Central Odontogenic Fibroma (WHO Type): A Case Report and Review of Literature

Abstract

We report a case of 15-year-old boy presented with painless swelling of right side of lower jaw since 2 years. A provisional diagnosis of dentigerous cyst involving an impacted lower second premolar was concluded after clinical examination. Radiographs revealed an expanding, well demarcated radiolucency with thin, fine, straight septae, causing root resorption and displacement of adjacent teeth and the impacted tooth was pushed to the inferior border of mandible. Histologically pronounced fibroblastic hypercellularity with epithelial rests and focal areas with dentinoid or cementoid material was seen, suggestive of Central Odontogenic Fibroma (WHO Type). Only eight such cases have been reported in English literature and present one is 9th case.

Epithelium Rich Type Central Odontogenic Fibroma in Maxilla a Case Report and Review of Literature

“…Earlier they used to name every enlarged dental follicle as COF but actual cases been reported as the criteria proposed by Gardner in 1980 [3]. It is believed that it arises from true odontogenic mesenchyme influenced by the odontogenic apparatus [4]. As mentioned in literature about the types of COF, being the complex type favoring the mandible with aggressive behavior involving pain, facial asymmetry, teeth displacement and rhizolysis but here in our case showing the same type with the same features but in maxilla [2][3][4][5].…”

“…It is believed that it arises from true odontogenic mesenchyme influenced by the odontogenic apparatus [4]. As mentioned in literature about the types of COF, being the complex type favoring the mandible with aggressive behavior involving pain, facial asymmetry, teeth displacement and rhizolysis but here in our case showing the same type with the same features but in maxilla [2][3][4][5]. The presence of some elements like Myofibroblasts, macrophage, giant cells, as well as the proliferative index can be related to the potential aggressiveness of the tumor; so suggested to do immunohistochemical and electron microscopic studies for better understanding of the biology and eventually the pathogenesis of this unusual odontogenic tumor [3].…”

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

“…Thin and straight septae can also be noted in some lesions. 9 22 23 24 25 Less common CT findings include calcified materials within the lesion, a diffuse sclerotic border, and peripheral osteosclerosis. 26 27 The present case demonstrated a very unique malignancy-like radiographic appearance of COF with periosteal reaction.…”

Central Odontogenic Fibroma: characteristics and management

“…They were absent in 74.8% of cases [11,24,36,47,50,[57][58][59][60][61][62][63][64][65]. Facial asymmetry was observed in 23.7% of cases [5,[7][8][9][12][13][14][15][16][17][18][20][21][22]25,26,31,33,40,58,60,63,[66][67][68][69][70][71][72][73][74]. This facial asymmetry was isolated in 20.7% of cases and associated with other extraoral clinical signs in 3% of cases (lymphadenopathy in 1.5% of cases [12,66], trismus in 0.7% [33] and paraesthesia in 0.7% [73] depression could also be associated in 2.2% of cases…”

“…The association of COF with impacted tooth was relatively common (28.9% of cases). It might be canine or molar [5,12,15,16,18,20,25,[35][36][37]40,43,44,46,48,50,51,[57][58][59][60]62,66,67,69,72,77,78,80,83]. Finally, cortical bone perforations were reported in 16.3% of cases [5,10,12,13,16,18,22,28,33,43,47,50,54,56,67,69,71,72,77,81,83,…”