Central cementifying fibroma of maxilla
A 37-year-old man was referred to the department of oral and of maxillofacial radiology of dentistry school of Isfahan medical science university. The patient had a chief compliant of pain and swelling in the right maxilla and asymmetry in it []. The patient mentioned that the mass had first appeared 3 months ago and became slightly larger since then. Furthermore, the patient mentioned that he experienced pain in the right side of his face with referral to the right eye and also episodes of blur vision.\nThe intraoral examination demonstrated an enlargement of the buccal maxillary right region, extending to the area of the canine and first premolar. In addition, the patient had a slight swelling at the palatal region []. The swelling was bony hard, non-tender with no fluctuation on manual palpation. The covering mucosa and gingiva had normal color and smooth in texture. The first premolar appeared to have been displaced by the lesion. The first premolar and canine at the right side were positive to thermal testing; percussion and palpation tests were within the normal limits. The needle biopsy did not revealed any sign.\nRadiographic evaluation showed the presence of a lesion extending throughout the maxillary right toberousity and right canine. The margins of the lesion appeared to be well-defined. Bone pattern is radiolucent with a few wispy trabeculae [Figures and ]. The tumor caused displacement of first right premolar with disappearing of its lamina dura. The mass caused expansion in all direction, but the cortical plate of the bone remained intact. The lesion occupied maxillary sinus and expanded its walls outward. Meanwhile a bony partition existed between the walls of the remaining sinus and the mass.\nThe CBCT showed a multi locular mass with wispy trabeculaes (similar to the pattern seen on Central Giant Cell Granuloma), occupying and expanding the right maxillary sinus [Figures -].\nThe expansion of Central Ossifying Fibroma into the antrum of the maxilla was convex, which was different from the fibrous dysplasia that its borders are unrecognizable from the antrum.\nA comprehensive explanation of treatment was explained to the patient and an informed consent was taken. The tumor was removed under local anesthesia and the gross measures of the specimen were approximately 45 × 30 × 15 mm []. Histological analysis showed a cellular fibroblastic tissue characterized by bundles of collagen densely packed and proliferating fibroblasts. There was presence of spherules of acellular mineralization that resembled dental cementum (cementoid type) [Figures and ]. Diagnosis of central cementifying fibroma was made. The postoperative follow up was favorable, and 1 year later the patient reported no discomfort in the area. A control panoramic X-ray study confirmed good bone regeneration.