Cemento-Ossifying Fibroma in Maxillofacial Region: A Series of 16 Cases

  • Tejinder KaurEmail author
  • Amit Dhawan
  • Ramandeep Singh Bhullar
  • Sakshi Gupta
Original Article



Cemento-ossifying fibroma is considered as a benign osseous tumour, closely related to other lesions such as fibrous dysplasia and cementifying periapical dysplasia. These lesions occur in the second to the fourth decade of life. It is a bony tumour of maxilla and mandible of possibly odontogenic origin with aggressive behaviour and high tendency for recurrence. Radiologically, the lesion appearances varied ranging from radiolucent cyst-like appearance to mixed and/or radiopaque areas.

Aims and objectives

The article attempts to highlight the importance of clinical, imaging aspects and histopathology in diagnosis of cemento-ossifying fibroma along with management and long-term follow-up.

Materials and methods

This retrospective study was done on histologically diagnosed 16 fibro-osseous lesions. These patients were treated under general anaesthesia at our institute. The demographic data, radiographic features, and histopathologic findings were analysed and compared. The treatment and follow-up data were also recorded.


Cemento-ossifying fibroma showed higher predilection for female than for male patients and with an equal number of cases reported in maxilla and mandible with no signs of recurrence in long-term follow-up of 15 years.


Complete surgical excision of cemento-ossifying fibroma comes out to be only effective treatment that gave satisfactory results and can be considered as a definitive treatment modality.


Cemento-ossifying fibroma Ossifying fibroma Radiographic patterns Histopathological features Surgical management 



Cemento-ossifying fibroma


Ossifying fibroma


Computed tomography


Compliance with Ethical Standards

Informed Consent

Patients in the study have given informed consent to participate in the study.


  1. 1.
    Eversole LR, Leider AS, Nelson K (1985) Ossifying fibroma: a clinicopathologic study of sixty-four cases. Oral Surg Oral Med Oral Pathol 60:505–511CrossRefGoogle Scholar
  2. 2.
    Waldron CA (1985) Fibro-osseous lesions of the jaws. J Oral Maxillofac Surg 43:249–262CrossRefGoogle Scholar
  3. 3.
    Mitrani M, Remsen K, Lawson W, Biller HF (1988) Giant ossifying fibroma of the paranasal sinuses. Ear Nose Throat J 67:186–192PubMedGoogle Scholar
  4. 4.
    Khanna JN, Andrade NN (1992) Giant ossifying fibroma. Case report on a bimaxillary presentation. Int J Oral Maxillofac Surg 21:233–235CrossRefGoogle Scholar
  5. 5.
    More C, Thakkar K, Asrani M (2011) Cemento-ossifying fibroma. Indian J Dent Res 22:352–355CrossRefGoogle Scholar
  6. 6.
    Jankowski DSM (2009) Ossifying fibroma: a systematic review. Dentomaxillofac Radiol 38:495–513CrossRefGoogle Scholar
  7. 7.
    Sridevi U, Jain A, Turagam N, Prasad MD (2016) Cemento-ossifying fibroma: a case report. Adv Cancer Prev 1:111CrossRefGoogle Scholar
  8. 8.
    Ram R, Singhal A, Singhal P (2012) Cemento-ossifying fibroma. Contemp Clin Dent 3:83–85CrossRefGoogle Scholar
  9. 9.
    Sarwar HG, Jindal MK, Ahmad SS (2008) Cemento-ossifying fibroma—a rare case. J Indian Soc Pedod Prev Dent 26:128–131CrossRefGoogle Scholar
  10. 10.
    Slootweg PJ, Panders AK, Koopmans R, Nikkels PG (1994) Juvenile ossifying fibroma. An analysis of 33 cases with emphasis on histopathological aspects. J Oral Pathol Med 23:385–388CrossRefGoogle Scholar
  11. 11.
    Kaushik SK, Haranal S, Naresh N (2015) Cemento-ossifying fibroma of the mandible: a benign but potentially destructive tumor. Oral Maxillofac Pathol J 6:561–564Google Scholar
  12. 12.
    Van Heerden WF, Raubenheimer EJ, Weis RG, Kreidler J (1989) Giant ossifying fibroma: a clinico-pathologic study of 8 tumors. J Oral Pathol Med 18:506–509CrossRefGoogle Scholar
  13. 13.
    Marx RE, Stern D (2012) Oral and maxillofacial pathology: a rationale for diagnosis and treatment, 2nd edn. Quintessence Publishing Co, Inc, China, pp 841–844Google Scholar
  14. 14.
    Waldron CA, Giansanti JS (1973) Benign fibro-osseous lesions of the jaws: a clinical-radiologic-histologic review of sixty-five cases. Oral Surg 35:340–350CrossRefGoogle Scholar
  15. 15.
    Titinchi F, Morkel J (2016) Ossifying fibroma: analysis of treatment methods and recurrence patterns. J Oral Maxillofac Surg 74(12):2409–2419CrossRefGoogle Scholar
  16. 16.
    Barberi A, Cappabianca S, Collela G (2003) Bilateral cement-ossifying fibroma of the maxillary sinus. Br J Radiol 76:279–280CrossRefGoogle Scholar
  17. 17.
    Eversole LR, Merrell PW, Strub D (1985) Radiographic characteristics of central ossifying fibroma. Oral Surg Oral Med Oral Pathol 59:522–527CrossRefGoogle Scholar
  18. 18.
    White SC, Pharoah MJ (2000) Oral radiology principles and interpretation, 4th edn. Mosby, Philadelphia, pp 444–471Google Scholar
  19. 19.
    Neville BW, Damm DD, Allen CM, dan Bouquot JE (2002) Oral and maxillofacial pathology, 2nd edn. W B Saunders Company, Philadelphia, pp 533–589Google Scholar
  20. 20.
    Mithra R, Baskaran P, Sathyakumar M (2012) Imaging in the diagnosis of cemento-ossifying fibroma: a case series. J Clin Imaging Sci 2:52CrossRefGoogle Scholar
  21. 21.
    Bala TK, Soni S, Dayal P, Ghosh I (2017) Cemento-ossifying fibroma of the mandible. A clinicopathological report. Saudi Med J 38(5):541–545CrossRefGoogle Scholar
  22. 22.
    Shafer WG, Hine MK, Levy BM (2009) Textbook of oral pathology, 6th edn. Elsevier, India, pp 126–155Google Scholar
  23. 23.
    Chatterjee A, Ajmera N, Singh A (2010) Peripheral cemento-ossifying fibroma of maxilla. J Indian Soc Periodontol 14:186–189CrossRefGoogle Scholar
  24. 24.
    Endo Y, Uzawa K, Mochida Y, Nakatsuru M, Shiiba M, Yokoe H et al (2003) Differential distribution of glycosaminoglycans in human cementifying fibroma and fibro-osseous lesions. Oral Dis 9:73–76CrossRefGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2019

Authors and Affiliations

  • Tejinder Kaur
    • 1
    Email author
  • Amit Dhawan
    • 1
  • Ramandeep Singh Bhullar
    • 1
  • Sakshi Gupta
    • 1
  1. 1.Department of Oral and Maxillofacial SurgerySri Guru Ram Das Institute of Dental Sciences and ResearchAmritsarIndia

Personalised recommendations