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Quick Review #128 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental
Fibro-osseous lesions of the jaw refer to a group of conditions characterized by the replacement of normal bone with a tissue mix comprising fibrous connective tissue and abnormal bone formations:
1. Fibrous Dysplasia
• Histology: Replaces normal bone with fibrous tissue and irregular bony trabeculae.
• Clinical Presentation: Can affect any bone, manifests as painless swelling or deformity, often unilateral.
• Radiographic Features: Appears as a "ground glass" opacity on X-rays, lacking clear boundaries.
2. Ossifying Fibroma
• Histology: Composed of fibrous tissue with varying amounts of calcified material.
• Location: Frequently affects the mandible more than the maxilla.
• Treatment: Surgical excision is typically curative with a low recurrence rate.
3. Cemento-Osseous Dysplasia
• Demographics: More common in middle-aged black women.
• Radiographic Features: Shows mixed radiolucent and radiopaque lesions, often around the tooth apices.
• Symptoms: Generally asymptomatic, discovered incidentally on radiographs.
4. Juvenile Ossifying Fibroma
• Aggressiveness: More aggressive than standard ossifying fibroma, with a higher recurrence rate.
• Clinical Presentation: Rapid growth, which may lead to facial asymmetry and displacement of teeth.
• Subtypes: Includes trabecular and psammomatoid variants, each with distinct histological features.
5. Desmoplastic Fibroma
• Histology: Mimics the fibrous tissue of desmoid tumors of soft tissue, very rare in jaws.
• Clinical Features: Slowly enlarging, may cause significant bone expansion.
• Treatment: Often requires surgical resection due to its expansive nature.
6. Central Giant Cell Granuloma
• Location: Predominantly affects the mandible.
• Radiographic Features: Presents as a radiolucent lesion, often multilocular.
• Clinical Presentation: May cause pain, swelling, and root resorption of teeth.
7. Peripheral Giant Cell Granuloma
• Histology: Features multinucleated giant cells, hemorrhage, and reactive bone formation.
• Clinical Presentation: Appears as a red-purple lesion usually arising from the gum.
• Location: Exclusively occurs on the gingiva or edentulous alveolar margins.
8. Cemento-Ossifying Fibroma
• Histology: Contains fibrous tissue and mineralized components resembling bone and cementum.
• Radiographic Features: Well-defined, mixed radiolucent-radiopaque lesion.
• Treatment: Surgical excision is effective, with good prognosis after complete removal.
References:
1. Reichart, P. A., & Philipsen, H. P. (2018). Odontogenic tumors and allied lesions. Journal of Oral and Maxillofacial Surgery, 76(9), 1935.e1-1935.e12. https://lnkd.in/e8nFiRVB
2. Neville, B. W., Damm, D. D., Allen, C. M., & Chi, A. C. (2015). Oral and Maxillofacial Pathology (4th ed.). Saunders.
3. ChatGPT. 2024.