Extensive central ossifying fibroma of the maxilla: a case report with description of an alternative surgical technique.

Central ossifying fibroma (COF) is a fibrous-osseous lesion containing fibrous tissue and varying amounts of calcified tissue. Although the lesion is preferentially located in the jaws, it may be found elsewhere. It usually affects patients during their third and fourth decades of life, with a female predilection. The mandibular premolar-molar area is the most common site. Radiographically, COF may present a radiolucent, radiopaque or a mixed appearance. This article reports a case of an extensive COF in the maxilla of a 62-year-old patient. Intraoral examination revealed a swelling with undefined limits in the right side of the upper alveolar ridge, extending towards the palate. The lesion had invaded the maxillary sinus, nasal cavity and orbit. An incision including mucosa, periosteum, and a thin layer of the bone, was performed. The lesion was excised using a flap, and interrupted suture was utilized. The bone which was preserved in the flap was used as graft so that faster and more effective bone formation could occur. The patient has been followed-up for 5 years with no clinical or radiographic signs of recurrence. This article demonstrates that COF has a considerable growth potential. In addition, the surgical technique here in described shows very good cosmetic and functional results, especially when managing very large lesions.