Clinical, Radiological, and Pathological Diagnosis of Fibro-Osseous Lesions of the Oral and Maxillofacial Region: A Retrospective Study

Ellen Pick; Tobias Schäfer; Adib Al-Haj Husain; Niels J Rupp; Lukas Hingsammer; Silvio Valdec

doi:10.3390/diagnostics12020238

Clinical, Radiological, and Pathological Diagnosis of Fibro-Osseous Lesions of the Oral and Maxillofacial Region: A Retrospective Study

Diagnostics (Basel). 2022 Jan 19;12(2):238. doi: 10.3390/diagnostics12020238.

Authors

Ellen Pick¹, Tobias Schäfer¹, Adib Al-Haj Husain¹, Niels J Rupp², Lukas Hingsammer³, Silvio Valdec^{1

4}

Affiliations

¹ Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland.
² Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
³ Department of Oral and Maxillofacial Surgery, Medical University of Vienna, 1090 Vienna, Austria.
⁴ Department of Stomatology, Division of Periodontology, Dental School, University of São Paulo, Butantã 2227, SP, Brazil.

Abstract

Background: Fibro-osseous lesions (FOL) of the jaw represent a rare, benign group of lesions that share similar clinical, radiological, and histopathological features and are characterized by progressive, variable replacement of healthy bone tissue by fibrous connective tissue.

Methods: This retrospective study aimed to evaluate the incidence of fibro-osseous lesions and to reassess the efficacy of case-specific treatment management from a clinical, radiological, and histopathological perspective based on 14 years of data.

Results: Forty-four patients with a radiological and/or histopathological diagnosis of benign FOLs were identified and re-evaluated. Cemento-osseous dysplasia was the most common group of FOLs present in our patient cohort (45%), followed by ossifying fibroma (39%) and fibrous dysplasia (16%). The diagnostic imaging technique of choice was CBCT (68%), followed by PAN (18%), with most patients (95 %) additionally undergoing biopsy. The mean age of the patients at the time of diagnosis was 40.54 ± 13.7 years, with most lesions being located in the mandible (86%), with females being predominantly affected (73%).

Conclusion: An interdisciplinary approach that analyzes all case-specific factors, including demographic data, medical history, intraoperative findings, and, most importantly, histopathological and radiological features, is essential for an accurate diagnosis and key to avoiding inappropriate treatment.

Keywords: benign tumor; cemento-osseous dysplasia; demographics; fibro-osseous lesions; fibrous dysplasia; histology; oral anatomy; ossifying fibroma; radiology.