CEMENTIFYING FIBROMA PDF

Looking for online definition of cementifying fibroma in the Medical Dictionary? cementifying fibroma explanation free. What is cementifying fibroma? Meaning of . The term “cementifying fibroma” was originally applied to the lesion of the mandibular incisor teeth now referred to as “periapical cemental dysplasia” ( Pindborg. Cemento-ossifying fibroma (COF) are rare, benign neoplasms that usually arise from the mandible or maxilla. They most often arise from the tooth bearing areas .

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Cementifying fibroma is considered as a benign, osseous tumour, which arises from the periodontal ligament and is composed of varying amounts of cementum, bone and fibrous tissue. It is very closely related to other fibro-osseous lesions like fibrous dysplasia, cemental periapical dysplasia and other calcifying odontogenic cysts and tumour.

Case Report: Cementifying fibroma

We report a case of this entity along with differentiating radiographic features that set it apart from other fibro-osseous lesions. Menzel in first described ossifying fibroma. Cementifying fibroma is designated as a benign fibrmoa of fibro-osseous lesions with well circumscribed, slow growing and sharply defined margins with a radiolucent peripheral component.

This is reported commonly in women in the mandibular region but in this paper we summarise the clinical presentation of this rare entity in a male patient in the posterior maxillary region along with a review of literature. A year-old male patient figure 1 A reported to the outpatient department with a large swelling on the left side of upper back tooth region.

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There was no history of associated pain or trauma. Nothing noteworthy was noted in dental, medical and family history. There was considerable buccopalatal expansion, completely involving the buccal vestibule.

Cfmentifying overlying mucosa was smooth and intact. On palpation, the swelling was soft to firm in consistency with well-defined borders and non-tender on palpation.

There was no history of surface discolouration or discharge figure 1 B. On the basis of these clinical findings, a working diagnosis of benign odontogenic tumour was made and radiographic investigations were advised. The radiographic investigations maxillary cross-sectional occlusal radiograph, orthopantomogram and extraoral paranasal sinus view revealed a well-defined, mixed radiolucent-radiopaque lesion surrounded by a sclerotic margin.

Histopathology revealed microscopic diagnosis of cementifying fibroma and thus a final diagnosis of cementifying fibroma was given. A Clinical photograph of extraoral facial profile of the patient.

There was considerable bucco-palatal expansion, completely involving the buccal vestibule. A Maxillary cross-sectional occlusal radiograph demonstrated a round-shaped well-defined radiolucent lesion extending from 24 to 27 region.

It had sharp, sclerotic margin and spots of radiopacity were visible in the centre along the anterior margins. B Orthomopantogram revealed the presence of well-defined radiolucency in the region of 24, 25, 26, PNS demonstrated a mixed radiopaque—radiolucent lesion in left posterior maxillary region. Histopathology demonstrated increased number of collagen fibres which were haphazardly oriented. Whorled pattern was also seen.

Small, ovoid basophilic deposits of cementum like material randomly fibro,a were also present. No reoccurrence was reported suggesting a good prognosis. Maxillofacial fibro-osseous lesions comprise a group of face and jaw disorders which are characterised by replacement of normal bone by benign connective tissue matrix with varying amounts of mineralised substances. Earlier, it was classified as two different entities depending upon whether the bone ossifying fibroma or cementum fibrroma fibroma forms the major calcified product.

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In the past it was classified as Various hypotheses have been put forward to explain its aetiopathogenesis and the most widely accepted one considers it to be a tumour of periodontal origin. It is thought to arise from multipotent mesenchymal blast cells present in the periodontal membrane, which have the capacity to produce cementum, alveolar bone and fibrous tissue.

Clinically, fibroka presents as painless, slow-growing mass in the jaws where displacement of teeth is the only early clinical feature.

Cemento-ossifying fibroma | Radiology Reference Article |

If present in maxilla, it may cause cortical expansion, obliterating the buccal sulcus extending into nasal cavity and orbital floor and may lead to epistaxis and ce,entifying euphoria. This lesion has a strong cementifyinb predilection, affecting females twice as common as males. Second, it is more commonly seen in the mandible than in fivroma maxilla. The favourite sites in the mandible are typically areas inferior to premolars and molars and superior to the inferior alveolar canal.

Radiographic features are of utmost importance as they help to distinguish it from other closely mimicking fibro-ossseous lesions. The lesion may be either unilocular or multilocular. In early stages, it appears as a radiolucent lesion with no evidence of radiopacity.

As the lesion matures, it assumes mixed radiolucent—radiopaque density cementifyijg a pattern that depends on the amount and form of manufactured cementifyiing material. In a study performed by Toyosawa et al6 it was reported that cementifying fibroma usually presents with following radiographic features: In our case, a mixed radiopaque—radiolucent pattern was seen. Another interesting feature is the centrifugal growth pattern rather than linear, so the lesion grows by expansion equally in all direction and presents a round mass as seen in our patient.

