Clinic Health Academy, 11405 - 87 Avenue NW, T6G 1C9, Edmonton, AB, Canada.
| | - Adel Alzahrani
- Department of Oral Medicine and Diagnostic Sciences, Oral & Maxillofacial Radiology, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Kingdom of Saudi Arabia
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Ye Z, Li C, You M. Spontaneous Regression of Ossifying Fibroma in the Oral and Maxillofacial Region: A Rare Case With 4-Year Follow-Up. J Craniofac Surg 2023; 34:1826-1828. [PMID: 37271877 DOI: 10.1097/scs.0000000000009466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 06/06/2023] Open
Abstract
The case presented in this study is a rare instance of an ossifying fibroma (OF), a type of benign fibro-osseous lesions, spontaneously regressed without surgical intervention. A 9-year-old boy with an intraosseous lesion in the left maxilla was diagnosed as OF. The surgeon suggested surgical excision, but due to personal reasons, the patient and his parents deferred the surgery and opted for regular follow-up. During a 4-year follow-up, the surgeon found that the lesion had significantly decreased in size and the facial deformity had remitted. At the latest follow-up, the deformity of his left face became almost unnoticeable, and the lesion seemed to be subtle on cone-beam computed tomography images. This case highlights the possibility of spontaneous regression of OF. This phenomenon may occur due to the teeth eruption, which can lead to the formation of periodontal ligaments and engage the regression of OF.
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Affiliation(s)
- Zelin Ye
- Department of Medical Imaging, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University
| | - Chunjie Li
- Department of Oral Oncology, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Meng You
- Department of Medical Imaging, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University
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Ma J, Zhou B, Huang Q, Cui S, Cao D. Prognostic factors in transnasal endoscopic surgery for paediatric patients with ossifying fibroma of the paranasal sinuses and skull base. J Otolaryngol Head Neck Surg 2023; 52:48. [PMID: 37491362 PMCID: PMC10369828 DOI: 10.1186/s40463-023-00641-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 04/10/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Ossifying fibroma of the paranasal sinuses and skull base in paediatric patients is difficult to operate and can recur easily after surgery. This study aimed to analyse factors associated with recurrence after transnasal endoscopic resection of ossifying fibroma in paediatric patients. METHODS This retrospective observational study included 34 patients under 17 years of age who underwent transnasal endoscopic resection of ossifying fibroma of the paranasal sinuses and skull base from 2005 to 2021 at a single tertiary medical centre. Clinical indicators such as age; surgical history; pathological type; intraoperative bleeding; and orbit, anterior skull base, sphenoid bone, sella turcica, clivus, or frontal sinus involvement were subjected to univariate analysis using the χ2 test, to investigate whether any of these factors affected recurrence. RESULTS All 34 patients underwent transnasal endoscopic resection. The follow-up period was 6-120 months (mean: 48.0 months). Five patients experienced local recurrence during the follow-up period (14.7%). Results of χ2 tests indicated that a history of previous surgery, the amount of intraoperative bleeding, and sphenoid and/or sella turcica and clivus involvement were significantly associated with recurrence (P < 0.05). Age; pathological stage; and orbit, anterior skull base, and frontal sinus involvement were not associated with recurrence (P > 0.05). CONCLUSIONS The increased risk of recurrence after transnasal endoscopic resection of nasal-skull base ossifying fibroma should be considered during endoscopic surgery in paediatric patients with a history of previous surgery, intraoperative bleeding tendency, and sphenoid and/or sella turcica and clivus involvement. These patients require careful postoperative follow-up.
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Affiliation(s)
- Jingying Ma
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology and Head and Neck Surgery, Ministry of Education, 1 Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Bing Zhou
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology and Head and Neck Surgery, Ministry of Education, 1 Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, People's Republic of China.
| | - Qian Huang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology and Head and Neck Surgery, Ministry of Education, 1 Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Shunjiu Cui
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology and Head and Neck Surgery, Ministry of Education, 1 Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Dingfang Cao
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
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V D, Kumar Vadivel J, Ganapathy D. A Painless Bump: A Case Report of Cemento-Ossifying Fibroma of the Anterior Maxilla. Cureus 2023; 15:e41799. [PMID: 37457603 PMCID: PMC10338891 DOI: 10.7759/cureus.41799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 07/18/2023] Open
Abstract
Cemento-ossifying fibroma (COF) is a benign odontogenic neoplasm. It is considered an ossifying fibroma with traces of interspersed cementum fragments. Here we present a case report of the occurrence of COF in the maxillary anterior region of an elderly woman. A 61-year-old female reported with a painless, progressive, slow-growing swelling on the upper front jaw region for the past five years. A single, localized, swelling on the anterior region of the maxilla which was non-tender and bony hard in consistency. Radiological examination consisting of orthopantomagram (OPG) and cone-beam computed tomography (CBCT) revealed increased thickness of bone over frontal, parietal and maxilla with alteration of trabecular pattern - cotton wool/ground glass. Serum alkaline phosphatase level was found to be 865 U/l, however, serum calcium level and other routine blood investigations (hemogram) were within normal limits. The above radiological and laboratory findings are more in favour of primary bone pathology and with a biopsy later correlating with histopathological findings; it was diagnosed as COF. Under conscious sedation, surgical excision of the bony mass was done along with extraction of associated teeth. The patient is currently on regular follow-up and planning for a dental prosthesis is in progress.
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Affiliation(s)
- Divyadharshini V
- Oral Medicine and Radiology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Jayanth Kumar Vadivel
- Oral Medicine and Radiology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Dhanraj Ganapathy
- Prosthodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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Adham M, Dewi DJ, Reksodiputro MH, Ranakusuma R. Single stage maxillofacial reconstruction combined radical surgery for managing juvenile ossifying fibroma: A case report. Natl J Maxillofac Surg 2023; 14:334-338. [PMID: 37661994 PMCID: PMC10474534 DOI: 10.4103/njms.njms_170_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/03/2022] [Accepted: 11/28/2022] [Indexed: 01/18/2023] Open
Abstract
Ossifying fibroma (OF) in craniofacial is a rare disease, benign, locally aggressive fibro-osseous tumor. The 2017 World Health Organization classifications divided OF into two types: OF of odontogenic origin and juvenile ossifying fibroma (JOF). Determining the right surgical treatment to reduce the postoperative recurrence rate is incredibly challenging. The author reports two cases of paranasal sinuses with disease onset progressed from pre-pubertal age. The first case is an example of a recurrent case after undergoing conservative surgery, and the second is a new one. All cases underwent radical surgery with subtotal maxillectomy and reconstructive surgery in one stage. After observing all patients until one year, there was no sign of recurrence through clinical and endoscopic examination. There are two types of surgery that compare in this case report: conservative surgery and radical surgery. Conservative surgical procedures include curettage, enucleation, or peripheral osteotomies. Several studies have shown high recurrence levels in OF patients when curettage or enucleation is performed; residue caused by incomplete excision is the most common reason that is easily caused by conservative surgery. Radical surgery such as open maxillectomy is a promising approach for degrading the level of recurrence. JOF, especially trabecular juvenile ossifying fibroma, shows a high recurrence percentage comparing other types. The first-choice management for treating OF was the surgical approach. Types of surgery depend on the disease's aggressiveness and morbidity. Radical surgery was proven better at decreasing recurrence level than conservative surgery.
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Affiliation(s)
- Marlinda Adham
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dwi J. Dewi
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Mirta Hediyati Reksodiputro
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Respati Ranakusuma
- Department of Clinical Epidemiology and Evidence Based Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Collins LHC, Zegalie NFT, Sassoon I, Speight PM. A Clinical, Radiological and Histopathological Review of 74 Ossifying Fibromas. Head Neck Pathol 2023:10.1007/s12105-022-01522-w. [PMID: 36622534 DOI: 10.1007/s12105-022-01522-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 12/16/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Ossifying fibroma (OF) is a fibro-osseous lesion of the jaws and craniofacial bones. Accurate diagnosis can be challenging due to significant overlap of clinicopathological features. This study aimed to evaluate the clinical, radiological and histological features that can aid in diagnosis and identify characteristics that allow categorisation into the three subtypes: juvenile trabecular, psammomatoid and cemento-ossifying OF. METHODS A total of 74 cases of OF were systematically reviewed for their principle features. Of these, 46 cases were evaluated for their radiographic features including size, location and relationship to the teeth. Histological assessment and stereological point counting were performed in 69 cases to assess the pattern, type and proportion of calcification, the nature of the stroma, the border of the lesion and the presence of secondary changes. Fisher's exact test and Chi-squared tests were used to determine associations between clinicopathological parameters and maxillary, mandibular, odontogenic, non-odontogenic and psammomatoid or trabecular lesions. RESULTS OF showed a female predilection (F: M; 2:1) and a slight bimodal age distribution with peaks in the second (23%) and fourth decades (27%) (Mean age: 32.4 years). 83% of cases presented as an intra-oral swelling, with the mandible being the most common site (73%). Histologically, a range of morphological patterns were seen, with 50% of cases showing mixed trabecular and psammomatoid features. However, there were no significant differences between the variants of OF in terms of age, gender or histological features. CONCLUSION Histological features of OF cannot be used to differentiate between the subtypes.
