612 Benign Fibro-Osseous Lesions of the Jaws

Fibrous dysplasia

- histology

Normal trabeculae w/ a lot of fibrous tissue in between

- Normal fibroblasts

- Not a malignancy

FIbrous dysplasia - radiographic

Ground glass appearance of involved bone

Central ossifying fibroma

- Radiographic

Well circumscibed radiolucency with or without radiopacities

- Has sclerotic border

- Grows slowly

-Txt: scoop out

Variant of Central Ossifying Fibroma

Juvenile Ossifying FIbroma

- Aggressive variant in younger children (1st decade of life)

- in midface

- often goes up by brain

- May be quiescent for long periods of time and then show rapid growth

- High recurrence rate: 30-50%

Central Ossifying Fibroma - histology

- Droplet-like calcifications

- More nuclei

- Not malignant but grows fast

Central Ossifying Fibroma - txt

Can frequently be removed by shelling out

Cemento-Osseous Dysplasia - 3 types

- Periapical cemento-osseous dysplasia

- Focal cemento-osseous dysplasia

- Florid cemento-osseous dysplasia

Cemento-Osseous Dysplasia - Radiographic appearance

Mixed RL/RP with defined rather than diffuse borders

Florid cemento-osseous dysplasia - radiographic

- Multiple quads

- Looks like cotton wool

- Good OHI and cleanings

- Do not go into lesion bc poorly vascularized

- Poor oxygenation to tissues

Florid cemento-osseous dysplasia - most frequent in which pop?

middle-aged African American females

Periapical cemento-osseous dysplasia - Radiographic

Mixed RL/RP lesions

- Do nothing, cleanings

Focal cemento-osseous dysplasia

- Can be anywhere

- Can be RL or RP

FCOD - what is it

= Focal cemento-osseous dysplasia

- A reactive lesion of PDL origin

- Prob most common lesion of alveolar bone

FCOD - diagnostic criteria

Cemento osseous dysplasia - histology

FCOD vs ossifying fibroma txt

- FCOD: radiographic follow-up

- COF: conservative total surgical removal

What is the typical age of presentation for fibrous dysplasia?

Before puberty

Describe the classical radiographic appearance of fibrous dysplasia

Ground glass

Describe the classical histologic appearance of fibrous dysplasia

Fibroblasts are normal, a lot of fibrous tissue w normal trabeculae

Why is a "watch and wait" approach sometimes best with fibrous dysplasia?

Usually resolves after puberty

Which fibro-osseous lesion is frequently found in middle aged African American women?

Florid cemento-osseous dysplasia