Oral Pathology: Fibro-Osseous Bone Lesions

Introduction

• Focus on benign tumors composed of fibrous tissue with new bony islands.
• Many lesions contain a radiopaque component due to osseous mineralized and fibrous tissue.

Central Ossifying Fibroma

• Composition: Fibroblastic stroma or connective tissue with mineralized products.
• Appearance: Radiolucent lesion with radiopaque specks of ossification.
• Location: Central lesions occur in bone, peripheral lesions in gum tissue.
• Juvenile Variant: Aggressive, rapid growth, affects younger population.
• Related Lesion: Cemento-ossifying fibroma (odontogenic tumor).
• Treatment: Surgical excision.

Fibrous Dysplasia

• Key Term: Ground-glass appearance, likened to fiberglass.
• Growth Pattern: Stops growing after puberty; may cause facial distortions before then.
• Syndrome: McCune-Albright Syndrome
  • Polyostotic fibrous dysplasia.
  • Cutaneous café-au-lait spots.
  • Endocrine abnormalities (e.g., precocious puberty).
• Treatment: Surgical recontouring post-puberty to minimize recurrence.

Periapical Cemento-Osseous Dysplasia (PICAOD)

• Nature: Reactive process of unknown origin.
• Common Location: Apices of mandibular anterior teeth.
• Demographics: Most common in middle-aged black females.
• Diagnosis: Teeth appear vital despite lesion appearance.
• Progression: Starts radiolucent, becomes radiopaque with radiolucent border.
• Treatment: Monitoring only.

Osteoblastoma

• Description: Circumscribed opaque mass of bone and osteoblasts.
• Appearance: Radiopaque due to mineralized tissue.
• Treatment: Surgical excision.

Conclusion

• Review of various fibro-osseous lesions with emphasis on appearance, location, and treatment.
• Encourage further study and monitoring of lesions for proper diagnosis and management.