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Affiliation(s)
- L H C Collins
- School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield, S10 2TA, UK. .,Head and Neck Pathology, Guy's Hospital, Floor 4 Tower Wing, London, SE1 9RT, UK.
| | - N F T Zegalie
- School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield, S10 2TA, UK
| | - I Sassoon
- Department of Computer Science, Brunel University, Kingston Lane, London, UB8 3PH, UK
| | - P M Speight
- School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield, S10 2TA, UK
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Clinico-Pathological Characteristics, Management, and Outcome of Benign Intraosseous Maxillary Tumors in Adolescents: A Prospective Study. J Craniofac Surg 2022; 33:e620-e626. [PMID: 35762625 DOI: 10.1097/scs.0000000000008695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/29/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Benign intraosseous maxillary tumors, although uncommon among the adolescents, represent a major challenge to the maxillofacial surgeons. Treatment ranges from conservative surgery to radical resection and reconstruction. Maxillary defect reconstruction in adolescents is uncommon. it can be achieved by prosthetic obturators, local and regional flaps, and free-tissue transfer. AIM OF THE WORK To investigate the clinical and pathological patterns, treatment, and outcome of benign intraosseous maxillary tumors in adolescents. PATIENTS AND METHODS A 10-years prospective study included patients between 12-18 years who presented with benign intraosseous maxillary tumors and surgically treated (conservative surgery or radical resection) with immediate reconstruction. Cases were followed up to assess functional and aesthetic outcomes and detect complications. RESULTS Study included 38 patients; 63.2% had non-odontogenic tumors and 36.8% had odontogenic tumors. The most common non-odontogenic tumor was central giant cell granuloma (31.6%). The most common odontogenic tumors were adenomatoid odontogenic tumor and ameloblastoma (10.5% each). Treatment included Conservative surgery (55.3%) and radical resection (44.7%). Reconstruction was performed in 17 cases by temporalis muscle flap (9.83%), obturator (2.46%), and free fibula flap (1.64%). All cases gained accepted functional and esthetic results. CONCLUSIONS Non-odontogenic tumors were more common than odontogenic tumors. Central giant cell granulomas and ossifying fibromas were the most common non-odontogenic tumors. Ade-nomatoid odontogenic tumor and ameloblastoma were the most common odontogenic tumors. Maxillary reconstructions with tem-poralis muscle flap and obturator were simple and satisfactory. Microsurgical reconstruction had high success rates. Aesthetic, and functional results were satisfactory when appropriate reconstruction was performed.
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Bhat SV, Kumar SP, Periasamy S, Krishna VK. An Uncommon Presentation of Ossifying Fibroma in the Maxilla. Cureus 2022; 14:e23638. [PMID: 35510009 PMCID: PMC9057319 DOI: 10.7759/cureus.23638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 11/05/2022] Open
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Akers JA, Johnson TM, Wagner JC, Vargas SM, Colamarino AN, Jenzer AC, Lincicum AR, Hawie JB, Lancaster DD. Dental implants at sites of focal high and mixed density osseous lesions: Clinical practice guidelines. Clin Adv Periodontics 2022. [PMID: 35108460 DOI: 10.1002/cap.10192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/21/2021] [Indexed: 11/07/2022]
Abstract
FOCUSED CLINICAL QUESTION Under what circumstances may a clinician consider dental implant placement at a site exhibiting a focal high or mixed density (HMD) osseous lesion radiologically? SUMMARY Some conditions and pathologic entities exhibiting high and mixed density radiological appearance pose low risk for dental implant failure or complications following implant surgery. However, other lesions represent contraindications to implant placement, and implant surgery at such sites can result in severe morbidity. CONCLUSION Potential implant sites exhibiting focal HMD osseous lesions/conditions present varying levels of risk. In most cases, optimal management will include advanced imaging of the site, multidisciplinary consultations, and detailed informed consent to assure full understanding of procedural risks, benefits, and complications. Currently, clinical recommendations rely on case reports, opinion, and usual practice (level 3 evidence). The strength of each recommendation provided in this report is categorized as level C.
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Affiliation(s)
- Joshua A Akers
- Department of Periodontics, United States Army Dental Health Activity, Landstuhl, Germany
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Jennah C Wagner
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Sarah M Vargas
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Aaron N Colamarino
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Andrew C Jenzer
- Department of Oral and Maxillofacial Surgery, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Adam R Lincicum
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Jennifer B Hawie
- Department of Oral Pathology, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
| | - Douglas D Lancaster
- Department of Periodontics, Army Postgraduate Dental School, Fort Gordon, Georgia, USA
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Berberi AN, Aoun GT, Aad GP, Khalaf EN. Benign mesenchymal odontogenic tumors of the maxillofacial bones: A report of 3 cases with 3 years follow-up. J Oral Maxillofac Pathol 2022; 26:S46-S50. [PMID: 35450255 PMCID: PMC9017847 DOI: 10.4103/jomfp.jomfp_94_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 09/05/2021] [Indexed: 11/12/2022] Open
Abstract
Benign mesenchymal odontogenic tumors are lesions derived from the mesenchymal components of the tooth-forming apparatus and are consequently found within the jawbone. Benign fibro-osseous tumors are part of this category of lesions in which normal bone is substituted, initially by fibrous tissue and within time become infiltrated by osteoid and cementoid elements. They are asymptomatic, slow-growing lesions and remain undiagnosed until swelling of the face becomes prominent and they share similar radiological characteristics. Herein, we report three cases of ossifying fibroma, cemento-osseous fibroma and periapical cemento-osseous dysplasia and analyze all the correlating factors, clinical history, radiological and histological features, intraoperative appearance, and treatment with a 3-year follow-up period. Despite the advances in the identification of these pathologies, clinicians still face difficulties in their classification and the diagnosis due to overlap in both histological and radiographic findings. An accurate final diagnosis is essential for appropriate treatment and an informative prognosis.
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Affiliation(s)
- Antoine N Berberi
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Georges T Aoun
- Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Georges P Aad
- Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Emile N Khalaf
- Department of Oral Surgery, Beirut Arab University, Beirut, Lebanon
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13
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Pick E, Schäfer T, Al-Haj Husain A, Rupp NJ, Hingsammer L, Valdec S. Clinical, Radiological, and Pathological Diagnosis of Fibro-Osseous Lesions of the Oral and Maxillofacial Region: A Retrospective Study. Diagnostics (Basel) 2022; 12:diagnostics12020238. [PMID: 35204329 PMCID: PMC8870765 DOI: 10.3390/diagnostics12020238] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 12/30/2021] [Accepted: 01/17/2022] [Indexed: 12/27/2022] Open
Abstract
Background: Fibro-osseous lesions (FOL) of the jaw represent a rare, benign group of lesions that share similar clinical, radiological, and histopathological features and are characterized by progressive, variable replacement of healthy bone tissue by fibrous connective tissue. Methods: This retrospective study aimed to evaluate the incidence of fibro-osseous lesions and to reassess the efficacy of case-specific treatment management from a clinical, radiological, and histopathological perspective based on 14 years of data. Results: Forty-four patients with a radiological and/or histopathological diagnosis of benign FOLs were identified and re-evaluated. Cemento-osseous dysplasia was the most common group of FOLs present in our patient cohort (45%), followed by ossifying fibroma (39%) and fibrous dysplasia (16%). The diagnostic imaging technique of choice was CBCT (68%), followed by PAN (18%), with most patients (95 %) additionally undergoing biopsy. The mean age of the patients at the time of diagnosis was 40.54 ± 13.7 years, with most lesions being located in the mandible (86%), with females being predominantly affected (73%). Conclusion: An interdisciplinary approach that analyzes all case-specific factors, including demographic data, medical history, intraoperative findings, and, most importantly, histopathological and radiological features, is essential for an accurate diagnosis and key to avoiding inappropriate treatment.
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Affiliation(s)
- Ellen Pick
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (E.P.); (T.S.); (A.A.-H.H.)
| | - Tobias Schäfer
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (E.P.); (T.S.); (A.A.-H.H.)
| | - Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (E.P.); (T.S.); (A.A.-H.H.)
| | - Niels J. Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland;
| | - Lukas Hingsammer
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (E.P.); (T.S.); (A.A.-H.H.)
- Department of Stomatology, Division of Periodontology, Dental School, University of São Paulo, Butantã 2227, SP, Brazil
- Correspondence: ; Tel.: +41-44-634-32-90
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14
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Makkad RS, Naidu GS, Nagi R, Sagtani A, Patil S, Shrivastava S. Multiple fibro-osseous lesions of the jaws: A report of a rare case with a literature review. Imaging Sci Dent 2022; 51:461-466. [PMID: 34988008 PMCID: PMC8695463 DOI: 10.5624/isd.20210021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/22/2021] [Accepted: 05/14/2021] [Indexed: 11/18/2022] Open
Abstract
Fibro-osseous lesions are a poorly defined category of conditions affecting the jaws and craniofacial bones, and include developmental lesions, reactive or dysplastic lesions, and neoplasms. Fibrous dysplasia and ossifying fibroma are the 2 main types of fibro-osseous lesions affecting the jaw, and ossifying fibroma is a true benign neoplasm of the bone-forming tissues with several well-recognized variants ranging from innocuous to extensively aggressive lesions. However, multiple simultaneous fibro-osseous lesions of the jaw bones involving all quadrants are exceedingly rare. One such case diagnosed by conventional radiography and computed tomography is discussed here.
