Odontogenic fibromas are benign mesenchymal odontogenic tumors with varying amounts of fibrous connective tissue.
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Epidemiology
Odontogenic fibromas are rare tumors and are more common in women. Central odontogenic fibromas occur in a wide age range and peripheral odontomas have a peak between the second and fourth decade 1,2.
Clinical presentation
Peripheral odontogenic fibromas might present as exophytic gingival mass 1.
Complications
Odontogenic fibromas might cause root resorption 1.
Pathology
Subtypes
Odontogenic fibromas can be classified according to their location into central and peripheral odontogenic fibromas 1.
Location
Central odontogenic fibromas of the maxilla are usually located anteriorly, whereas central odontogenic fibromas of the mandibula often occur in the molar region 2. Peripheral lesions usually arise from gingival or alveolar mucosa 1,2.
Microscopic appearance
Histologically odontogenic fibromas are characterized by the following features 2,3:
- fibrous connective tissue background
- small nests, clusters and/or linear cords of inactive-looking odontogenic epithelium in variable amounts
- possible cementum-like calcifications
Radiographic features
Imaging features are generally described as well-defined and lytic with possible expansion and bone erosion.
Plain radiograph
Central odontogenic fibromas usually appear as unilocular radiolucencies with well-defined and sometimes sclerotic borders. Larger tumors can be multilocular 2.
Radiology report
A description of the following features should be included in the radiology report:
- type location and size of the tumor
- unilocular/multilocular
- relation to the adjacent structures and teeth
Treatment and prognosis
Treatment consists of enucleation and curettage. Peripheral lesions can be treated with simple excision and central lesions might be treated with laser excision 3. Recurrence is rare and can occur upon incomplete removal 2,3.