A Novel Treatment of Aggressive Psammomatoid Juvenile Ossifying Fibroma: A Case Report

Juvenile ossifying fibroma is a benign, bone-forming neoplasm with aggressive local growth that is distinguished from other fibro-osseous lesions primarily by its age of onset, clinical presentation and aggressive behavior. Although a benign entity, juvenile ossifying fibroma is known to be locally aggressive and has a high tendency to recur. Two distinctive microscopic patterns have been described: a trabecular variant and a psammomatoid variant. This latter variant is predominantly a craniofacial lesion and occurs rarely in the jaws. Treatment plans include a range of enucleation to total resection.. Reported here is a case of a huge psammomatoid juvenile ossifying fibroma of the maxilla in a 19-year-old man. Right maxillectomy was done while brain exposure in sphenoid and ethmoidal region was covered with fat and bone graft. After 1 year follow up, an endosseous dental implant was inserted in right lateral pterygoid plate.. Six months later an obturator was made over that osseointegrated implant to reconstruct the anatomic defect, achieving functional rehabilitation and satisfactory facial appearance..