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Affiliation(s)
- Ramanpal Singh Makkad
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Giridhar S Naidu
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Ravleen Nagi
- Department of Oral Medicine and Radiology, Saveetha Dental College, Chennai, Tamil Nadu, India
| | - Alok Sagtani
- Department of Oral and Maxillofacial Surgery, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal
| | - Santosh Patil
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Swatantra Shrivastava
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
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15
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Nwoga M, Okwuosa C, Adisa A. Ossifying fibroma of the jaws: Review of 57 cases in Enugu and of global literature. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_87_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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16
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Idani M, Millogo M, Badini SAP, Ili BV, Zango A, Nongkouni G, Konsem T. Ossifying fibroma of the jawbones: Epidemiology and management in the Yalgado ouedrago university hospital. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2021.100248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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17
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Endoscopic Resection of a Massive Ossifying Fibroma in the Sinonasal Cavity. J Craniofac Surg 2021; 32:1800-1802. [PMID: 33534305 DOI: 10.1097/scs.0000000000007504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT An ossifying fibroma (OF) is a type of benign fibro-osteoma that rarely involves the sinonasal cavity. Recent developments in endoscopic sinus surgery allow the removal of large benign tumors from the nasal cavity and sinuses. Here, the athors report the case of a 48-year-old female who underwent endoscopic sinus surgery under general anesthesia to completely remove a large OF involving the sphenoid sinus and nasal cavity. No recurrence was noted during the recent 3-year follow-up. Endoscopic resection of OFs is an excellent choice for very experienced surgeons, affording the advantages of direct observation as well as visual enhancement and magnification, thus reducing intra- and post-operative morbidity.
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18
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Costa-Guda J, Pandya C, Strahl M, Taik P, Sebra R, Chen R, Uzilov AV, Arnold A. Parafibromin Abnormalities in Ossifying Fibroma. J Endocr Soc 2021; 5:bvab087. [PMID: 34159287 PMCID: PMC8212678 DOI: 10.1210/jendso/bvab087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Indexed: 12/11/2022] Open
Abstract
Ossifying fibromas are very rare tumors that are sometimes seen as part of the hyperparathyroidism-jaw tumor syndrome (HPT-JT), which is caused by inactivating mutations of the HRPT2/CDC73 tumor suppressor gene. CDC73 mutations have been identified in a subset of sporadic cases but aberrant expression of the encoded protein, parafibromin, has not been demonstrated in ossifying fibroma. We sought to determine if loss of parafibromin regularly contributes to the development of sporadic, nonsyndromic ossifying fibroma. We examined a series of 9 ossifying fibromas, including ossifying, cemento-ossifying, and juvenile active variants, for parafibromin protein expression by immunohistochemistry and for CDC73 sequence abnormalities by Sanger sequencing and/or targeted AmpliSeq panel sequencing. Four ossifying fibromas showed a complete absence of nuclear parafibromin expression; loss of parafibromin expression was coupled with aberrant cytoplasmic parafibromin expression in 1 case. CDC73 mutations were detected in 2 cases with aberrant parafibromin expression. These results provide novel evidence, at the level of protein expression, that loss of the parathyroid CDC73/parafibromin tumor suppressor may play a role in the pathogenesis of a subset of ossifying fibromas.
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Affiliation(s)
- Jessica Costa-Guda
- Center for Molecular Oncology, University of Connecticut School of Medicine, Farmington, CT 06030, USA.,Center for Regenerative Medicine and Skeletal Development, Department of Reconstructive Sciences, University of Connecticut School of Dental Medicine, Farmington, CT 06030, USA
| | - Chetanya Pandya
- Sema4, a Mount Sinai venture , Stamford, CT 06902, USA.,Department of Genetics and Genomic Sciences and Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6501, USA
| | - Maya Strahl
- Sema4, a Mount Sinai venture , Stamford, CT 06902, USA
| | - Patricia Taik
- Sema4, a Mount Sinai venture , Stamford, CT 06902, USA.,Department of Genetics and Genomic Sciences and Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6501, USA
| | - Robert Sebra
- Sema4, a Mount Sinai venture , Stamford, CT 06902, USA.,Department of Genetics and Genomic Sciences and Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6501, USA
| | - Rong Chen
- Sema4, a Mount Sinai venture , Stamford, CT 06902, USA.,Department of Genetics and Genomic Sciences and Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6501, USA
| | - Andrew V Uzilov
- Sema4, a Mount Sinai venture , Stamford, CT 06902, USA.,Department of Genetics and Genomic Sciences and Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6501, USA
| | - Andrew Arnold
- Center for Molecular Oncology, University of Connecticut School of Medicine, Farmington, CT 06030, USA.,Division of Endocrinology and Metabolism, University of Connecticut School of Medicine, Farmington, CT 06030, USA
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19
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Holmes KR, Holmes RD, Martin M, Murray N. Practical Approach to Radiopaque Jaw Lesions. Radiographics 2021; 41:1164-1185. [PMID: 34086497 DOI: 10.1148/rg.2021200187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Radiopaque lesions of the jaw are myriad in type and occasionally protean in appearance. In turn, the radiologic analysis of these lesions requires a systematic approach and a broad consideration of clinical and imaging characteristics to enable reliable radiologic diagnosis. Initially categorizing lesions by attenuation pattern provides a practical framework for organizing radiopaque jaw lesions that also reflects important tissue characteristics. Specifically, the appearance of radiopaque lesions can be described as (a) densely sclerotic, (b) ground glass, or (c) mixed lytic-sclerotic, with each category representing a distinct although occasionally overlapping differential diagnosis. After characterizing attenuation pattern, the appreciation of other radiologic features, such as margin characteristics or relationship to teeth, as well as clinical features including demographics and symptoms, can aid in further narrowing the differential diagnosis and lend confidence to clinical decision making. The authors review the potential causes of a radiopaque jaw lesion, including pertinent clinical and radiologic features, and outline a simplified approach to its radiologic diagnosis, with a focus on cross-sectional CT. An invited commentary by Buch is available online. ©RSNA, 2021.
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Affiliation(s)
- Kenneth R Holmes
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - R Davis Holmes
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - Montgomery Martin
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - Nicolas Murray
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
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20
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Abstract
Sclerotic lesions of the jaw are uncommon but may be clinically relevant. In this pictorial review, the most common sclerotic lesions are discussed. Three categories of lesions are distinguished; odontogenic sclerotic lesions, non-odontogenic sclerotic lesions, and mixed lytic-sclerotic lesions. In each group, non-neoplastic conditions are discussed first, followed by benign and malignant neoplasms. For each disease a brief overview is given, including histological features, epidemiology, symptoms, typical location, imaging features, and treatment. This review emphasizes which basic observations are essential to the evaluation of sclerotic jaw lesions and what elements have to be taken into account to create a proper differential diagnosis.
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21
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Classification and nomenclature of fibro-osseous lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131:385-389. [DOI: 10.1016/j.oooo.2020.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 11/24/2020] [Accepted: 12/06/2020] [Indexed: 12/12/2022]
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22
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Alsufyani NA, Aldosary RM, Alrasheed RS, Alsaif RF. A systematic review of the clinical and radiographic features of hybrid central giant cell granuloma lesions of the jaws. Acta Odontol Scand 2021; 79:124-131. [PMID: 32730731 DOI: 10.1080/00016357.2020.1797160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Central giant cell granuloma (CGCG) can coexist with other benign lesions of the jaw. These hybrid lesions are diagnostically challenging to both oral pathologists and radiologists. This work systematically reviews the clinical and radiographic features of hybrid-CGCG lesions in the jaws. MATERIALS AND METHODS Three reviewers conducted an electronic search of five databases for histologically diagnosed hybrid-CGCG lesions in human jaws. RESULTS Thirty-four of 1224 articles met the inclusion criteria. Of 39 hybrid-CGCG lesions, 14 (35.9%) were central odontogenic fibroma, 11 (28.2%) were central ossifying fibroma, seven (17.9%) were fibrous dysplasia, and seven (17.9%) were other bone conditions. There were 22 females and 17 males with a mean age of 30.5 ± 19.9 years. 89.5% of hybrid-CGCG lesions were well defined, 57.9% were non-corticated, 60.5% were radiolucent, and 66.7% were in the posterior mandible. Most hybrid lesions affected the cortical plates by thinning, expansion, or perforation (93.1%), displaced, or resorbed teeth (60%). CONCLUSION The radiographic features of hybrid-CGCG lesions vary according to the concurrent bony lesion. Hybrid-CGCG lesions altered the radiographic appearance with the following entities: fibrous dysplasia, melorheostosis, and Paget's disease. Optimal imaging modalities are crucial to detail radiographic features and direct representative biopsy of suspicious sites that may host a CGCG hybridisation.
