Unusual radiographic aspects of conventional ossifying fibroma: 2 cases reported

Conventional ossifying fibroma (COF) is a benign bone neoplasm that predominantly affects the jawbones. We report 2 cases of COF arising in the mandible that radiographically resembled odontogenic cysts. The first case is from a female 15-year-old patient presenting an expansive radiolucent lesion in the mandible, between the left second premolar e and first molar (vital teeth). The clinical hypothesis was a periodontal lateral cyst. The second case presented as a radiolucent lesion mimicking a periapical cyst in a 23-year-old male patient. The lesion was associated with the canine and first lower left premolar, both teeth were vital, however, the second premolar had undergone endodontic therapy. Clinical hypotheses included inflammatory lesions and central giant cell granuloma. Both lesions underwent surgical excision and microscopic analyses revealed cellular fibrous tissue with mineralized product, including osteoid, bone, and basophilic acellular spherules, with a final diagnosis of COF. Both patients are under follow-up with no recurrences.