Excision of an Extensive Cemento-Ossifying Fibroma in the Right Mandible: Case Report

Abstract

Cemento-ossifying fibroma is a benign fibro-osseous lesion of odontogenic mesenchymal origin, most commonly affecting the mandible. It is typically characterized by slow growth, cortical expansion, and well-defined radiographic features. This case report describes the diagnosis and surgical management of a cemento-ossifying fibroma involving the right mandible of a 55-year-old female patient who presented with facial asymmetry without associated pain. Radiographic and tomographic examinations revealed a well-circumscribed expansile lesion involving the mandibular body, ramus, and angle. Surgical treatment consisted of complete excision of the lesion followed by mandibular stabilization using a 2.4-mm reconstruction plate system and adjunctive xenogeneic bone grafting. Histopathological analysis confirmed the diagnosis of cemento-ossifying fibroma. At the 8-month postoperative follow-up, satisfactory bone neoformation, stable fixation, and favorable functional and aesthetic outcomes were observed. This case highlights the importance of accurate diagnosis, appropriate surgical planning, and long-term follow-up in the management of extensive mandibular cemento-ossifying fibromas.