Ossifying fibroma: a systematic review

The aim was to evaluate the principal features of ossifying fibroma (OF) by systematic review (SR), and to compare their frequencies among four global groups.

The databases searched were the PubMed interface of MEDLINE and LILACS. Only those reports of OFs that occurred in a series in the reporting authors' caseload were considered. All cases were confirmed fibro-osseous lesions histopathologically. The SR-included series had also to have used radiographs.

Of the 64 reports (including the Hong Kong report) considered, 32 reports and a total of 781 cases were included in the SR. Ten SR-included series were in languages other than English. OF affected females more frequently, but was three times more prevalent in the mandible. The mean age at first presentation was 31 years. The decade with the greatest frequency was the fourth. Females were in the majority except in the first decade. The main symptom in 66% of all SR-included cases was swelling (including deformation of the jaws). 31% were found incidentally. 84% of cases displayed buccolingual expansion; half of the mandibular cases exhibited downward displacement of the lower border of the mandible and 90% of maxillary cases involved the maxillary antrum. Only 28% of reports included follow-up; 12% of cases recurred or were reactivated.

Although long-term follow-up of large series that would have revealed the long-term outcomes of OF was lacking, a 12% recurrence rate is clinically significant and suggests that OFs should be considered for long-term follow-up.