Patterns of Ossifying Fibromas in the Maxillofacial Skeleton: A Case Series and Literature Review.

Abstract

Ossifying fibroma is a benign fibro-osseous neoplasm of the jaws characterized by the replacement of normal bone with a well-demarcated mass containing fibrous tissue and varying amounts of mineralized material. Although slow-growing, these lesions may attain considerable size and produce facial asymmetry, tooth displacement, or functional impairment if not detected early. This case series highlights the clinical presentation, radiographic features, and surgical management of patients diagnosed with ossifying fibroma of the mandible and maxilla. All cases demonstrated well-defined, unilocular or multilocular radiolucencies with varying radiopaque foci, consistent with the lesion's maturation stage. Surgical enucleation or resection was performed based on lesion size, location, and cortical expansion. Histopathologic examination in all patients confirmed the diagnosis by revealing a fibrous stroma containing trabeculae of woven bone and cementum-like calcifications. Postoperative follow-up showed satisfactory healing without evidence of early recurrence. This series emphasizes the importance of correlating clinical, radiologic, and histologic findings for accurate diagnosis and appropriate treatment planning. Early intervention and complete surgical removal remain essential to minimize recurrence and preserve jaw function. A brief review of current literature is included to contextualize the evolving understanding of this lesion’s behavior and optimal management strategies.