A Clinical, Radiological and Histopathological Review of 74 Ossifying Fibromas

Area of Science:

• Oral and Maxillofacial Pathology
• Fibro-osseous Lesions
• Tumor Classification

Background:

• Ossifying fibroma (OF) is a fibro-osseous lesion affecting the jaws and craniofacial bones.
• Accurate diagnosis of OF is often difficult due to overlapping clinicopathological features.
• This study investigates features to aid OF diagnosis and subtype classification.

Purpose of the Study:

• To evaluate clinical, radiological, and histological features of ossifying fibroma.
• To identify characteristics for categorizing OF into juvenile trabecular, psammomatoid, and cemento-ossifying subtypes.
• To assess the diagnostic utility of histological features for OF subtyping.

Main Methods:

• Systematic review of 74 ossifying fibroma cases.
• Radiographic assessment of 46 cases for size, location, and tooth relationship.
• Histological analysis and stereological point counting of 69 cases for calcification patterns, stroma, borders, and secondary changes.
• Statistical analysis (Fisher's exact, Chi-squared tests) to correlate clinicopathological parameters with lesion characteristics.

Main Results:

• Ossifying fibroma exhibits a female predilection (2:1) and a bimodal age distribution (peaks in 2nd and 4th decades).
• The mandible is the most common site (73%), often presenting as intra-oral swelling (83%).
• Histologically, mixed trabecular and psammomatoid features were observed in 50% of cases, but no significant differences were found between variants regarding age, gender, or histology.

Conclusions:

• Histological features alone are insufficient to differentiate between the subtypes of ossifying fibroma.
• Clinical and radiological features may play a more significant role in OF diagnosis and classification.
• Further research may be needed to identify reliable markers for OF subtype differentiation.