Ameloblastic Fibroma: Clinical Perspectives on a Rare Odontogenic Lesion

Ameloblastic fibroma (AF) is a rare non-cancerous growth in the jaw that involves abnormal development of the epithelial and connective tissue parts of a tooth. A 33-year-old female presented with bleeding gums, mobile anterior mandibular teeth, and persistent halitosis. Initial oral examination and orthopantomogram revealed a unilocular radiolucent lesion with partially sclerotic borders, associated with an unerupted supernumerary tooth in the mandibular ramus. Computed tomography demonstrated cortical plate thinning around the lesion. Given the clinical and radiographic presentation, a differential diagnosis included odontogenic keratocyst and ameloblastoma. Histopathological evaluation following incisional biopsy and surgical enucleation performed under local anesthesia confirmed the diagnosis of AF, characterized by distinctive epithelial islands and mesenchymal stroma. This case highlights the imperative for meticulous differential diagnosis, supported by histopathological examination, to distinguish AF from related lesions with overlapping features. Given its potential for recurrence and the rare risk of malignant transformation into ameloblastic fibrosarcoma, long-term radiologic surveillance remains essential for optimal patient management.