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Affiliation(s)
- Noura A. Alsufyani
- Division of Oral and Maxillofacial Radiology, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
- Adjunct, Division of Oral Medicine, Pathology and Radiology, School of Dentistry, Department of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Reem M. Aldosary
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Rand F. Alsaif
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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23
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Turek B, Górski K, Drewnowska O, Buczkowska R, Kozłowska N, Sapierzyński R. Ossifying Fibroma in the Nasal Cavity of a 2-Year-Old Horse. Animals (Basel) 2021; 11:ani11020317. [PMID: 33513907 PMCID: PMC7911738 DOI: 10.3390/ani11020317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/08/2021] [Accepted: 01/20/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary This article reports on the clinical features, diagnosis, and management of ossifying fibroma in the nasal cavity of a 2-year-old horse. Ossifying fibromas (OFs) are rare, benign, fibro-osseous neoplasms that occur more frequently in the rostral mandible of young horses (termed equine juvenile mandibular ossifying fibromas) but rarely in older horses. The occurrence of OF in young animals suggests developmental disorders or trauma as etiological factors. The local recurrence of OFs is common if they are not completely surgically excised, but metastatic spread is unusual. The presented case remained clinically asymptomatic until the mass obliterated the whole nasal cavity, causing severe breathing difficulties. The exact mass location was revealed using diagnostic images—namely, radiographs and computed tomography (CT) images. A concurrent problem of an underdeveloped and hypoplastic last premolar tooth of the maxilla was diagnosed. Because the mass was well-demarcated, the horse underwent standing surgery to remove the mass and the tooth. Histopathological diagnosis of ossifying fibroma was confirmed. The patient recovered uneventfully and remained free of disease at the 2-year postoperative follow-up. Abstract A 2-year-old mare of an unknown breed was referred to the clinic due to undetermined breathing difficulties. Physical examination revealed painless swelling rostral to the nasoincisive notch and a large, firm mass protruding from the left nostril. Radiographic examination of the head revealed a mass occupying the left nasal cavity and a displaced and hypoplastic last premolar of the left maxilla. The CT scan showed a well-demarcated heterogeneous mass measuring 22 × 9 × 5 cm (length × height × width) in the left nasal cavity attached to the roots of the displaced tooth and conchae. The surgery was performed on the standing horse. Firstly, due to the oblique position of the displaced tooth, the extraction was performed extra-orally through the trephination and repulsion of the maxillary bone. In the next step, a direct surgical approach was chosen for the caudal part of the mass via the osteotomy of the left nasal bone. The mass was bluntly separated from the conchae and removed through the nostril using Fergusson forceps. The histopathological characteristics of the mass led to the diagnosis of ossifying fibroma. The horse recovered completely in seven months, without recurrence after two years.
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Affiliation(s)
- Bernard Turek
- Department of Large Animals Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska 159, 02-776 Warsaw, Poland; (K.G.); (O.D.); (R.B.)
- Correspondence: (B.T.); (N.K.); Tel.: +48-604-247-640 (B.T.)
| | - Kamil Górski
- Department of Large Animals Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska 159, 02-776 Warsaw, Poland; (K.G.); (O.D.); (R.B.)
| | - Olga Drewnowska
- Department of Large Animals Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska 159, 02-776 Warsaw, Poland; (K.G.); (O.D.); (R.B.)
| | - Roma Buczkowska
- Department of Large Animals Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska 159, 02-776 Warsaw, Poland; (K.G.); (O.D.); (R.B.)
| | - Natalia Kozłowska
- Department of Large Animals Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska 159, 02-776 Warsaw, Poland; (K.G.); (O.D.); (R.B.)
- Correspondence: (B.T.); (N.K.); Tel.: +48-604-247-640 (B.T.)
| | - Rafał Sapierzyński
- Department of Pathology and Veterinary Diagnostic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska 159, 02-776 Warsaw, Poland;
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24
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Nottle BF, Tatarniuk DM, Caldwell FJ, Bell CD, Caston SS, Merkatoris PT, Gillen AM, Katzman SA. Fibro-Osseous Lesions Of The Craniofacial Complex In Horses: 30 Cases (2001-2019). Vet Surg 2021; 50:383-392. [PMID: 33399249 DOI: 10.1111/vsu.13559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/20/2020] [Accepted: 11/28/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the presentation, diagnosis, treatment, and outcome for horses with fibro-osseous lesions of the craniofacial complex. STUDY DESIGN Retrospective multicenter case series. ANIMALS Thirty horses evaluated for fibro-osseous lesions of the skull from January 1, 2001 through December 31, 2019 in four centers. METHODS Medical records were reviewed for signalment, clinical presentation, histological and diagnostic imaging findings, treatment instituted, and outcome. Long-term outcome information was obtained by owner questionnaire or the medical record. RESULTS Diagnoses included ossifying fibroma in 20 of 30 horses, osteoma in eight of 30 horses, and fibrous dysplasia in two of 30 horses. Twelve of 30 lesions were diagnosed in horses <1 year old, and 20 of 30 lesions originated from the rostral mandible. The most common treatment was rostral mandibulectomy. Recurrence was not reported after complete excision. Incomplete excision was confirmed in eight horses (four ossifying fibromas, three osteomas, and one fibrous dysplasia), and follow-up information was available for seven horses. Recurrence occurred in one horse, while six horses had long-term resolution of clinical signs. Prognosis for survival and return to use was excellent in 23 horses with long-term follow-up. CONCLUSION Fibro-osseous lesions were uncommon in this multicenter study; they were most commonly diagnosed in young animals and most frequently affected the rostral mandible. Long-term survival was excellent. CLINICAL SIGNIFICANCE The definitive diagnosis of fibro-osseous lesions of the craniofacial complex in horses is made from results of histopathology and cannot be determined on the basis of clinical presentation alone. Surgical excision is indicated, and prognosis can be favorable even when complete surgical margins are not obtained.
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Affiliation(s)
- Bridget F Nottle
- William R. Pricthard Veterinary Medical Teaching Hospital, University of California, Davis, California, USA
| | - Dane M Tatarniuk
- Department of Veterinary Clinical Sciences, Lloyd Veterinary Medical Center, Iowa State University, Ames, Iowa, USA
| | - Fred J Caldwell
- Department of Clinical Sciences, JT Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, Alabama, USA
| | - Chris D Bell
- Elders Equine Veterinary Services, Winnipeg, Manitoba, Canada
| | - Stephanie S Caston
- Department of Veterinary Clinical Sciences, Lloyd Veterinary Medical Center, Iowa State University, Ames, Iowa, USA
| | - Paul T Merkatoris
- Department of Veterinary Clinical Sciences, Lloyd Veterinary Medical Center, Iowa State University, Ames, Iowa, USA
| | - Alex M Gillen
- Philip Leverhulme Equine Hospital, University of Liverpool, Neston, Cheshire, United Kingdom
| | - Scott A Katzman
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
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25
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Nilesh K, Punde P, Patil NS, Gautam A. Central ossifying fibroma of mandible. BMJ Case Rep 2020; 13:e239286. [PMID: 33372024 PMCID: PMC7772295 DOI: 10.1136/bcr-2020-239286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2020] [Indexed: 12/30/2022] Open
Abstract
Ossifying fibroma (OF) is a rare, benign, fibro-osseous lesion of the jawbone characterised by replacement of the normal bone with fibrous tissue. The fibrous tissue shows varying amount of calcified structures resembling bone and/or cementum. The central variant of OF is rare, and shows predilection for mandible among the jawbone. Although it is classified as fibro-osseous lesion, it clinically behaves as a benign tumour and can grow to large size, causing bony swelling and facial asymmetry. This paper reports a case of large central OF of mandible in a 40-year-old male patient. The lesion was treated by segmental resection of mandible. Reconstruction of the surgical defect was done using avascular fibula bone graft. Role of three-dimensional printing of jaw and its benefits in surgical planning and reconstruction are also highlighted.
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Affiliation(s)
- Kumar Nilesh
- Oral & Maxillofacial Surgery, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Prashant Punde
- Oral & Maxillofacial Surgery, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Nitin Shivajirao Patil
- Department of Orthopedics, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Amol Gautam
- Department of Radiodiagnosis, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
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26
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González-Garrido L, González CV, Ramos RC, Wasterlain SN. Osseous mass in a maxillary sinus of an adult male from the 16th-17th-century Spain: Differential diagnosis. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2020; 31:38-45. [PMID: 32937254 DOI: 10.1016/j.ijpp.2020.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 08/17/2020] [Accepted: 08/22/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To undertake a differential diagnosis of a large mass found in the left maxillary sinus of a cranium dated to the 16th-17th-century, and to expand knowledge of the diagnosis of osseous tissue formation in osteoarchaeological studies. MATERIAL A cranium recovered from the cemetery of San Salvador de Palat de Rey church, León (Spain). METHODS Macroscopic analysis, CT scanning. RESULTS Macroscopic analysis indicated that the individual was probably a male over 30 years old with an ossified mass in the left maxillary sinus, measuring 24 × 19 × 24 mm, occupying approximately 27 % of the maxillary antrum. Computed tomography revealed a well-demarcated radiolucent unilocular mass with some radiopaque areas, with no communication with the alveoli of the premolars or molars. No erosive lesions or signs of inflammation were found. CONCLUSIONS Neither the macroscopic, nor the radiological characteristics are compatible with inflammatory or malignant pathology, favoring a diagnosis of ossifying fibroma. SIGNIFICANCE This case adds to the few reported cases in the osteoarchaeological literature, especially since there is limited relevant reference data to assist diagnosis. The CT scans and 3D reconstruction presented here facilitate differential diagnosis in future paleopathological studies. LIMITATIONS Destructive methods were not authorized. SUGGESTIONS FOR FURTHER RESEARCH In the future, micro-CT analysis, which was not performed in the current study, may add new and valuable information.
