Fibro-Osseous Lesions Of The Jaws: Radiologic Features And Differential Diagnosis
Özet
Fibro-osseous lesions of the jaws comprise a heterogeneous group of disorders with overlapping histopathological features but distinct biological behavior, radiological presentation, treatment strategies, and prognosis. Accurate diagnosis relies on the integration of clinical, radiological, and histopathological findings, with imaging playing a central role in lesion characterization and differential diagnosis. This chapter provides a comprehensive overview of the three principal benign fibro-osseous lesions of the jaws—fibrous dysplasia, cemento-osseous dysplasias, and ossifying fibroma. Their definitions, etiopathogenesis, epidemiology, clinical manifestations, radiological and histopathological characteristics, differential diagnosis, and treatment approaches are systematically reviewed. Particular emphasis is placed on radiological assessment, including lesion location, border characteristics, internal structure, maturation pattern, expansion behavior, and effects on adjacent anatomical structures. The contribution of cone-beam computed tomography (CBCT) to diagnosis and treatment planning is also highlighted. Comparative tables and practical radiological points are included to serve as a practical reference that supports differential diagnosis and clinical decision-making in everyday practice.
Referanslar
Neville BW, Damm DD, Allen CM, Chi AC. Oral and Maxillofacial Pathology. 5th ed. St. Louis: Elsevier; 2024.
Vered M, Wright JM. Update from the 5th edition of the World Health Organization Classification of Head and Neck Tumors: odontogenic and maxillofacial bone tumours. Head Neck Pathol. 2022;16:63-75. doi:10.1007/s12105-021-01404-7.
Pick E, Schäfer T, Al-Haj Husain A, Rupp NJ, Hingsammer L, Valdec S. Clinical, radiological, and pathological diagnosis of fibro-osseous lesions of the oral and maxillofacial region: a retrospective study. Diagnostics. 2022;12:238. doi:10.3390/diagnostics12020238.
Soluk-Tekkesin M, Sinanoglu A, Selvi F, Cakir Karabas H, Aksakalli N. The importance of clinical and radiological findings for the definitive histopathologic diagnosis of benign fibro-osseous lesions of the jaws: study of 276 cases. J Stomatol Oral Maxillofac Surg. 2022;123:364-371. doi:10.1016/j.jormas.2021.04.008.
Alsufyani N, Alzahrani A. Imaging of fibro-osseous lesions and other bone conditions of the jaws. Dent Clin North Am. 2024;68:297-317. doi:10.1016/j.cden.2023.09.005.
Lam EWN, Mallya SM. White and Pharoah’s Oral Radiology: Principles and Interpretation. 9th ed. St. Louis: Elsevier; 2025.
Baumhoer D, Haefliger S, Ameline B, Hartmann W, Amary F, Cleven A, et al. Ossifying fibroma of non-odontogenic origin: a fibro-osseous lesion in the craniofacial skeleton to be (re-)considered. Head Neck Pathol. 2022;16:257-267. doi:10.1007/s12105-021-01351-3.
Nemec SF, Schneider S, Friedrich KM, Weber M, Schwarz-Nemec U. Radiological follow-up of cemento-osseous dysplasia on cone-beam computed tomography. J Craniomaxillofac Surg. 2024;52:644-651. doi:10.1016/j.jcms.2024.03.008.
Günaçar DN, Köse TE, Arıcıoğlu B, Çene E. Retrospective radiological analysis of cemento-osseous dysplasia. Dent Med Probl. 2023;60(3):393-400. doi:10.17219/dmp/133405.
Nishimura S, Oda M, Habu M, Takahashi O, Tsurushima H, Otani T, et al. Imaging characteristics of embedded tooth-associated cemento-osseous dysplasia by retrospective study. Tomography. 2024;10:231-242. doi:10.3390/tomography10020018.
Pandiar D, Krishnan RP, Gopinath D, Reddy SSP, Veeraiyan DN, Vijayakumar G. Benign fibro-osseous lesions of the cranio-maxillofacial bones: an updated review with special emphasis on molecular pathogenesis. J Bone Miner Metab. 2026;44:1-17. doi:10.1007/s00774-025-01662-3.
Dewara ND, Sejati BP, Haryosuwandito E. Fibrous dysplasia of the jaws: four cases with conservative and resective surgical management. Case Rep Plast Surg Hand Surg. 2026;13(1):2646776. doi:10.1080/23320885.2026.2646776.
Kaur H, Mohanty S, Kochhar GK, Iqbal S, Verma A, Bhasin R, et al. Comprehensive management of malocclusion in maxillary fibrous dysplasia: a case report. World J Clin Cases. 2021;9(34):10671-10680. doi:10.12998/wjcc.v9.i34.10671.
Gresky J, Frotscher M, Thiem S, Stoessel A, Kalmykov A, Berezina N. Cemento-osseous dysplasia in a female Bronze Age skeleton (North Caucasus). Head Neck Pathol. 2025;19:28. doi:10.1007/s12105-025-01767-1.
Ko DE, Yoon JH, Kim AY, Song HM, Lee SB, Park WJ, et al. Cemento-osseous dysplasia mimicking periapical cyst after the orthodontic treatment of the mandible. J Craniofac Surg. 2025. doi:10.1097/SCS.0000000000011128.
Farias Morais HG, Colares DF, Souto Medeiros MR, Barros CCS, Morais EF, Miguel MCC, et al. Clinical, radiographic and histopathological analysis of cemento-ossifying fibromas and fibro-osseous lesions of the oral and maxillofacial region: a 53-year retrospective study and update of current concepts. J Oral Pathol Med. 2025;54:1062-1073. doi:10.1111/jop.70059.
Mishra D, Nayyar V, Viswanathan DJ, Jain T, Bhalla AS, Manchanda S, et al. Distinguishing the indistinct: a comparative clinicopathologic and radiologic analysis of cemento-ossifying fibroma, psammomatoid ossifying fibroma, and juvenile trabecular ossifying fibroma. Oral Maxillofac Surg. 2026;30:19. doi:10.1007/s10006-026-01507-x.
Patel JM, Joshi S, Pawar S, Nair V, Koranne V. Cemento-ossifying fibroma of the craniofacial region: a diagnostically challenging case report. Cureus. 2025;17(10):e94539. doi:10.7759/cureus.94539.
