Central Odontogenic Fibroma & Central Osteoma of The Mandible

Healthy Female, age 29 years. The tumor was developed without any clinical symptoms for about 2 years. Maybe changes at the cellular level led to pulpitis and second to pulp necrosis 46. The endodontic treatment was not carried out correctly, due to significant obliteration of the root canals 46. A revision of the area 46 was made, the tumor was removed (highly mineralized part similar to osteoma and granulation tissue from area around). We made a root resections of tooth 46 with retrograde filling of the root canals using MTA. We filled the bone defect with Bond Apatite (1 cc).

Histopathological study showed the presence of a odontogenic fibroma structure in granulation tissue and osteoma in mineralized part. We observed a good healing of bone and soft tissue in 2 years months follow-up.

Figure 1. Panoramic. Visible changes of the bone structure in area 46-47

Figure 2. X-ray confirmed the changes . Visible highly mineralized part in the middle of the tumor reg.46 and smaller in reg 47

Figure 3. Cbct. Confirmation of the panoramic view

Figure 4.No tumor infiltration of bone laminae. Nerve canal covered with bone tissue.

Figure 5.Endodontic treatment ineffective due to canal obliteration

Figure 6. Operation view

Figure 7. Enucleated mineralized element looks like osteoma

Figure 8. Histological structure of the osteoma (hard part of tumor)

Figure 9. Histological structure of the granulation-odontogenic fibroma(

Figure 10. X-ray after surgery

Figure 11. Half-panoramic 3 months after surgery

Figure 12. Normal healing of the soft tisuue after 3 months

Figure 13. Control X-ray after 6 months

Figure 14. Panoramic after 6 months

Figure 15. Cbct 6 months

Figure 16. Cbct 6 months

Figure 17. Cbct 6 months

Figure 18. Cbct 6 months

Figure 19. Cbct after 6 months

Figure 20. Panoramic after 2 years