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Affiliation(s)
- Laura González-Garrido
- Área de Antropología Física, Departamento de Biodiversidad y Gestión Ambiental, Universidad de León, 24071 León, Spain; IBIOMED - Institute of Biomedicine, Universidad de León, 24071 León, Spain; CIAS - Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal.
| | - Claudina V González
- Instituto de Antropología de Córdoba (Consejo Nacional de Investigaciones Científicas y Técnicas) and Museo de Antropología (Facultad de Filosofía y Humanidades, Universidad Nacional de Córdoba), 174(5000) Córdoba, Argentina
| | - Rosa C Ramos
- CIAS - Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal; Medical Image Unit, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal
| | - Sofia N Wasterlain
- CIAS - Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
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27
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Vanhoenacker FM, Bosmans F, Vanhoenacker C, Bernaerts A. Imaging of Mixed and Radiopaque Jaw Lesions. Semin Musculoskelet Radiol 2020; 24:558-569. [PMID: 33036043 DOI: 10.1055/s-0039-3402766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Radiopaque lesions and lesions of mixed density are less frequent than radiolucent lesions of the jawbones. They comprise a spectrum of odontogenic and non-odontogenic lesions. The latter group includes inherited and developmental disorders, osteomyelitis, and benign and malignant primary bone tumors and metastases. Most odontogenic radiopaque or mixed lesions are either related to the apex or more rarely to the crown of the tooth, although there are exceptions to this rule. Some lesions, such as a torus mandibularis and torus palatinus, have a characteristic location, whereas others show no relationship to the dentition. This article describes the most characteristic and prevalent radiopaque and mixed lesions of the jaws and their imaging characteristics. Paget's disease, fibrous dysplasia, and rare sclerotic bone diseases of the maxillofacial bones are discussed elsewhere in this issue. Careful correlation of clinical presentation, panoramic radiographs, cone beam computed tomography, and histopathology are the cornerstones for appropriate lesion characterization.
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Affiliation(s)
- Filip M Vanhoenacker
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium.,Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium.,Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - Frederik Bosmans
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium.,Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium
| | | | - Anja Bernaerts
- Department of Radiology, GZA Hospitals, Antwerp, Belgium
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Piezoelectric-Assisted Removal of a Mandibular Cementoossifying Fibroma: An Innovative Technique. Case Rep Dent 2020; 2020:8821090. [PMID: 33005458 PMCID: PMC7503107 DOI: 10.1155/2020/8821090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 11/24/2022] Open
Abstract
Diagnosis of cementoossifying fibroma is oriented by the clinical and radiological aspects of the lesion. Histology confirms the diagnosis. Treatment is surgical with enucleation-resection depending on the lesion size or wider resection with bone reconstruction in cases of large fibromas. The use of piezoelectric bone surgery is associated with low surgical trauma, exceptional precision, and fast healing response. It also allows easy performance of complex osteotomy and reduces the necessary dimensions of mucoperiosteal dissection. The purpose of the present article was to present the advantages of piezoelectric-assisted surgical removal of a cementoosseous fibroma of the mandible and to provide a precise description of the procedure using atraumatic surgery.
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Aburas S, Bandura P, Al-Ibraheem A, Berger S, Meier M, Turhani D. A large maxillary cemento-ossifying fibroma superimposed with solitary bone cyst documented over 18 years: A case report. Int J Surg Case Rep 2020; 68:257-262. [PMID: 32199251 PMCID: PMC7082601 DOI: 10.1016/j.ijscr.2020.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/28/2020] [Accepted: 03/02/2020] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION Cemento-ossifying fibromas are rare, benign lesions of the head and neck regions. The origin of these lesions can be traced to the periodontal ligament, because its cells are able to form cement, lamellar bone, or fibrous tissue. CASE PRESENTATION A rare case report of a young Caucasian female with a COF is described including follow-ups. She remained untreated for several years despite early radiographic findings of the lesion without a definitive diagnosis. The patient ultimately underwent radical surgery and the whole lesion was removed. The subsequent histological examination confirmed the clinical diagnosis of a COF. Since then, the patient has been under regular clinical and radiological follow-ups. DISCUSSION This rare case report of a COF, documented over 18 years, shows the importance of consecutive therapy after radiologic and clinical findings, as such lesions continue growing and may subsequently lead to severe medical conditions. Therefore, complete surgical resection of COFs is advised to achieve good results in terms of health and recurrence. CONCLUSION Long-term follow-up of patients is required as recurrences can occur for up to 10 years following treatment. Well-planned radical and wide surgical resection of these lesions has proven not only to be effective in eliminating the aetiological factors, but can also achieve decent bone regeneration and aesthetic results with almost no deformation in the surgical site.
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Affiliation(s)
- Sarmad Aburas
- Centre for Oral and Maxillofacial Surgery, University of Dental Medicine and Oral Health, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria
| | - Patrick Bandura
- Centre for Oral and Maxillofacial Surgery, University of Dental Medicine and Oral Health, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria
| | - Ali Al-Ibraheem
- Centre for Oral and Maxillofacial Surgery, University of Dental Medicine and Oral Health, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria
| | - Sebastian Berger
- Centre for Oral and Maxillofacial Surgery, University of Dental Medicine and Oral Health, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria
| | - Marius Meier
- Centre for Oral and Maxillofacial Surgery, University of Dental Medicine and Oral Health, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria
| | - Dritan Turhani
- Centre for Oral and Maxillofacial Surgery, University of Dental Medicine and Oral Health, Danube Private University, Steiner Landstraße 124, 3500 Krems-Stein, Austria.
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Mupparapu M, Shi KJ, Ko E. Differential Diagnosis of Periapical Radiopacities and Radiolucencies. Dent Clin North Am 2020; 64:163-189. [PMID: 31735225 DOI: 10.1016/j.cden.2019.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Periapical pathoses represent changes noted at the apices of teeth within the alveolar process that are suspected on examination, visualized via imaging, and confirmed via histopathology. They can be bone forming or destructive. There are pathologic entities that show both types of changes at the apical regions. These lesions must be identified if they are odontogenic in origin because treatment modalities differ. This article discusses identification of radiopaque and radiolucent lesions noted on radiographs. The common opacities and lucencies are described. When required, advanced imaging is used to depict changes within the bone near the periapical regions of mandibular and maxillary teeth.
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Affiliation(s)
- Mel Mupparapu
- Department of Oral Medicine, Robert Schattner Center, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | - Katherine Jie Shi
- Department of Endodontics, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA
| | - Eugene Ko
- Department of Oral Medicine, Robert Schattner Center, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
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Adham M, Dewi DJ. Comparison radical surgery versus conservative surgery to decrease post-operative recurrence in ossifying fibroma: systematic review. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2020. [DOI: 10.1051/mbcb/2020031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Ossifying fibroma in craniofacial is a rare disease, benign, locally aggressive fibro-osseous tumor. In the recent 2017 WHO classifications, ossifying fibroma divided into 2 type, ossifying fibroma of odontogenic origin and juvenile ossifying fibroma. Choosing the right treatment that can reduce the recurrence rate are particularly challenging. In this systematic review we try to analyse related study to determine the best treatment for ossifying fibroma. Aim: The aim of this review to evaluate best treatment option and analysed level of recurrence in each type of treatment. Method: Collected Juvenile Ossifying Fibroma (JOF) and Ossifying Fibroma (OF) related Article from four different database (PubMed, Scopus, Cochrane Library, and Proquest). Study selection was done by using PRISMA strategy. Result: Eight retrospective case series studies were analyzed. Recurrence rate after surgery was 15.3%, most frequent recurrence occurs in conservative surgery. Recurrence rate after conservative surgery was 19.7%, compared with radical surgery which relatively lower in percentage, with recurrence rate after surgery was 10.6%. Conclusion: Juvenile Ossifying Fibroma, especially Trabecular Juvenile Ossifying Fibroma (TrJOF), show high recurrence percentage comparing other type. The first-choice management for treating OF was surgical approach. Types of surgery choose to depend on the aggressiveness and morbidity of the disease. Radical surgery was proven better to decrease level of recurrence compared with conservative surgery.
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Chen P, Wu WJ, Lü XM, Zheng L. [Intraoral anastomosis for maxillary reconstruction with medial femoral condyle periosteal flap: a case report]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:681-683. [PMID: 31875451 DOI: 10.7518/hxkq.2019.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Maxillary defects result in esthetic and functional defects in patients. Several techniques are available for ma-xillary reconstruction. Herein, we present a case of maxillary reconstruction with medial femoral condyle periosteal flap by intraoral anastomosis. The characteristics of medial femoral condyle periosteal flap and the advantages of intraoral anasto-mosis are introduced.
