26. Cemento ossifying fibroma Aadya Reviewed.cdr

Abstract

Cemento-ossifying fibroma(COF) is a benign fibro-osseous lesion which belongs to same category as fibrous dysplasia and cement-ossifying dysplasia. It is arises from periodontal membrane which contains multipotential cells that are capable of forming cementum, lamellar bone and fibrous tissue. It is more common in mandible than maxilla. We present a case of cementoossifying fibroma in maxilla,a rare occurrence in a 66 year old female with the chief complaint of a swelling in left upper back teeth region for last 3 years. A panoramic radiograph was taken which showed oval radiopaque lesion in second quadrant from 24 to maxillary tuberosity. In the maxilla, the clinical and radiological differential diagnosis include fibrous dysplasia, giant cell lesions, cementoblastoma, calcifying epithelial odontogenic tumor and peripheral giant cell granuloma. It is sharply circumscribed and demarcated from the surrounding bone so surgical excision is the treatment of choice. 1 2 3 4 Aadya Sharma, Dayashankara Rao JK, Neelima Gehlot and Khushboo Walecha, 1 2 3 4 Associate Professor, Professor and Head, Professor, PG Student, Faculty of Dental Sciences, SGT University, Chandu-Budhera, Gurgaon-Badli Road, Gurgaon (Haryana)-122505 INTRODUCTION : Cemento-ossifying fibroma is a benign fibro-osseous tumor belonging to the same category as fibrous dysplasia & cemento-ossifying dysplasia. They arise in the mandible in 62 to 89% of patients with 77% of them occurring in the premolar region. It is not commonly seen in the maxilla.(1) Common age of occurrence is between the third & fourth decades of life & is seen more frequently in women than in men. COF is a benign neoplasm characterized by the replacement of normal bone by fibrous tissue & varying amount of newly formed bone or cementum like material or both.[2] It is a fibro-osseous lesion that arises from periodontal membrane. Periodontal membrane is a layer of connective tissue surrounding the roots of teeth. It contains multipotential cells that are capable of forming cementum, lamellar bone & fibrous tissue.[3] Fibro-osseous lesions are characterized by three radiographic stages: initial or early (radiolucent), mixed (radiolucent & radiopaque) & mature (radiopaque). In early stages, the COF appears as a radiolucent lesion. As the tumor matures, there is increasing calcification so that the radiolucent area becomes flecked with opacities until ultimately the lesion appears as an extremely radiopaque mass. One additional important diagnostic feature is that there is a centrifugal growth pattern rather than a linear one and therefore the lesions grow by expansion equally in all directions and present as a round tumor mass. The differential diagnosis of COF includes other lesions that contain radiopacities within a well-defined radiolucent mass. These lesions are chondrosarcoma and osteosarcoma, fibrous dysplasia, odontogenic cysts, squamous cell carcinoma, Gorlin's cyst, Pindborg tumor. The well defined borders of COF help differentiate it from aggressive sarcomas and carcinomas. Fibrous dysplasia has a typical ground glass appearance. Gorlin cysts and Pindborg tumors are difficult to distinguish and can only be done on histologic examination. Treatment comprises surgical resection of the lesion with enucleation & curettage of the bone bed. Radiotherapy has been proven inefficient & is contraindicated. Inadequate surgical treatment may cause recurrence of the lesions, therefore, proper diagnosis & treatment plan is required to achieve good result in the management of this tumor. CEMENTO-OSSIFYING FIBROMA OF THE MAXILLA – A CASE REPORT. Journal of Dental Sciences University

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Cite this paper

@inproceedings{Sharma201526CO, title={26. Cemento ossifying fibroma Aadya Reviewed.cdr}, author={Aadya Sharma and Dayashankara JK Rao and Khushboo Walecha}, year={2015} }