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    S Sunil

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    Central cementifying fibroma is a rare fibro-osseous lesion arising from the periodontal ligament that is usually seen in tooth-bearing areas of the jaws. This case report describes a recurrent central cementifying fibroma lesion in the ramus of the mandible of a 34-year-old female patient. The affected bone was surgically resected and the deformity was repaired with a rib graft. Histopathological examination revealed moderately dense collagen fibers with bone spicules and cementum-like masses, consistent with central cementifying fibroma.

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    S Sunil

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    Central cementifying fibroma is a rare fibro-osseous lesion arising from the periodontal ligament that is usually seen in tooth-bearing areas of the jaws. This case report describes a recurrent central cementifying fibroma lesion in the ramus of the mandible of a 34-year-old female patient. The affected bone was surgically resected and the deformity was repaired with a rib graft. Histopathological examination revealed moderately dense collagen fibers with bone spicules and cementum-like masses, consistent with central cementifying fibroma.

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    ORAL & mAXILLOFACIAL PATHOLOGY JOURNAL [ OMPJ ]

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    S.Sunil

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    Central cementifying fibroma is a rare fibro-osseous lesion arising from the periodontal ligament that is usually seen in tooth-bearing areas of the jaws. This case report describes a recurrent central cementifying fibroma lesion in the ramus of the mandible of a 34-year-old female patient. The affected bone was surgically resected and the deformity was repaired with a rib graft. Histopathological examination revealed moderately dense collagen fibers with bone spicules and cementum-like masses, consistent with central cementifying fibroma.

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    43 views4 pages

    S Sunil

    Uploaded by

    editorompj
    Central cementifying fibroma is a rare fibro-osseous lesion arising from the periodontal ligament that is usually seen in tooth-bearing areas of the jaws. This case report describes a recurrent central cementifying fibroma lesion in the ramus of the mandible of a 34-year-old female patient. The affected bone was surgically resected and the deformity was repaired with a rib graft. Histopathological examination revealed moderately dense collagen fibers with bone spicules and cementum-like masses, consistent with central cementifying fibroma.

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    of 4

    CENTRAL OSSIFYING FIBROMA OF MANDIBLE - A CASE REPORT

    * B.S. Sreenivasan ** Joseph Edward *** S. Sunil

    Abstract
    Central cementifying fibroma is a rare non odontogenic tumor coming in the group of fibro osseous
    lesion, arising from periodontal ligament and is usually seen in tooth bearing area. It can affect both
    the mandible and the maxilla, particularly the mandible. This bone tumour consists of highly cellular,
    fibrous tissue that contains varying amounts of calcified tissue resembling bone, cementum or both.
    Here we present a case of Central cementifying fibroma (recurrent) in a 34 year old female.

    The origin of OF is thought to be the


    Introduction
    periodontal membrane. Some Ossifying
    In 1971 WHO classified four types of
    fibromass do, in fact, contain prevalent
    cementum- containing lesions: fibrous
    cementum-like calcifications and others show
    dysplasia, ossifying fibroma, cementifying
    only bony material, but a mixture of the two
    fibroma and cemento-ossifying fibroma.
    types of calcification is commonly seen in a
    According to the second WHO classification,
    single lesion. It can occur at any age, however,
    benign fibro-osseous lesions in the oral and
    many authors confirmed that OF of the jaw
    maxillofacial regions were divided into two
    tended to occur middle-aged patients. OF of
    categories, osteogenic neoplasm and non-
    the jaw bone shows a predilection for females.
    neoplastic bone lesions; cementifying
    OF predominantly affects the craniofacial
    ossifying fibroma belonged to the former
    bone and rarely involves the long bones.
    category. However, the term ‘‘cementifying
    ossifying fibroma’’ was reduced to Ossifying
    fibroma[ OF ] in the new WHO classification
    in 2005.

    Oral & Maxillofacial Pathology Journal [ OMPJ ] Vol 1 No 1 Jan- Jun 2010 ISSN 0976-1225
    Case Report Histopathologically lesion is made of
    moderately dense bundles of collagen fibers

    A thirty four year old lady presented with a with moderate cellularity.There is presence of

    swelling in ramus of mandible. Swelling spicules of lamellated bone. Peripheral part of

    started eight years back and it was slowly lesion show discrete masses of cementum

    growing. Swelling was not painful.There was .With the above mentioned features diagnosis

    no history of dental pain or trauma She had of central cementifying fibroma was made.

    undergone surgery for the same 4 years back


    and diagnosis was cementoma.General
    examination revealed a moderately built lady
    with no other systemic problems.

