A CLINICAL STUDY ON FIBRO-OSSEOUS LESIONS OF THE JAWS

악골내 섬유조직성-골성병소에 관한 임상연구

  • Kim, Uk-Kyu (Department of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Cha, Seong-Man (Department of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Hwang, Dae-Seok (Department of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Kim, Yong-Deok (Department of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Shin, Sang-Hun (Department of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Kim, Jong-Ryoul (Department of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University) ;
  • Chung, In-Kyo (Department of Oral and Maxillofacial Surgery, College of Dentistry, Pusan National University)
  • 김욱규 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 차승만 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 황대석 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 김용덕 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 신상훈 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 김종렬 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 정인교 (부산대학교 치과대학 구강악안면외과학교실)
  • Published : 2005.05.31

Abstract

The challenging task of classifying the fibro-osseous(FO) lesions has been previously attempted but only in the past 15 years has the entire spectrum of diversity been appreciated. For the clinicians, it is hard to clearly diagnose the lesions before operations. The purpose of this study was to review the literature about fibro-osseous lesions of the jaws and to analyse our clinical cases. As the results of the review of clinical features, radiography and histopathologic findings of sixteen cases of fibro-osseous lesions, we could elucidate diagnostic aids for treatment of benign FO lesion in jaws. Six patients involving fibrous dysplasia complained the facial swelling and facial asymmetry. The radiographic features of the lesions showed ground-glass radiopacity mostly and the histologic findings showed typically Chinese character-shaped trabeculae without osteoblastic rimming in the fibrous stroma. Six patients with ossifying fibroma were notified as swollen buccal cheek state. Their radiographic findings showed cortical expanded radiolucent lesion with sclerotic defined border, which was contrast to the normal adjacent bone. The lesions showed variant radiolucent lesions. Histological findings were revealed as cellular fibrous stroma with woven bones, variable patterns of calcifications. Three patients with cemental dysplasia didn't have specific complaints. Well circumscribed radiopaque lesions on mandibular molar area were observed. Cementum-like ossicles with fibrous stroma were found on microscopic findings. A osteoblastoma case with jaw pain was found. The radiographic feature was a mottled, dense radiopacity with osteolytic border on mandibular molar area. Under microscopy trabecule of osteoid with vascular network were predominantly found. Numerous osteoblast cells with woven bone were found. These clinical, radiographic and microscopic findings of benign fibrous-osseous lesions would suggest diagnostic criteria for each entity of FO lesions.

