Central Cemento-Ossifying Fibroma: Primary Odontogenic or Osseous Neoplasm?

• Published in: Journal of oral and maxillofacial surgery Vol. 73; no. 12; pp. S87 - S93
• Main Author: Woo, Sook-Bin, DMD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2015
• Subjects: Adolescent; Adult; Age Factors; Bone Matrix - pathology; Bone Neoplasms - diagnosis; Bone Neoplasms - pathology; Cementoma - diagnosis; Cementoma - pathology; Child; Dental Cementum - pathology; Dentistry; Diagnosis, Differential; Female; Fibroblasts - pathology; Fibrous Dysplasia of Bone - diagnosis; Fibrous Dysplasia of Bone - pathology; Humans; Jaw Neoplasms - diagnosis; Jaw Neoplasms - pathology; Male; Odontogenesis - physiology; Odontogenic Tumors - diagnosis; Odontogenic Tumors - pathology; Periodontium - cytology; Pluripotent Stem Cells - physiology; Sex Factors; Surgery; Young Adult
• ISSN: 0278-2391; 1531-5053
• DOI: 10.1016/j.joms.2015.05.010

Currently, central cemento-ossifying fibroma is classified by the World Health Organization as a primary bone-forming tumor of the jaws. However, histopathologically, it is often indistinguishable from cemento-osseous dysplasias in that it forms osteoid and cementicles (cementum droplets) in varying proportions. It is believed that pluripotent cells within the periodontal membrane can be stimulated to produce either osteoid or woven bone and cementicles when stimulated. If this is true, cemento-ossifying fibroma would be better classified as a primary odontogenic neoplasm arising from the periodontal ligament. Cemento-ossifying fibromas also do not occur in the long bones. The present report compares several entities that fall within the diagnostic realm of benign fibro-osseous lesions and reviews the evidence for reclassifying central cemento-ossifying fibroma as a primary odontogenic neoplasm.