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Affiliation(s)
- Peng Chen
- Dept. of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Wen-Jie Wu
- Dept. of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Xiao-Ming Lü
- Dept. of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Lei Zheng
- Dept. of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
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33
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Kaur T, Dhawan A, Bhullar RS, Gupta S. Cemento-Ossifying Fibroma in Maxillofacial Region: A Series of 16 Cases. J Maxillofac Oral Surg 2019; 20:240-245. [PMID: 33927492 DOI: 10.1007/s12663-019-01304-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 11/02/2019] [Indexed: 11/29/2022] Open
Abstract
Introduction Cemento-ossifying fibroma is considered as a benign osseous tumour, closely related to other lesions such as fibrous dysplasia and cementifying periapical dysplasia. These lesions occur in the second to the fourth decade of life. It is a bony tumour of maxilla and mandible of possibly odontogenic origin with aggressive behaviour and high tendency for recurrence. Radiologically, the lesion appearances varied ranging from radiolucent cyst-like appearance to mixed and/or radiopaque areas. Aims and objectives The article attempts to highlight the importance of clinical, imaging aspects and histopathology in diagnosis of cemento-ossifying fibroma along with management and long-term follow-up. Materials and methods This retrospective study was done on histologically diagnosed 16 fibro-osseous lesions. These patients were treated under general anaesthesia at our institute. The demographic data, radiographic features, and histopathologic findings were analysed and compared. The treatment and follow-up data were also recorded. Results Cemento-ossifying fibroma showed higher predilection for female than for male patients and with an equal number of cases reported in maxilla and mandible with no signs of recurrence in long-term follow-up of 15 years. Conclusion Complete surgical excision of cemento-ossifying fibroma comes out to be only effective treatment that gave satisfactory results and can be considered as a definitive treatment modality.
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Affiliation(s)
- Tejinder Kaur
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Mall Mandi, GT Road, Amritsar, 143001 India
| | - Amit Dhawan
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Mall Mandi, GT Road, Amritsar, 143001 India
| | - Ramandeep Singh Bhullar
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Mall Mandi, GT Road, Amritsar, 143001 India
| | - Sakshi Gupta
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Mall Mandi, GT Road, Amritsar, 143001 India
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Mortazavi H, Baharvand M, Safi Y, Behnaz M. Common conditions associated with displacement of the inferior alveolar nerve canal: A radiographic diagnostic aid. Imaging Sci Dent 2019; 49:79-86. [PMID: 31281784 PMCID: PMC6597375 DOI: 10.5624/isd.2019.49.2.79] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/06/2018] [Accepted: 10/19/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose This study reviewed the common conditions associated with displacement of inferior alveolar nerve canal. Materials and Methods General search engines and specialized databases including Google Scholar, Pub Med, Pub Med Central, Science Direct, and Scopus were used to find relevant studies by using keywords such as “mandibular canal”, “alveolar canal”, “inferior alveolar nerve canal”, “inferior dental canal”, “inferior mandibular canal” and “displacement”. Results About 120 articles were found, of which approximately 70 were broadly relevant to the topic. We ultimately included 37 articles that were closely related to the topic of interest. When the data were compiled, the following 8 lesions were found to have a relationship with displacement of mandibular canal: radicular/residual cysts, dentigerous cyst, odontogenic keratocyst, aneurysmal bone cyst, ameloblastoma, central giant cell granuloma, fibrous dysplasis, and cementossifying fibroma. Conclusion When clinicians encounter a lesion associated with displaced mandibular canal, they should first consider these entities in the differential diagnosis. This review would help dentists make more accurate diagnoses and develop better treatment plans according to patients' radiographs.
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Affiliation(s)
- Hamed Mortazavi
- Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Baharvand
- Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Behnaz
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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35
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Veltrini VC, Figueira JA, Santin GC, de Sousa SCOM, de Araújo NS. Can non-collagenous proteins be employed for the differential diagnosis among fibrous dysplasia, cemento-osseous dysplasia and cemento-ossifying fibroma? Pathol Res Pract 2019; 215:152450. [PMID: 31109869 DOI: 10.1016/j.prp.2019.152450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/27/2019] [Accepted: 05/12/2019] [Indexed: 11/20/2022]
Abstract
Differential diagnosis among fibrous dysplasias, cemento-ossifying fibromas and cemento-osseous dysplasias is difficult, since there is considerable overlap of histologic features, but also extremely important, since they differ greatly in etiology, clinical behaviour, prognosis and terapeuthic approach. There is no data about the use of immunohistochemistry, a viable and accessible technique, for this purpose. The objective of this study was to investigate, comparatively, the immunohistochemical expression of major non-collagenous proteins (osteonectin [ON], osteopontin [OP], bone sialoprotein [BSP] and osteocalcin [OC]) of mineralized tissue extracellular matrix in 22 cases of fibrous dysplasias, 16 of cemento-ossifying fibromas and 16 of cemento-osseous dysplasias. ON maintained the same expression profile in all cases; the staining for OP was negative in fusiform cells producing cementoid globules and weak, as well as heterogeneous, in high mineralized matrixes; there was negativity for BSP in cementoid globules and in the fusiform cells that produce them, differently from the strong positive expression found in the majority of bone trabeculae and their peripheral cuboidal osteoblasts; and finally, the immuno-reactivity for OC was weak, except in cuboidal osteoblasts and osteocytes. We can conclude that the nature of mineralized structure and the cellular phenotype are much more responsible for variability in immunohistochemical profile than the type of lesion (fibrous dysplasias, cemento-ossifying fibromas and cemento-osseous dysplasias) which makes difficult, at least for a while, the use of these proteins with diagnosis purpose.
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Affiliation(s)
- Vanessa Cristina Veltrini
- Oral Pathology Discipline, Dentistry Department, State University of Maringa, Av. Mandacaru, 1550, CEP 87080-000, Maringa, PR, Brazil
| | - Jéssica Araújo Figueira
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil.
| | - Gabriela Cristina Santin
- Pediatric Dentistry Discipline, Dentistry Department, State University of Maringa, Av. Mandacaru, 1550, CEP 87080-000, Maringa, PR, Brazil
| | | | - Ney Soares de Araújo
- Oral Pathology Department, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, CEP 05508-000, São Paulo, SP, Brazil
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Le Donne M, Abattu O, Pernier C, Durieux E, Bodard AG. Impacted canine and ossifying fibroma: case report and literature review. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2019. [DOI: 10.1051/mbcb/2019018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: An impacted tooth is a permanent tooth that has a completely developed root but which has failed to erupt. Many etiologies can lead to impaction, including a mechanical obstacle, such as benign tumor. Observation: An 11-year-old girl was referred for the avulsion of the left mandibular permanent canine, which was impacted. A radiolucent lesion with ground glass opacity was found on the eruption pathway of the tooth. Anterior radiographs showed the lesion that seemed to be the cause of the impacted canine. Anatomopathological examination revealed the lesion to be a juvenile trabecular ossifying fibroma. Comments: Ossifying fibromas are rare jaw tumors. They can be of various types: ossifying fibroma, psammomatoid, or trabecular juvenile ossifying fibroma. This is the first case that clearly shows the association between ossifying fibroma and tooth impaction. A literature review of ossifying fibromas and the management of fibro-osseous benign lesions of the jaws was performed. Conclusion: Although benign, juvenile trabecular ossifying fibroma can be locally aggressive and has a high rate of recurrence. It is very important to establish a precise diagnosis of a fibro-osseous benign lesion of the jaws to plan optimal management.
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Bhattacharjee A, Bhuvaneshwari S, Khan S, Bulgannawar B. A diagnostic dilemma of progressive, unilateral mandibular swelling: A mirage unveiled. JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2019. [DOI: 10.4103/jiaomr.jiaomr_217_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
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Kharsan V, Madan RS, Rathod P, Balani A, Tiwari S, Sharma S. Large ossifying fibroma of jaw bone: a rare case report. Pan Afr Med J 2018; 30:306. [PMID: 30637089 PMCID: PMC6320444 DOI: 10.11604/pamj.2018.30.306.15877] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/10/2018] [Indexed: 11/17/2022] Open
Abstract
Ossifying fibroma (OF) is classified as, and behaves like, a benign bone neoplasm. It is often considered to be a type of fibro-osseous lesion (FOL). It can affect both mandible and the maxilla, particularly the mandible. This bone tumour consists of highly cellular, fibrous tissue that contains varied amounts of bone or cementum resembling calcified tissue. Present case is an unusual report of central ossifying fibroma involving the left side of mandible in an 18 year old female patient, who presented to the department with a painless hard swelling. The lesion was treated by surgical resection and reconstruction.
