PMC8107670_01
Extraoral and intraoral views of the patient: (a) Face view without particularities (no facial asymmetry). (b) Intraoral view showing insufficient hygiene, absence of swelling and deep decay in tooth 36.
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The extraoral examination was without particularities (no facial asymmetry) (Figure 1(a)). The intraoral examination revealed insufficient hygiene, absence of swelling and deep decay in tooth 36 (Figure 1(b)).
Preoperative panoramic radiograph. Panoramic radiograph showing a well-defined, corticated radiolucent lesion extended over the ramus in relation to the impacted wisdom tooth 38 (the arrows indicate the outlines of the lesion).
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The panoramic radiograph showed a well-defined, corticated radiolucent lesion extended over the ramus in relation to the impacted wisdom tooth 38 (Figure 2).
Preoperative CT scan: (a), (b) Sagittal and coronal cuts showing a unilocular osteolytic lesion was with tissue matrix containing sparse millimetric calcifications and thinning the cortical bone without rupture. The lesion invades the mandibular canal. (c) 3D reconstruction showing a thinning of the cortical bone.
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This lesion measured 34 mm in the coronal plane and 10 x 25 mm in the axial plane (Figure 3(a)-(c)).
Macroscopic view and histological examination of the lesion leading to the diagnosis of COF of simple type: (a) The tumour was a whitish-yellow mass of soft consistency related to the impacted tooth 38 (Macroscopic view). (b), (d) Tissue of fibrous appearance containing fibroblasts and rare amounts of epithelial cells (HE x40, x100, respectively). The cell density was moderate with the presence of a few hyaline and oedematous areas. There was no atypia or mitotic activity. (c) Presence of intralesional calcifications (Yellow arrows) (HE x40). (e) Rare foci where the cells take on an epithelial aspect (Red arrows) (HE x200). They were cubic with a regular nucleus. (f) Fibrosis: the fibroblasts have an abundant pale cytoplasm with rounded or ovoid nucleus and fine chromatin (HE x200). There were a few thick-walled vessels.
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Macroscopically, the tumour consisted in a whitish-yellow mass of soft consistency related to the impacted tooth (Figure 4(a)). No signs of malignancy were seen (Figure 4(b)-(f)).
Panoramic radiograph (5 months follow-up). Beginning of re-ossification of the ramus. No signs of recurrence.
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The panoramic radiograph performed 5 months after the surgery showed the beginning of re-ossification of the ramus (Figure 5).