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Osteomas are benign osteogenic neoplasms caused by proliferation of mature compact or cancellous bone. Clinically they may be classified as peripheral, central or extraskeletal. Osteomas usually involve the craniofacial region with mandible being the most common site. Central osteoma of the jaws is a very rare entity with only 13 cases reported in the literature till date of which only five cases occurred in the maxilla. Here we present a case of a large central osteoma of anterior maxilla associated with an impacted tooth, the first of its kind and a review of literature.

Objective The purpose of this retrospective analysis is to document and discuss the features, treatment rendered and result of 25 histologically proven cases of ossifying fibromas of jaw bones operated by a single surgeon over a period of 10 years. Results Twenty-five patients were analyzed with a final diagnosis of ossifying fibroma comprising of 14 males (56 %) and 11 females (44 %). The age range was 11-45 years with a mean of 24.12 years. Mandible was involved in 72 % and maxilla in 28 % cases with a predominance of mandibular posterior [19 (76 %)] cases. The study showed similar findings in regard to clinical, radiographic & histological features of ossifying fibroma as compared to other studies. It also showed that the treatment rendered in the form of eneucleation, curettage or resection of the lesion depending on its stage and extent were adequate, as no recurrence has been reported till date. Conclusion Enucleation is preferred in small and well demarcated lesions. Curettage should be done in relatively large lesions with ill defined borders, not involving basal bone of mandible or cortical perforation. Resection should be reserved for aggressive and extensive cases with involvement of basal bone or perforation of cortices.

Osteomyelitis is defined as inflammation of the medullary cavities, haversian system and adjacent cortex of bone. Osteomyelitis involving maxilla is quite rare when compared to that of mandible. Fungal osteomyelitis is very rarely seen and documented in the maxillofacial area. It is devastating to patients if it is invasive in nature. A prospective study was undertaken from December 2011 to December 2013. Biopsied hard tissue bits were decalcified and sections were stained with H&E, periodic acid Schiff and Grocott methenamine silver. Culture sensitivity was carried out in all cases. Surgical intervention followed by antifungal therapy was advocated to treat the patients. The current series showed five cases of fungal osteomyelitis which included candidal osteomyelitis, aspergillosis and mucormycosis with slight predominance of maxilla over mandible. Osteomyelitis of facial bones needs to be investigated thoroughly as there is no difference in clinical presentation between bacterial and fungal osteomyelitis. The diagnostic workup with biopsy and culture sensitivity helps to identify the pathogen at the earliest. Appropriate antifungal treatment needs to be advocated for successful treatment.

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