Ossifying fibroma: A systemic review

Division of Oral & Maxillofacial Radiology, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada.
Dentomaxillofacial Radiology (Impact Factor: 1.39). 12/2009; 38(8):495-513. DOI: 10.1259/dmfr/70933621
Source: PubMed


The aim was to evaluate the principal features of ossifying fibroma (OF) by systematic review (SR), and to compare their frequencies among four global groups.
The databases searched were the PubMed interface of MEDLINE and LILACS. Only those reports of OFs that occurred in a series in the reporting authors' caseload were considered. All cases were confirmed fibro-osseous lesions histopathologically. The SR-included series had also to have used radiographs.
Of the 64 reports (including the Hong Kong report) considered, 32 reports and a total of 781 cases were included in the SR. Ten SR-included series were in languages other than English. OF affected females more frequently, but was three times more prevalent in the mandible. The mean age at first presentation was 31 years. The decade with the greatest frequency was the fourth. Females were in the majority except in the first decade. The main symptom in 66% of all SR-included cases was swelling (including deformation of the jaws). 31% were found incidentally. 84% of cases displayed buccolingual expansion; half of the mandibular cases exhibited downward displacement of the lower border of the mandible and 90% of maxillary cases involved the maxillary antrum. Only 28% of reports included follow-up; 12% of cases recurred or were reactivated.
Although long-term follow-up of large series that would have revealed the long-term outcomes of OF was lacking, a 12% recurrence rate is clinically significant and suggests that OFs should be considered for long-term follow-up.

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    • "Cemento-ossifying fibroma was the most common lesion within this subgroup, which was in contrast to the results of Ali [7], who reported central giant cell granuloma to be the most common lesion. Most cemento-ossifying fibromas were located in the mandible, and were diagnosed most frequently in the fourth decade of life in the current study, which was the same as the data of MacDonald-Jankowski [29]. Cemento-osseous dysplasia was the second most common lesion, most documented in the fifth and sixth decades of life, and mostly in females; all these findings were compatible with the study of Alsufyani & Lam [30]. "
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    ABSTRACT: Introduction A study of the whole spectrum of biopsied head and neck (HN) diseases in Taiwan has not yet been performed. Therefore, the current study aimed to provide updated information about HN lesions in a cohort of referral Taiwanese patients for histopathological examination. Methods HN lesions (2000–2011) in patients with records of age, sex, and histological diagnoses were retrieved from the Oral Pathology Department of the institution. These lesions were classified into four main categories: tumor/tumor-like reactive lesions, cystic/pseudocystic lesions, inflammatory/infective lesions, and others/miscellaneous lesions. Results A total of 37,210 HN lesions were included in the current study. Most of these lesions were distributed in the group of tumor/tumor-like reactive lesions, followed by the groups of inflammatory/infective lesions, cystic/pseudocystic lesions, and others/miscellaneous lesions. Squamous cell carcinoma was the most common HN lesion, and was also the most frequent malignant lesion among the referral patients. Conclusion It was worthy of note that squamous cell carcinoma and oral potentially malignant disorders comprised high percentages of all HN lesions for the present cohort of referral patients.
    Full-text · Article · Jul 2014 · Head & Face Medicine
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    • "Currently, complete surgical removal of the affected bone is widely recommended in the management of OF. However, patients often suffer from difficult reconstruction with postsurgical disfigurement, high and unpredictable recurrence rates, and major loss of vital tissues (MacDonald-Jankowski, 2009). Therefore, more appropriate treatments for OF are needed. "
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    ABSTRACT: Abnormal stem cell function makes a known contribution to many malignant tumors, but the role of stem cells in benign tumors is not well understood. Here, we show that ossifying fibroma (OF) contains a stem cell population that resembles mesenchymal stem cells (OFMSCs) and is capable of generating OF-like tumor xenografts. Mechanistically, OFMSCs show enhanced TGF-β signaling that induces aberrant proliferation and deficient osteogenesis via Notch and BMP signaling pathways, respectively. The elevated TGF-β activity is tightly regulated by JHDM1D-mediated epigenetic regulation of thrombospondin-1 (TSP1), forming a JHDM1D/TSP1/TGF-β/SMAD3 autocrine loop. Inhibition of TGF-β signaling in OFMSCs can rescue their abnormal osteogenic differentiation and elevated proliferation rate. Furthermore, chronic activation of TGF-β can convert normal MSCs into OF-like MSCs via establishment of this JHDM1D/TSP1/TGF-β/SMAD3 autocrine loop. These results reveal that epigenetic regulation of TGF-β signaling in MSCs governs the benign tumor phenotype in OF and highlight TGF-β signaling as a candidate therapeutic target.
    Full-text · Article · Nov 2013 · Cell stem cell
    • "Fibroosseous lesions present a diagnostic dilemma owing to overlapping clinical and histopathological findings. A differential diagnosis of fibrous dysplasia, malignant bony tumors, aneurysmal bone cyst, central giant cell granuloma, osteogenic sarcoma, osteoblastoma, Calcifying Odontogenic cyst, Adenomatoid Odontogenic Tumor and primordial cysts (keratocyst) should be considered.[4520] Fibrous dysplasia can be ruled out as it typically blends with normal bone at the margin of the lesion and has less cellular stroma, and its osteoid does not exhibit osteoblastic rimming and large amount of lamellar bone is found rather than woven bone.[51819] "
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    ABSTRACT: Juvenile ossifying fibroma (JOF) is a rare controversial fibroosseous lesion affecting the craniofacial skeleton and occurring commonly in children and young adults. It is highly aggressive and has a high tendency to recur. It is distinguished from the adult variant of ossifying fibroma on the basis of age, site, clinical behavior and microscopic appearance. Because of its high recurrence rate, which is 30-58%, complete excision is essential. Early diagnosis will circumvent the necessity of radical treatment. We report a rare case of trabecular JOF of maxilla where a computed tomography scan was taken to further support the characteristic feature of the lesion.
    No preview · Article · Apr 2012
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