Keywords

References

  1. Von Recklinghausen F : Die fibrose oderdeformiende Osteite. Festschrift R. Vichow zu seinem 71 Geburstage, Berlin, 1891
  2. Waldron CA : Fibro-osseous lesion of the jaws. J Oral Maxillofac Surg 43 : 249, 1985 https://doi.org/10.1016/0278-2391(85)90283-6
  3. Eversole LR : Clinical outline of Oral Pathology: diagnosis and treatment. 3rd Ed. Lea & Febiger, Philadelphia, 1992, P261
  4. Brannon RB and Flolwer CB, Benign Fibro-Osseous Lesions : A Review of Current Concepts. Advances in Anatomic Patholgy Vol 8(3), 2001, P126 https://doi.org/10.1097/00125480-200105000-00002
  5. Shafer WG, Hine MK, Levy BM : Textbook of Oral Pathology: 4th Ed. WB, Saunders, Philadelphia, 1983, P162
  6. Eversole LR, Leider AS, Nelson K : Ossifying fibroma: a clinicopathologic study of sixty-four cases. Oral Surg Oral Med Oral Pathol 60 : 505, 1985 https://doi.org/10.1016/0030-4220(85)90239-7
  7. Slootweg PJ, Panders AK, Koopmans R et al : Juvenile ossifying fibroma, An analysis of 33 cases with emphasis on histopathological aspects. J Oral Pathol. Med 23 : 385, 1994 https://doi.org/10.1111/j.1600-0714.1994.tb00081.x
  8. Melrose RJ, Abams AM, Mills BG : Florid osseous dysplasia, A clinical pathologic study of thirty four cases. Oral surg 41 : 62, 1976 https://doi.org/10.1016/0030-4220(76)90254-1
  9. Regezi JA, Sciubba J : Oral pathology: clinical pathologic correlations. 2nd Ed, W.B. Saunders, Philadelphia, 1993, P143
  10. Waldron CA, Giansanti JS : Benign fibro-osseous lesions of the jaws: a clinical-radiologic-histologic review of sixtyfive cases. Part II. Benign fibro-osseous lesions of periodontal ligament origin. Oral Surg Oral Med Oral Pathol 35 : 340, 1973 https://doi.org/10.1016/0030-4220(73)90072-8
  11. Waldron CA : Fibro-osseous lesions of the jaws. J Oral Maxillofac Surg 51 : 828, 1993 https://doi.org/10.1016/S0278-2391(10)80097-7
  12. Houston WO, Jr : Fibrous dysplasia of maxilla and mandible; Clinico-pathologic study and comparison of facial bone lesions with lesions affecting general skeleton. J Oral Surg 23 : 17, 1965
  13. Boysen ME, Olving JH, Vatne K, et al : Fibro-osseous lesions of the cranio-facial bones. J Laryngol Otol 93 : 793, 1979 https://doi.org/10.1017/S0022215100087739
  14. Hamner JE: Scofield HH, Cornyn J : Benign fibro-osseous jaw lesions of periodontal membrane origin: an analysis of 249 cases. Cancer 22 : 861, 1968 https://doi.org/10.1002/1097-0142(196810)22:4<861::AID-CNCR2820220425>3.0.CO;2-C
  15. Albright F, Butler AM, Hampton AD et al: Syndrome characterized by osteitis fibrosa disseminata, areas of pigmentation and endocrine dysfunction, with precocious puberty in females. N Eng J Med 216 : 727, 1937 https://doi.org/10.1056/NEJM193704292161701
  16. Cohen MM, Howel RE : Etiology of fibrous dysplasia and McCune-Albright syndrome, Int J Oral Maxillofac Surg 28 : 366, 1999 https://doi.org/10.1016/S0901-5027(99)80085-X
  17. Harris WH, Dudley H, Barry RJ : Natural history of fibrous dysplasia, An orthopedic, pathological, and roentgenographic study. J Bone Joint Surg 44A : 207, 1962
  18. Jaffe HL, Lichtenstein L : Nonosteogenic fibroma of bone. Am J Pathol 18 : 205, 1942
  19. Zimmerman DC, Dablin DC, Stafne EC : Fibrous dysplasia of the maxilla and mandible. Oral surg. 11 : 55, 1958 https://doi.org/10.1016/0030-4220(58)90222-6
  20. Bazar-Malik G, Mukerjee S : Fibrosarcomatous change in fibrous dysplasia of mandible. Indian J Cancer 17 : 67, 1980
  21. Chetty R, Kalan MR, Kranold DH : Malignant transformation in fibrous dysplasia, a report of 3 cases. S Afr J Surg 28 : 80, 1990
