Oral and Maxillofacial Surgery Department

Faculty of Dental Medicine, Airlangga University, Surabaya

Trabecular Juvenille Ossifying Fibroma of

the Mandible
(Case Report)

Christ Bianto SW ; Elissa Chairani

David Buntoro Kamadjaja, drg., MDS., SpBM
 Introduction
Fibroosseous lesions are a diverse group of
processes that are characterized by
replacement of normal bone by fibrous tissue
containing a newly formed mineralized
product.
Juvenile ossifying fibroma (JOF) is an
uncommon, benign, bone-forming neoplasm
that is distinguished from other fibro-osseous
lesions.

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 Case Presentation

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 Orthopantogram

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 Orthopantogram

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 Histopathology
A partly encapsulated
fibro-osseous lesion
consisting of dense
cellular proliferation of
spindle fibroblasts
arranged in a whorled
pattern, monoton and
smoth cromatin.
Some areas showed
trabeculae of bone and
osteoid like material and
showed osteoblastic
rimming

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 Follow Up
In the present case, oral functions of the
patient remained adequate and cosmetically
tolerable.
After follow up for 6 month, there are no sign
of reccurences, no complication and good oral
function.

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 Discussion

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 JOF has been separated as a distinct entity
from central ossifying fibroma due to its early
onset and aggressive behavior.
JOF has two well defined histopathological
variants, psammomatoid juvenile ossifying
fibroma (PJOF) and trabecular juvenile
ossifying fibroma (TJOF).

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 Based on the clinical history, and histological
findings, the case was reported as juvenille
trabecular ossifying fibroma (JOF)
The main characteristics are:
a patient under 15 years of age,
the location of the tumour,
The radiologic pattern, and HPA

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 Eversole et al (2008)
TJOF
typically occurs in children
and adolescents; only about
20% of cases occur in those
older than 15 years
almost exclusively in the
maxilla and mandible and
rarely in extragnathic
locations
HPA : highly cellular and
contains trabeculae or
spheroids of new bone.
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PJOF
Slightly older population
principally in the
extragnathic craniofacial
bones, particularly the
paranasal sinuses and
periorbital bones
HPA : relatively cellular
stroma containing small,
rounded calcifications
(psammomatoid)
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 TJOF is expansile, well defined, unilocular or
multilocular with cortical thinning and
perforation.
The tumor is usually radiolucent with variable
calcification
Root resorption and displacement of involved
teeth are observed
(El-Mofty,2002)

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 HPA

cellular proliferation of spindle fibroblasts Ossifying fibroma composed of bony

arranged in a whorled pattern, Some trabeculae in benign fibroblast matrix.
areas showed trabeculae of bone and (Eversole, 2008)
osteoid like material and showed
osteoblastic rimming

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 There is no consensus on the treatment of JOF
cases.
Radical resection, local excision conservatively
or enucleation with curettage are among the
treatment alternatives.
Rate of recurrence after conservative
treatment was reported in 30 - 58% of cases
(Alawi F, 2002)

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 The propensity of JOF to perforate cortical
bone may explain its high rate of recurrence
following enucleation as the tumor typically
has infiltrative borders.
Long term follow up with regular assessment
at 6 month intervals is essential to prevent
recurrence.
(Alawi F, 2002)

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Thank You

Suramadu Bridge, East Java, Indonesia

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