Ossifying Fibroma vs Fibrous Dysplasia — MFDS Part 1 MCQ

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ModerateOral PathologyOssifying Fibroma vs Fibrous DysplasiaMFDS Part 1

Which finding most strongly favours a conventional cemento-ossifying fibroma of the jaw rather than fibrous dysplasia?

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Correct answer: C — A sharply demarcated lesion with a surgically separable plane from adjacent bone

Explanation lettering: B = shown as A · D = shown as B · A = shown as C · C = shown as D

Conventional cemento-ossifying fibroma is typically a sharply demarcated benign neoplasm with a plane separating it from adjacent bone; appropriately selected lesions can therefore be enucleated or curetted. Fibrous dysplasia instead blends imperceptibly into surrounding bone and commonly has a diffuse ground-glass radiographic appearance, making B, D and E characteristic of fibrous dysplasia. Activating GNAS mutations also strongly support fibrous dysplasia rather than ossifying fibroma, so C is incorrect. Management depends on lesion size, site and subtype: juvenile ossifying fibromas may be more aggressive and sometimes require wider surgery. Mineralisation patterns overlap and should not be used without clinical and radiographic correlation.

Reference: Chidzonga M, Sunhwa E, Makunike-Mutasa R. Ossifying Fibroma in the Maxilla and Mandible: A Case Report With a Brief Literature Review. 2023. https://pubmed.ncbi.nlm.nih.gov/36843790/