Citation, DOI & article data
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.
Treatment and prognosis
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.
- 1. Paul M. Speight, Takashi Takata. New tumour entities in the 4th edition of the World Health Organization Classification of Head and Neck tumours: odontogenic and maxillofacial bone tumours. (2018) Virchows Archiv. 472 (3): 331. doi:10.1007/s00428-017-2182-3
- 2. Chrcanovic B, Chrcanovic GR, Chrcanovic. Ameloblastic Fibrodentinoma and Ameloblastic Fibro-Odontoma: An Updated Systematic Review of Cases Reported in the Literature. (2017) Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. doi:10.1016/j.joms.2016.12.038 - Pubmed
- 3. Surej Kumar LK, Manuel S, Khalam SA, Venugopal K, Sivakumar TT, Issac J. Ameloblastic fibro-odontoma. International journal of surgery case reports. 5 (12): 1142-4. doi:10.1016/j.ijscr.2014.11.025 - Pubmed
- 4. Buchner A, Kaffe I, Vered M. Clinical and radiological profile of ameloblastic fibro-odontoma: an update on an uncommon odontogenic tumor based on a critical analysis of 114 cases. Head and neck pathology. 7 (1): 54-63. doi:10.1007/s12105-012-0397-9 - Pubmed
- 5. Aslıer M, Ecevit MC, Sarıoğlu S, Sütay S. A Case of Ameloblastic Fibroodontoma Extending Maxillary Sinus with Erupted Tooth: Is Transcanine Approach with Alveolectomy Feasible?. Case reports in otolaryngology. 2016: 8594074. doi:10.1155/2016/8594074 - Pubmed
- 6. Takeda Y, Tomich CE. Ameloblastic ﬁbro-odontoma. In: Leon Barnes, World Health Organization, International Agency for Research on Cancer. Pathology and Genetics of Head and Neck Tumours. ISBN: 9789283224174