“What Are 8 Lesions of the Jaw with Fibro-Osseous Characteristics?”

4.25.24 - #podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast Quick Review #128 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental Fibro-osseous lesions of the jaw refer to a group of conditions characterized by the replacement of normal bone with a tissue mix comprising fibrous connective tissue and abnormal bone formations: 1. Fibrous Dysplasia • Histology: Replaces normal bone with fibrous tissue and irregular bony trabeculae. • Clinical Presentation: Can affect any bone, manifests as painless swelling or deformity, often unilateral. • Radiographic Features: Appears as a "ground glass" opacity on X-rays, lacking clear boundaries. 2. Ossifying Fibroma • Histology: Composed of fibrous tissue with varying amounts of calcified material. • Location: Frequently affects the mandible more than the maxilla. • Treatment: Surgical excision is typically curative with a low recurrence rate. 3. Cemento-Osseous Dysplasia • Demographics: More common in middle-aged black women. • Radiographic Features: Shows mixed radiolucent and radiopaque lesions, often around the tooth apices. • Symptoms: Generally asymptomatic, discovered incidentally on radiographs. 4. Juvenile Ossifying Fibroma • Aggressiveness: More aggressive than standard ossifying fibroma, with a higher recurrence rate. • Clinical Presentation: Rapid growth, which may lead to facial asymmetry and displacement of teeth. • Subtypes: Includes trabecular and psammomatoid variants, each with distinct histological features. 5. Desmoplastic Fibroma • Histology: Mimics the fibrous tissue of desmoid tumors of soft tissue, very rare in jaws. • Clinical Features: Slowly enlarging, may cause significant bone expansion. • Treatment: Often requires surgical resection due to its expansive nature. 6. Central Giant Cell Granuloma • Location: Predominantly affects the mandible. • Radiographic Features: Presents as a radiolucent lesion, often multilocular. • Clinical Presentation: May cause pain, swelling, and root resorption of teeth. 7. Peripheral Giant Cell Granuloma • Histology: Features multinucleated giant cells, hemorrhage, and reactive bone formation. • Clinical Presentation: Appears as a red-purple lesion usually arising from the gum. • Location: Exclusively occurs on the gingiva or edentulous alveolar margins. 8. Cemento-Ossifying Fibroma • Histology: Contains fibrous tissue and mineralized components resembling bone and cementum. • Radiographic Features: Well-defined, mixed radiolucent-radiopaque lesion. • Treatment: Surgical excision is effective, with good prognosis after complete removal. References: 1. Reichart, P. A., & Philipsen, H. P. (2018). Odontogenic tumors and allied lesions. Journal of Oral and Maxillofacial Surgery, 76(9), 1935.e1-1935.e12. https://lnkd.in/e8nFiRVB 2. Neville, B. W., Damm, D. D., Allen, C. M., & Chi, A. C. (2015). Oral and Maxillofacial Pathology (4th ed.). Saunders. 3. ChatGPT. 2024.