  22. Tanner HC, Dahlin DC : Sarcoma complicating fibrous dysplasia. Probable role of radiation therapy. Oral Surg Oral Med Oral Pathol 14 : 837, 1961 https://doi.org/10.1016/S0030-4220(61)80014-5
  23. Ramsey HE, Strong EW, Frazell EL : Progressive fibrous dysplasia of the maxilla. J Am Dent Assoc 81 : 1388, 1970
  24. Su L, Weathers DR, Waldron CA : Distinguishing features of focal cemento-osseous dysplasias and cemento-ossifying fibromas 1. A pathologic spectrum of 316 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 84 : 301, 1997 https://doi.org/10.1016/S1079-2104(97)90348-6
  25. Su L, Weathers DR, Waldron CA : Distinguishing features of focal cemento-osseous dysplasia and cemento-ossifying fibromas II. A Clinical and radiologic spectrum of 316 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 84 : 540, 1997 https://doi.org/10.1016/S1079-2104(97)90271-7
  26. Eversol LR : Craniofacial fibrous dysplasia and ossifying fibroma. Oral Maxillofac Surg Clin North Am 9 : 625, 1997
  27. Pedersen GW : Fibro-osseous lesion of the mandible: cementifying fibroma: report of case. J Oral Surg 29 : 280, 1971
  28. Cin PD, Sciot R, Fossion E, et al. : Chromosome abnormalities in cemento-ossifying fibroma. Cancer Genet Cytogenet 71 : 170, 1993 https://doi.org/10.1016/0165-4608(93)90025-H
  29. Voytek TM, Ro JY, Edeiken J, et al : Fibrous dysplasia and cemento-ossifying fibroma, A histologic spectrum. Am J Surg Pathol 19 : 775, 1995 https://doi.org/10.1097/00000478-199507000-00005
  30. Commins DJ, Tolley NS, Milford CA : Fibrous dysplasia and ossifying fibroma of the paranasal sinuses. J Laryngol Otol 112 : 964, 1998
  31. Slootweg PJ, Panders AK, Koopmans R, et al : Juvenile ossifying fibroma, An analysis of 33 cases with emphasis on histopathologic aspects. J Oral Pathol Med 23 : 385, 1994 https://doi.org/10.1111/j.1600-0714.1994.tb00081.x
  32. Slootweg PJ, Muller H : Juvenile ossifying fibroma, Report of four cases. J Craniomaxillofac Surg 18 : 125, 1990 https://doi.org/10.1016/S1010-5182(05)80329-4
  33. Fun-chee L, Jinn-fei Y : Florid osseous dysplasia in Orientals. Oral Surg Oral Med Oral Pathol 68 : 748, 1989 https://doi.org/10.1016/0030-4220(89)90166-7
  34. Schneider LC, Mesa LM : Differences between florid osseous dysplasia and chronic diffuse sclerosing osteomyelitis, Oral surg Oral Med Oral Pathol 70:308, 1990 https://doi.org/10.1016/0030-4220(90)90146-J
  35. Higuchi Y, Nakamura N, Tashiro H : Clinicopathologic study of cemento-osseous dysplasia producing cysts of the mandible-report of four cases. Oral Surg Oral Med Oral Pathol 65 : 339, 1988 https://doi.org/10.1016/0030-4220(88)90119-3
  36. Smith S, Patel K, Hoskinson AE : Periapical cemental dysplasia: a case of misdiagnosis. Br Dent J 185 : 122, 1998 https://doi.org/10.1038/sj.bdj.4809747
  37. Stafne E.C : Cementoma, a study of 35 cases. Dent Surv 9 : 27, 1933
  38. Chaudhry AP, Spink JH, Gorlin RJ : Periapical fibrous dysplasia (cementoma). J Oral Surg 16:483, 1958
  39. Storkel S, Wagner W, Makek MS : Psammous desmosteoblastoma: ultrastructural and immunohistochemical evidence for an osteogenic histogenesis, Virchows Arch A 411 : 561, 1987 https://doi.org/10.1007/BF00713287
  40. Miller AS : Benign osteoblastoma of the jaws: report of three cases. J Oral Surg 38 : 694, 1980
  41. Dorfman HD, Weiss SW : Borderline osteoblastic tumors: problems in differential diagnosis of aggressive osteoblastoma and low grade osteoblastoma. Semin Diagn Pathol 1 : 215, 1984
  42. Eisenbud L, Kahn L, Friedman Z : Benign osteoblastoma of the mandible: fifteen year follow-up showing spontaneous regression after biopsy. J Oral Maxillofac Surg 45 : 51, 1987