    Extra oral examination revealed a uniform swelling


    extended from angle of mandible to condylar
    area ,and mandible was expanded 1cm in
    lateral direction. There was no rise of
    temperature over the lesion.Consistency of
    the swelling was hard and was not tender.
    Dental examination revealed no abnormalities.

    Radiographic examination revealed a


    radiolucency extending throughout right
    ramus .Central portion of radiolucency shows
    a radio opaque lesion near the lower part.
    Lower part of mandible was thinned out .

    Oral & Maxillofacial Pathology Journal [ OMPJ ] Vol 1 No 1 Jan- Jun 2010 ISSN 0976-1225
    Discussion variable mixture of bony trabeculae,
    The origin of cementoossifying fibroma is cementum like spherules or both.
    supposed to be from periodontal ligament
    .Age range of this tumor is from 20-40 years . Surgical contouring of affected bone or local
    In a study by Eversole females were five times resection and bone grafting is done
    more affected than males. In Summerlin and
    Tomich study females were affected twice
    Summary
    than males. Usually condition is painless but if
    a nerve is involved there can be pain.
    Central cementifying fibroma is a fibro
    Mandible is more affected than maxilla. It is a
    osseous lesion arising from periodontal
    relatively slow growing tumor and because of
    ligament and is usually seen in tooth bearing
    this , the cortical plates of bone and overlying
    area. Here we presented a lesion occurred in
    mucosa or skin are almost invariably
    ramus of mandible. It was a recurrent lesion
    intact.Growth of the tumor will be usually in
    probably due to inadequate curettage. The
    centrifugal manner. Usually lesion occurs in
    affected bone was surgically resected and
    tooth bearing area .Radiographic appearance
    deformity was repaired with rib graft.
    of lesion vary according to stage of
    development of tumor. In early stages it is
    radiolucent lesion with no evidence of internal
    radiopacities. As it matures , there is
    References :-
    increasing calcification sothat radiolucency
    becomes flecked with opacities and ultimately 1. Rajendran R, Sivapathasundaram B;Shafer’s
    appears as uniform radiopaque mass. Textbook of Oral Pathology, 6th edition. Elsevier,
    Sometimes peripheral portion show sclerotic 2009;129-130.
    margin .Lesion is always well circumscribed
    and demarcated from the surrounding bone 2. Neville BW, Damm DD, Allen CM, Bouquot
    in contrast to fibrous dysplasia . The JE, (ed). Oral & Maxillofacial Pathology, 3rd
    connective tissue is characterized by many edition. Saunders, 2009.
    small foci of irregular bony trabeculae, bearing
    3. Waldron CA, Giansanti JS. Benign fibro-osseous
    some similarity to the chineese-letter shape of
    lesions of the jaws: a clinical-radiologic-histologic
    trabeculae in fibrous dysplasia.It contains

    Oral & Maxillofacial Pathology Journal [ OMPJ ] Vol 1 No 1 Jan- Jun 2010 ISSN 0976-1225
    review of sixty-five cases. Oral Surg 1973;35:340– 5. Eversole LR, Merrell PW, Strub D. Radiographic
    350 characteristics of central ossifying fibroma. Oral Surg
    4. Bertrand B, Ely P, Cornelius JP, Gosseye S, Oral Med Oral Pathol 1985; 59: 522–527.
    Clotuche J, Gilliard C. Juvenile aggressive cemento- 6. Brademann G, Werner JA, Ja¨nig U, Mehdorn
    ossifying fibroma: case report and review of the HM, Rudert H. Cemento-ossifying fibroma of the
    literature. Laryngoscope 1994;103:1385–1390 petromastoid region: case report and review of the
    literature. J Laryngol Otol 1997; 111: 152–155

     *Professor, Dept. of Oral & Maxillofacial Pathology,Mar Baselios Dental College,


    Kerala
     ** Professor, Dept of Oral Surgery, Azeezia Dental College, Kerala.
     *** Reader, Dept. of Oral & Maxillofacial Pathology Mar Baselios Dental College,
    Kerala

    Oral & Maxillofacial Pathology Journal [ OMPJ ] Vol 1 No 1 Jan- Jun 2010 ISSN 0976-1225

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