Comparison radical surgery versus conservative surgery to decrease post-operative recurrence in ossifying fibroma: systematic review

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.

Single stage maxillofacial reconstruction combined radical surgery for managing juvenile ossifying fibroma: A case report

“…Adham et al . [ 10 ] and Chrcanovic et al . [ 6 ] reported conservative surgery which proved more frequent postoperative recurrence.…”

A Rare Location for Ossifying Fibroma: Temporal Bone Involvement

“…Although OFs are mostly seen in the third and fourth decades, they can occur at any age and their frequency is similar between the sexes [ 1 - 3 ]. Female predominance is remarkable among young adults [ 2 ]. The case we present is compatible with the literature in terms of age and gender.…”

“…OFs in the head and neck region are most commonly seen in the mandible, followed by the maxilla [ 1 , 2 ]. It may rarely involve the orbit, paranasal sinuses, occipital bone, and temporal bone [ 1 , 3 ].…”

“…It was stated that the recurrence rate in radical approaches is lower than in conservative approaches. In addition, it was revealed that 75% of recurrences are seen within the first year after surgery [ 2 ]. In our opinion, the rule that should be applied to prevent recurrence is to clearly reveal the borders of OF and to remove the bone with a drill until the healthy bone can be seen within these borders.…”

“…OFs are seen as well-circumscribed masses with disorganized calcifications and disrupt the bone structures on radiological examinations [ 4 ]. For treatment, the lesion should be removed with negative surgical margins to prevent recurrence [ 2 ]. In this study, a case of OF located in the temporal bone was discussed in light of the literature.…”