Takakazu et al 8 conducted a clinical ccementifying analysis of eight cases of cementifying fibroma and observed that out of eight, three demonstrated cystic radiographic appearance, four revealed mottled radiographic appearance while foffy appearance was seen in only one patient.

The borders of cementifying fibroma lesions are usually well defined. A thin radiolucent line representing a fibrous capsule may separate it from surrounding bone. Sometimes, the bone next to lesion develops a sclerotic border. Large size of the lesion along with aggressive behaviour may prompt the clinician to go for biopsy and the characteristic features revealed in histopathology are haphazardly arranged collagen fibres, although a whorled pattern may also be seen.

Calcified deposits are noted throughout the fibrous stoma. Irregular trabeculae of lamellar cementifhing are also evident. Apart from these, calcified material in the form of small, ovoid, globular, basophilic deposits may also be seen. Treatment of cemento-ossifying fibroma generally has been by conservative enucleation or curettage or fibrooma surgery depending on the size and location of the individual lesion. Mandibular central cemento-ossifying fibromas usually shell out easily at surgery, but maxillary central cemento-ossifying fibromas are more difficult to remove completely than mandibular central cemento-ossifying fibromas.

This may be attributable to the difference in bone character between the mandible and maxilla and to the available apace for expansion in the maxillary sinus. Conservative surgery is therefore recommended even if the tumour is large with bowing and erosion of the inferior border of the mandible and radical treatment of the tumour such as an en bloc resection should only be considered if there are recurrences due to its aggressive nature.

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Other authors, however, advocate more extensive surgery for more aggressive lesions and lesions involving craniofacial bones in light of the potential for recurrence. Cemenntifying and peer review: Not commissioned; externally peer reviewed.

National Center for Biotechnology InformationU. Published online Jul Author information Copyright and License information Disclaimer. Abstract Cementifying fibroma is considered as a benign, osseous tumour, which arises from the periodontal ligament and cemetnifying composed of varying amounts of cementum, bone and fibrous tissue. Background Menzel in first described ossifying fibroma. Case presentation A year-old male patient figure 1 A reported to the outpatient department with a large swelling on the cementifing side of upper back tooth region.

Open in a separate window. The maxillary cross-sectional occlusal radiograph demonstrated a round-shaped well-defined radiolucent lesion extending fiibroma 24 to 27 region. It had sharp, sclerotic margin and spots of radiopacity were visible in the centre and along the anterior margins figure fibgoma A.

The orthopantomogram revealed the presence of well-defined radiolucency in 24, 25, 26, 27 regions figure 2 B. Apart from these, calcified material in the form of small, ovoid, globular, basophilic deposits may also be seen figure 3. Differential diagnosis Postextraction socket or residual cyst in early radiolucent stage, radiographic features of cementifying fibroma and these two are similar but the positive history of extraction helps to distinguish the latter.

Ameloblastoma occurs in the posterior part of the mandible, fibromma appearance and cementifyjng may cause paraesthesia of lip. Periapical cemental dysplasia associated with vital teeth, usually in the lower anterior teeth, does not cause displacement of teeth.

Osteogenic sarcoma ill-defined borders with periosteal bone formation. These are rapid growing lesions and do not have surrounding fibrous capsule. Discussion Maxillofacial fibro-osseous lesions comprise a group of face and jaw disorders which are characterised by replacement of normal bone by benign connective tissue fibrona with varying amounts of mineralised substances. In the past it was classified as 3: Cementifying fibroma is round in shape and causes nodular or dome shaped jaw expansion while fibrous dysplasia is rectangular and causes elongated fusiform expansion.

The margins are sharply defined in cementifying fibroma while the margins are instinct, blending with normal bone in fibrous dysplasia. Cementifying fibroma has a wide age range from 7—58 years while the mean age in fibrous dysplasia is 20 years. Ann Essences Dent ; Cemento-ossifying fibroma—a rare case report. Ind J Radiol Imag ; Med Oral ; Ossifying fibroma vs fibroma of jaw: Modern Path ; Eight cases of cementifying fibroma of jaws. Japanese Soc Oral Maxillofac Radiol ; Textbook of oral pathology.

Bilateral cemento-ossifying fibroma of maxillary sinus. Br J Radiol ; Cemento-ossifying fibroma with mandibular fracture. Case report in a young patient. Aust Dent J ; Oral pathology-clinical pathologic correlations. WB Saunders Co, Slootweg PJ, Muller H.

J Cranio-Max-Fac Surg ; Fibrous dysplasia and ossifying fibroma of the paranasal sinuses. J Laryngol Otol ;