Central osteoma of the maxilla: implant rehabilitation with immediate loading in fresh extraction socket

Solitary central osteomas of the jaw seem to be especially rare lesions; since 1955, only 12 cases have been reported and 4 of these were located in the maxilla. Osteomas are benign osteogenic lesions considered as real tumours but without infiltrative or metastatic potential. Their growth potential is usually limited, but certain rare and large cases of peripheral osteoma are described in literature. Although surgery is recommended, there are no reports of malignant transformation. In this study, we describe successful implant rehabilitation in a patient with a central osteoma of the maxilla with immediate loading in a fresh extraction socket.

The report concerns a 33-year-old woman with a compromised deciduous first molar in the left premolar region of the maxilla; an asymptomatic bony expansion of the palatal and vestibular sides of the left canine/premolar/molar area of the maxilla and by radiograph revealed a well-defined radiopaque mass. An immediate non-occlusal loading was performed, and complete loading of the implant was completed five months later.

The pathogenesis of these osteomas is unclear. Several authors reported a clear history of traumatic events, but others had no history of previous trauma or contributory medical factors. Since in our case no cancer growth happened over a period of more than four years, we decided to perform an immediate loading procedure during the implant rehabilitation. The outcome was successful.