Ameloblastic Fibro-odontoma or Immature Odontoma: A Retrospective Analysis of 134 Cases ZC32-ZC37
Dr. Vichittra Vipismakul,
Associate Professor, Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand.
Introduction: According to 2017 WHO classification of odontogenic tumour, Ameloblastic Fibro-Odontoma (AFO) is no longer classified as an entity, probably representing immature stages of complex odontoma. However, there were few studies that revealed the differences between the lesion previously designated as AFO and complex odontoma.
Aim: To critically analyse the clinical, radiographic features and behaviour of AFO.
Materials and Methods: Eligible criteria included publications from PubMed, Scopus and Google Scholar reporting cases of AFO from 1975 to June, 2019 with available clinical, radiologic, and histologic information to confirm the diagnosis. Demographic data, localisation, size, treatment approach, follow-up period and recurrence were included.
Results: Analysis of 134 cases (124 previously reported and 10 new cases). The patientâ€™s age ranged from 7 months to 31 years (mean 10.3 years). There were 72 (54.1%) males, with a male-to-female ratio of 1.2:1. The mandible was involved in 79 (59%) cases, and the mandible-to maxilla ratio was 1.43:1. Nearly 80% of the lesions located in the posterior region of the jaws, and 48.5% were in the posterior mandible. Radiographically, most of the lesions were unilocular (95%) and only 5% were multilocular. The majority was mixed radiolucent radiopaque, and 15.8% were radiolucent. Almost all lesions (91%) were associated with the crown of an unerupted tooth. The range of follow-up was 6 months to 25 years. There were five recurrences among 134 cases accounting for a recurrence rate of 5.6%.
Conclusion: According to 2017 WHO classification of odontogenic tumours, AFO was not considered as an entity and was included in odontoma. However, there are some discrepancies between AFO and odontoma especially regarding the biologic behaviour. Therefore, long term follow-up for cases previously designated as AFO is warranted.