Cemento-ossifying fibroma: A diagnostic dilemma

Cemento-ossifying fibroma (COF) is a controversial term because of its terminology and its diagnosis. The COF is odontogenic in origin, although it is a central neoplasm of the bone and involves the periodontium. Most COFs exhibit slow and expansile growth in the jaws and are benign in origin. The lesion is encapsulated with mixed radiodensities. The COF is characterized by the replacement of normal bone by fibrous tissue and varying amounts of osteoid and cementum-like material. The definitive diagnosis of such lesions requires clinical, radiological, and histopathological observations. The treatment of choice is surgical resection, and recurrence is uncommon. We report a case of COF in the left mandibular premolar region and discuss how to confirm the diagnosis.