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Affiliation(s)
- Vinay Kharsan
- Department of Oral and Maxillofacial Surgery, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Ramnik Singh Madan
- Department of Oral and Maxillofacial Surgery, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Pankaj Rathod
- Department of Oral and Maxillofacial Surgery, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Abhishek Balani
- Department of Oral and Maxillofacial Surgery, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Sumit Tiwari
- Department of Oral and Maxillofacial Surgery, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Saurabh Sharma
- Department of Oral and Maxillofacial Surgery, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
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Extranodal lymphoma arising within the maxillary alveolus: a systematic review. Oral Radiol 2018; 34:113-126. [PMID: 30147235 DOI: 10.1007/s11282-017-0309-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 10/19/2017] [Indexed: 11/27/2022]
Abstract
Objectives Extranodal lymphomas affecting the head and neck infrequently arise within the jaw bones. Although clinical examination and conventional radiography may initially suffice for such lesions arising within the mandible, those arising within the maxillary alveolus generally require cross-sectional imaging because of the complex anatomy of this region. This study was performed to determine the prevalence, demographic characteristics, and clinical presentations of these lesions and the imaging modalities used for their diagnosis. Study design A systematic review (SR) on case series and another SR on case reports were performed to investigate the demographic, clinical, and radiological features of extranodal lymphomas arising within the maxillary alveolus. Results Most case series were derived from just four nations, whereas the case reports were derived from a wider range of ethnicities. The more detailed case reports significantly reported at least one imaging modality. Most patients were aware of their lesions for nearly 2 months before presentation. The most frequent symptom was swelling. Most case reports included a provisional diagnosis, the most frequent of which was dental infection followed by squamous cell carcinoma. Discussion Extranodal lymphomas arising within the maxillary alveolus were sufficiently frequent in four communities to be reported in two or more case series, and the occasional single case report indicated that such lesions are more widespread globally. Although the SR on case series revealed differences in the relative period prevalence and maxillary/mandibular ratio, the SR on case reports revealed details of the clinical presentation and imaging modalities used.
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Kato CDNADO, Nunes LFM, Chalub LLFH, Etges A, Silva TA, Mesquita RA. Retrospective Study of 383 Cases of Fibro-Osseous Lesions of the Jaws. J Oral Maxillofac Surg 2018; 76:2348-2359. [PMID: 29859157 DOI: 10.1016/j.joms.2018.04.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 04/26/2018] [Accepted: 04/28/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE The aims of this study were to describe the clinical and radiologic features of 383 fibro-osseous lesions (FOLs) from an oral pathology reference service in Brazil and to compare the findings with previous studies. The hypothesis of the study was that the most common type of FOL would differ from other investigations. MATERIALS AND METHODS We conducted a descriptive and retrospective study with review of the records of the clinical and biopsy services (1990 to 2015). All records of the patients included showed a definitive diagnosis of FOL. The primary outcome variable was the type of FOL, and the predictor variables were gender, age, ethnicity, location, and clinical and radiologic characteristics. Descriptive analyses and χ2 tests were performed. The P value was set at .05. RESULTS From the 27,998 records available, 383 showed FOLs, with 187 (48.8%) being cemento-osseous dysplasias (CODs), 103 (26.9%) being fibrous dysplasias (FDs), and 93 (24.3%) being ossifying fibromas (OFs). The mean age of the patients was 38.5 ± 17.5 years. CODs presented a predilection for female gender (n = 314, 82.0%), African descent (n = 134, 71.6%), and the mandible (n = 248, 64.6%). The most common radiologic feature was a mixed radiolucent-radiopaque image (n = 149, 51.7%). FDs and OFs were commonly diagnosed during the first and second decades of life (P < .001), whereas CODs were more frequently diagnosed beyond the third decade (P < .001). Secondary osteomyelitis was more significantly observed in CODs (P < .001) than in FDs and OFs. Swelling was more frequently reported for FDs and OFs than for CODs (P < .001). CONCLUSIONS CODs were the most frequently observed FOLs in this Brazilian population. Female patients, patients of African descent, and patients with mandibular localization were most commonly affected by these conditions. The most common type of FOL differed from that in similar case reports or series from various geographic locations. It is believed that the data source (clinical and/or biopsy services) can directly influence the outcome.
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Affiliation(s)
| | | | - Loliza Luiz Figueiredo Houri Chalub
- Professor, Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Adriana Etges
- Professor, Departament Oral Pathology, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Tarcília Aparecida Silva
- Professor, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Alves Mesquita
- Professor, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Gresky J, Kalmykov A, Berezina N. Benign fibro-osseous lesion of the mandible in a Middle Bronze Age skeleton from Southern Russia. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 20:90-97. [PMID: 29496222 DOI: 10.1016/j.ijpp.2017.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 09/12/2017] [Accepted: 09/15/2017] [Indexed: 06/08/2023]
Abstract
A discrete dysplastic lesion of the mandible found in a skeleton of a young adult male of the Middle Bronze Age in the Northern Caucasus/Russia is described. The periapical lesion of the right lower canine alveolus was examined by digital microscopy, plain radiology, and plain and polarizing microscopy. Its macroscopic, radiologic and microscopic characteristics are discussed in reference to different fibro-osseous lesions arising from the odontogenic apparatus and maxillofacial skeleton. Periapical osseous dysplasia was considered to be the most likely diagnosis.
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Affiliation(s)
- Julia Gresky
- Department of Natural Sciences, German Archaeological Institute, 14195 Berlin, Germany.
| | - Alexey Kalmykov
- SUE "Nasledie" Ministry of Culture of the Stavropol Region, 355006 Stavropol, Russia
| | - Natalia Berezina
- Research Institute and Museum of Anthropology, Moscow State University, 123001 Moscow, Russia
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Pereira TDSF, Brito JAR, Guimarães ALS, Gomes CC, de Lacerda JCT, de Castro WH, Coimbra RS, Diniz MG, Gomez RS. MicroRNA profiling reveals dysregulated microRNAs and their target gene regulatory networks in cemento-ossifying fibroma. J Oral Pathol Med 2017; 47:78-85. [PMID: 29032608 DOI: 10.1111/jop.12650] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cemento-ossifying fibroma (COF) is a benign fibro-osseous neoplasm of uncertain pathogenesis, and its treatment results in morbidity. MicroRNAs (miRNA) are small non-coding RNAs that regulate gene expression and may represent therapeutic targets. The purpose of the study was to generate a comprehensive miRNA profile of COF compared to normal bone. Additionally, the most relevant pathways and target genes of differentially expressed miRNA were investigated by in silico analysis. METHODS Nine COF and ten normal bone samples were included in the study. miRNA profiling was carried out by using TaqMan® OpenArray® Human microRNA panel containing 754 validated human miRNAs. We identified the most relevant miRNAs target genes through the leader gene approach, using STRING and Cytoscape software. Pathways enrichment analysis was performed using DIANA-miRPath. RESULTS Eleven miRNAs were downregulated (hsa-miR-95-3p, hsa-miR-141-3p, hsa-miR-205-5p, hsa-miR-223-3p, hsa-miR-31-5p, hsa-miR-944, hsa-miR-200b-3p, hsa-miR-135b-5p, hsa-miR-31-3p, hsa-miR-223-5p and hsa-miR-200c-3p), and five were upregulated (hsa-miR-181a-5p, hsa-miR-181c-5p, hsa-miR-149-5p, hsa-miR-138-5p and hsa-miR-199a-3p) in COF compared to normal bone. Eighteen common target genes were predicted, and the leader genes approach identified the following genes involved in human COF: EZH2, XIAP, MET and TGFBR1. According to the biology of bone and COF, the most relevant KEGG pathways revealed by enrichment analysis were proteoglycans in cancer, miRNAs in cancer, pathways in cancer, p53-, PI3K-Akt-, FoxO- and TGF-beta signalling pathways, which were previously found to be differentially regulated in bone neoplasms, odontogenic tumours and osteogenesis. CONCLUSION miRNA dysregulation occurs in COF, and EZH2, XIAP, MET and TGFBR1 are potential targets for functional analysis validation.
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Affiliation(s)
- Thaís Dos Santos Fontes Pereira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - João Artur Ricieri Brito
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Carolina Cavaliéri Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Wagner Henriques de Castro
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Marina Gonçalves Diniz
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Liu Y, Shan XF, Guo XS, Xie S, Cai ZG. Clinicopathological Characteristics and Prognosis of Ossifying Fibroma in the Jaws of Children: A Retrospective Study. J Cancer 2017; 8:3592-3597. [PMID: 29151945 PMCID: PMC5687175 DOI: 10.7150/jca.21556] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 09/14/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Ossifying fibroma in the jaws is a benign tumor and easily recurs in children, of which the treatment methods and prognosis still remain controversial. In this study, we aimed to review the clinicopathological characteristics, treatment, and prognosis of ossifying fibroma in the jaws of children, and offer recommendations for clinical decision-making. METHODS: A retrospective study was carried out on patients below the age of 18 years with ossifying fibroma in the jaws. Patients with complete clinical, pathological, and radiological records were included and followed-up. RESULTS: Sixty-three cases were collected with a preliminary search. After screening, fifty patients were included for general information analysis, of which forty-two patients were included in the recurrence analysis. Twelve patients showed a relapse, with a recurrence rate of 28.6% (12/42). The recurrence rates in cases with different surgical approaches and different X-ray boundaries were statistically different. Besides, twenty-three patients underwent reconstruction by free tissue grafting and the success rate was 96% (22/23). CONCLUSIONS: There was significant difference in the recurrence rates among different X-ray manifestations and surgical methods. An extended resection and reconstruction with free tissue grafting was a reliable method with a 96% success rate.
