Ameloblastic fibro-odontoma

Last revised by Andrea Molinari on 4 Jun 2022

Ameloblastic fibro-odontoma (AFO) is a rare benign mixed odontogenic lesion that usually arises in the maxilla and mandible. Once classified as a distinct entity, the lesion resembles an ameloblastic fibroma but contains hard odontoid tissue. It is now thought to represent part of the spectrum of histological changes seen in a developing odontoma.1

Ameloblastic fibro-odontoma is most frequently diagnosed in the 1st and 2nd decades of life with a peak age between 8 and 12 years and is more prevalent in males. 2

The prevalence of ameloblastic fibro-odontoma is in the range of 0-3.4% within odontogenic tumors among different regions.

Clinical presentation is with painless swelling, more common in the mandible than maxilla2, and delayed tooth eruption in the affected region.

Ameloblastic fibro-odontoma was classified as a benign tumor with odontogenic epithelium with odontogenic ectomesenchyme, with or without hard tissue formation according to 2005 WHO classification of odontogenic tumors. The latest WHO Classification has removed AFO (and the similar entity ameloblastic fibro-dentinoma) as distinct entities, and they are now part of the spectrum of odontomas. 

The lesion contains soft and hard tissue components, which resemble dental papilla and foci of enamel and dentin, respectively.

Ameloblastic fibro-odontoma is usually a well-defined unilocular radiolucent mass having a variable amount of radiopaque material within it and is often associated with the crown of an unerupted tooth/teeth.

Conservative surgical enucleation is the treatment of choice in well defined non-aggressive lesions. However, in destructive lesions, surgical resection with partial maxillectomy or partial mandibulectomy may be required. Recurrence is uncommon but can occur as a result of inadequate surgical removal.

Consderations include

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Cases and figures

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