What Is Fibrodysplasia Ossificans Progressiva?

According to the WHO classification in 2005, ossifying fibroma, fibrous dysplasia, and osseous dysplasia belong to fibro-osseous lesions. Fibrosclerotic lesions are a group of diseases in which normal bone contains fibrous tissue replacements of various ossifying components, including developmental and reactive or abnormally proliferative lesions and masses. Ossifying fibroma is a true tumor with benign and well-defined borders. Histologically, tumors consist of fibrous tissue and mineralized bone components. According to the proportion of fibrous component and bone component contained in tumor, they can be named as ossifying fibroma and fibroostoma respectively. ^[1]

Wang Yican	(Attending physician)	Department of Maxillofacial Surgery, Peking University Stomatological Hospital
Zhang Lei	(Deputy Chief Physician)	Department of Maxillofacial Surgery, Peking University Stomatological Hospital
Guo Chuanyu	(Chief physician)	Department of Maxillofacial Surgery, Peking University Stomatological Hospital

Ossifying fibroma is a more common benign tumor of the jaw with well-defined boundaries. Histologically, tumors are composed of cell-rich fibrous tissue and mineralized tissue with diverse manifestations. According to the proportion of fibrous component and bone component contained in tumor, they can be named as ossifying fibroma and fibroostoma respectively. The new WHO classification in 2005 simplifies the classification and naming of bone-related lesions, replacing "cemento-ossifying fibroma" with "ossifying fibroma", and adding "adolescent trabecular ossifying fibroma" and " Juvenile sarcomatoid ossifying fibroids "are two histological variants of ossifying fibroids.

Western Medicine Name: Ossifying fibroma
English name: Ossifying fibroma
Affiliated Department: Department of Physiology-Stomatology
Disease site: Maxilla and mandible

The main symptoms: Mass, mandibular damage
Main cause: Unknown cause
Contagious: Non-contagious
Whether to enter health insurance: Yes

Introduction to Ossifying Fibroma Disease

Classification of ossifying fibroma diseases

According to the proportion of fibrous component and bone component contained in tumor, they can be named as ossifying fibroma and fibroostoma respectively.

1. Ossifying fibroma: mainly composed of fibroblasts, bone-like tissue and trabecular bone only occupy a small part of the tumor, so the X-ray film shows a clear area of reduced density, sometimes round, oval, or not. A regular atrioventricular chamber with irregular rough bone septum, thin and swollen cortical bone, and displacement of adjacent teeth.

2. Fibroostoma: mainly bone, there are different forms of bone trabeculae, and gradually calcification, so the X-ray film is more dense, with irregular mass ossification or calcification, and bone trabecular structure can also be seen , Starting from the alveolar crest. ^[1]

Ossifying fibroma disease pathology

Macroscopically, the tumor had a clear boundary, had an envelope, and had a yellow-white section and a solid section.

Microscopic tumors consist of collagen-rich connective tissue, trabeculae formed by immature bone, and cell-free basophilic cementum deposits. In connective tissue, the number of cells varies greatly, and collagen fibers are disorderly arranged. There are various calcification structures in tumors. Bone trabeculae can be connected to each other to form a network, and trabecular braided bone surrounds rows of osteoblasts. Cementoid-like deposits are round or oval, with smooth perimeters, similar to cementar bodies. ^[1] ^[2]

Clinical manifestations of ossifying fibroma

Ossifying fibroma- prone population

It is common in young people, mostly single, and can occur in the upper and lower jaw, but the lower jaw is more common, more women than men. The maxilla is mostly located in the canine fossa, zygomatic arch, and sinuses, and the mandibular bone is more common in the lower edge of the molar area and the mandibular angle. The young age of trabecular ossifying fibroma in adolescents (8.5-12 years), the average age of adolescent patients with sarcomatoid ossifying fibroma is about 20 years, and the classic ossifying fibroma is 35 years old. Ossifying fibroids are mainly found in the back of the lower jaw. Adolescent trabecular ossifying fibroids are more common in the upper jaw, and juvenile sarcomatoid ossifying fibroids are more common in the bone wall of the paranasal sinuses.

Sclerosing fibroma disease symptoms

The tumor grows slowly and there are no conscious symptoms in the early stage. As the tumor grows, it can cause tooth displacement, disorder of occlusal relationship, and maxillofacial deformation due to swollen jaw.

Ossifying fibroma disease harm

As the tumor grows, it can cause tooth displacement, occlusal relationship disorders, and maxillofacial deformation due to jaw swelling. ^[2]

Diagnosis and differentiation of ossifying fibroma

Characteristics of ossifying fibroma

Bone fibrous dysplasia, a non-genuine tumor, is a type of developmental abnormality that is characterized by the abnormal proliferation of fibrous tissue with the ability to metamorphose into bone in bones and replace normal bone. More common in young people under 20 years of age, can occur in the upper and lower jaw, more common in the upper jaw.

Auxiliary examination of ossifying fibroma

The X-ray showed diffuse diffusion of the maxillofacial bone to varying degrees, and there was no obvious boundary with normal bone.

Ossifying fibroma diagnostic criteria

Most ossifying fibroids can be diagnosed based on clinical manifestations, X-ray findings, and histopathological findings. ^[1]

Treatment of Ossifying Fibroma Disease

Surgical removal. Localized ossifying fibroma is easy to be completely removed, and it is not easy to relapse after resection. Large and diffuse ossifying fibroids can be partially resected to improve facial deformity, and closely observed after surgery. After mandibular resection, bone defects can usually be repaired immediately or in two stages. After maxillary resection, the restoration can be used to restore its defect and function, or the maxillary bone can be reconstructed by bone transplantation. ^[2]

Prognosis of ossifying fibroma disease

Benign tumors are unlikely to recur after resection.

Variation of ossifying fibroma

The new WHO classification in 2005 simplifies the classification and naming of bone-related lesions, replacing "cemento-ossifying fibroma" with "ossifying fibroma", and adding "adolescent trabecular ossifying fibroma" and " Juvenile sarcomatoid ossifying fibroids "are two histological variants of ossifying fibroids. ^[2]