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Affiliation(s)
- Ying Liu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Xiao-Feng Shan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Xue-Sheng Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.,Department of Stomatology, Capital Medical University Pinggu Teaching Hospital, Beijing 101200, China
| | - Shang Xie
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Zhi-Gang Cai
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
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44
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Diagnosing the most common odontogenic cystic and osseous lesions of the jaws for the practicing pathologist. Mod Pathol 2017; 30:S96-S103. [PMID: 28060370 DOI: 10.1038/modpathol.2016.191] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/06/2016] [Accepted: 09/14/2016] [Indexed: 11/08/2022]
Abstract
Odontogenic cysts and osseous lesions are often seen as challenging diagnostic lesions but the majority of them are easily classified. This article outlines the diagnostic features required for separating the most common of odontogenic cysts and select osseous lesions of the jaws. Clinical and radiographic findings of these jaw lesions often lead to a differential diagnosis that only the histologic findings will clarify. Dentigerous cyst, keratocystic odontogenic tumor, and certain ameloblastomas that have cystic change, may have identical radiographic findings, with only separation by their specific histologic features leading to the significantly different treatments required for each. Conversely, some cystic lesions can appear histologically identical and cannot be diagnosed without the radiographic findings. Certain osseous lesions of the jaws are particularly problematic for diagnosis without the appropriate radiographic findings, and the diagnosis should probably not be attempted on the histologic findings alone. This article will integrate the necessary clinical, radiographic, and histologic findings required to address the most common odontogenic lesions.
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Ossifying Fibroma: Analysis of Treatment Methods and Recurrence Patterns. J Oral Maxillofac Surg 2016; 74:2409-2419. [DOI: 10.1016/j.joms.2016.05.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/15/2016] [Accepted: 05/16/2016] [Indexed: 12/13/2022]
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46
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Dewan HS, Dewan SK, Bahl S, Tushar Parekh P. Cemento-ossifying fibroma of mandible mimicking complex composite odontome. BMJ Case Rep 2016; 2016:bcr-2016-216053. [PMID: 27797795 DOI: 10.1136/bcr-2016-216053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Cemento-ossifying fibroma (COF) is a fibro-osseous lesion or non-odontogenic tumour that affects craniofacial bones. These lesions are included in the spectrum of fibro-osseous lesions arising from periodontal ligament cells, which can deposit combination of cementum and bone surrounded by fibrous tissue. It clinically, macroscopically and radiologically resembles complex composite odontome and can be differentiated only on the basis of histopathology. They usually occur solitarily as a painless and expansile spherical or ovoid jawbone mass that may displace the roots of adjacent teeth. They predominantly occur in females in third and fourth decades of life. We present a case report of a 20-year-old man, with a mildly painful swelling in the mandible which was successfully treated with enucleation and diagnosed as COF. Its resemblance to complex composite odontome and unique surgical approach are highlighted in this paper.
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Affiliation(s)
- Hitesh Sudarshan Dewan
- Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Dharmsinh Desai University, Nadiad, Gujarat, India
| | - Sudarshan Kumar Dewan
- Department of Oral and Maxillofacial Surgery, College of Dental Sciences and Research Centre, Ahmedabad, Gujarat, India
| | - Sumit Bahl
- Department of Oral Pathology and Microbiology, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
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47
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Mainville GN, Turgeon DP, Kauzman A. Diagnosis and management of benign fibro-osseous lesions of the jaws: a current review for the dental clinician. Oral Dis 2016; 23:440-450. [PMID: 27387498 DOI: 10.1111/odi.12531] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 06/28/2016] [Accepted: 07/02/2016] [Indexed: 02/07/2023]
Abstract
Benign fibro-osseous lesions of the maxillofacial skeleton constitute a heterogeneous group of disorders that includes developmental, reactive (dysplastic) and neoplastic lesions. Although their classification has been reviewed multiple times in the past, the most common benign fibro-osseous lesions are fibrous dysplasia, osseous dysplasia and ossifying fibroma. For the dental clinician, the challenges involve diagnosis and treatment (or lack thereof). A careful correlation of all clinical, radiologic and microscopic features is essential to establish a proper diagnosis and a clear treatment plan. This article aimed to review the clinical, radiologic and histopathologic characteristics of benign fibro-osseous lesions of the jaws, with emphasis on their differential diagnoses. With a deeper understanding of benign fibro-osseous lesions, clinicians will be better prepared to manage these lesions in their practice.
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Affiliation(s)
- G N Mainville
- Department of Stomatology, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada
| | - D P Turgeon
- Department of Stomatology, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada
| | - A Kauzman
- Department of Stomatology, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada
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48
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Jurlina M, Skitarelić N, Passali D, Passali F, Mladina R. Endonasal endoscopic resection of ossifying fibroma involving the ethmoid sinus, orbit and anterior skull base: case report and literature review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2016; 36:144-8. [PMID: 27196080 PMCID: PMC4907162 DOI: 10.14639/0392-100x-674] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 06/01/2015] [Indexed: 11/23/2022]
Abstract
Ossifying fibroma is a benign fibro-osseous tumour that rarely involves the ethmoid sinuses and orbit. It is classified as a benign fibroosseous lesion, a term that is synonymous with a variety of lesions reported in the literature. Recurrence rate with deleterious effects in cases of extramandibular ossifying fibroma is the impetus for open en bloc resection of the tumour. Continuously evolving techniques in endonasal endoscopic sinus surgery has rendered resection of large benign sinonasal and cephalonasal tumours possible. The authors report a case of ossifying fibroma involving the ethmoid sinus, orbit and anterior skull base in a 65-year-old previously healthy woman completely resected by endonasal endoscopic sinus surgery. The patient was free from postoperative complications and was dismissed from hospital on the sixth postoperative day. At present, the patient is disease-free at a regular five-year postoperative follow-up. Endonasal endoscopic resection of sinonasal ossifying fibromas is an excellent therapeutic option when performed by a surgeon experienced in endoscopic sinonasal surgery. The advantages of an endonasal endoscopic approach include direct visualization, enhanced visibility and magnification resulting in decreased intraoperative and postoperative morbidity. Aesthetic outcome is excellent in the absence of facial scars.
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Affiliation(s)
- M. Jurlina
- Department of Otolaryngology Head and Neck Surgery, University Hospital Rebro, Zagreb, Croatia
| | - N. Skitarelić
- Department of Otolaryngology Head and Neck Surgery, General Hospital Zadar, Zadar, Croatia
| | - D. Passali
- Department of ORL, University of Siena, Italy
| | - F.M. Passali
- Department of ORL University of Rome Tor Vergata, Italy
| | - R. Mladina
- Department of Otolaryngology Head and Neck Surgery, University Hospital Rebro, Zagreb, Croatia
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Mohapatra M, Banushree CS, Nagarajan K, Pati D. Cemento-ossifying fibroma of mandible: An unusual case report and review of literature. J Oral Maxillofac Pathol 2016; 19:405. [PMID: 26980975 PMCID: PMC4774300 DOI: 10.4103/0973-029x.174646] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The term ossifying fibroma (OF) has recently been included under fibro-osseous lesions. Cemento-OF (COF) is a benign neoplasm that arises from the periodontal membrane which contains multipotential cells that are capable of forming cementum, lamellar bone and fibrous tissue. These tumors occur in the third and fourth decades of life with a predilection for women. The mandible is more commonly involved than the maxilla. This lesion has caused considerable controversy regarding the use of terminology, origin and diagnostic criteria. This article describes an unusual case of COF presenting as unilocular lytic lesion of mandible in a 38-year-old male patient with review of literature.
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Affiliation(s)
- Mounabati Mohapatra
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - C S Banushree
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - K Nagarajan
- Department of Radiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Debashish Pati
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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50
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MacDonald DS. A systematic review of the literature of nevoid basal cell carcinoma syndrome affecting East Asians and North Europeans. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:396-407. [PMID: 26297395 DOI: 10.1016/j.oooo.2015.05.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 05/06/2015] [Accepted: 05/29/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To compare, by systematic review, North European and East Asian consecutive case series of nevoid basal cell carcinoma syndrome (NBCCS). STUDY DESIGN A systematic review of the literature was performed for all consecutive case series of NBCCS, which included keratocystic odontgenic tumors (KCOTs) arising in North European and East Asian communities. The clinical and radiologically apparent features were identified and synthesized, and a meta-analysis was performed. RESULTS East Asian reports were significantly more "proband only" compared with North European reports. Significant differences between these 2 communities were observed for 5 of the 6 major features and 11 of the 27 minor features. With regard to the major NBCCS features, the North Europeans displayed significantly more frequent basal cell carcinomas, calcified falx cerebri, palmar and plantar pits, and a family history, whereas the East Asians displayed KCOTs significantly more frequently. With regard to minor features, East Asians displayed significantly more frequent cleft lips and palates and hypertelorism. CONCLUSIONS East Asians displayed multiple KCOTs and cleft lips and palates more frequently compared with North Europeans.
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Affiliation(s)
- David S MacDonald
- University of British Columbia, Chairman of the Division of Oral & Maxillofacial Radiology, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
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