Maxillofacial fibro-osseous lesions

Area of Science:

• Oral and Maxillofacial Radiology
• Pathology
• Dental Surgery

Background:

• Recent advancements have significantly altered the understanding of fibro-osseous lesions (FOLs) of the jaws.
• Changes encompass imaging, nomenclature, classification, and potential systemic health implications.
• Distinguishing between fibrous dysplasia (FD), ossifying fibroma (OF), and osseous dysplasia (OD) remains challenging due to similar histopathology but distinct clinical behaviors.

Purpose of the Study:

• To review the updated understanding of jaw FOLs, including nomenclature, classification, and associated syndromes.
• To highlight the distinct clinical and radiological presentations, behaviors, and treatment outcomes of FD, OF, and OD.
• To discuss the central role of radiology, particularly cone-beam computed tomography (CBCT), in diagnosing FOLs.

Main Methods:

• Review of current literature and clinical guidelines on jaw FOLs.
• Analysis of diagnostic criteria and imaging modalities, with a focus on CBCT.
• Inclusion of a flowchart to illustrate classification and management pathways.

Main Results:

• FD requires lifelong monitoring due to potential reactivation; OF necessitates surgical excision to prevent recurrence; OD typically requires no treatment unless symptomatic.
• Radiology is crucial for diagnosis as histopathology alone cannot differentiate these lesions.
• CBCT has transformed FOLs imaging due to improved resolution, accessibility, and reduced radiation dose.

Conclusions:

• Accurate diagnosis and tailored management of jaw FOLs are essential for optimal patient outcomes.
• CBCT is a valuable tool for imaging FOLs, guiding clinical decisions.
• Continued vigilance and appropriate follow-up are necessary for managing these lesions.