Fibro-osseous lesions of the face and jaws

Maxillofacial fibro-osseous lesions (FOL) consists of lesions that differ, with the exception of fibrous dysplasia, to those found in the rest of the skeleton. FOLs of the face and jaws are cemento-ossifying dysplasia, fibrous dysplasia and cemento-ossifying fibroma. Radiology is central to their diagnosis because the pathology for all FOLs is similar, although they range widely in behaviour, from dysplasia, hamartoma to benign neoplasia with occasional recurrence. Furthermore, once diagnosed the management of each is different. For cemento-ossifying dysplasia, this may mean doing nothing, simply because no treatment is generally appropriate. Almost all cemento-ossifying fibromas should be treated surgically, whereas cases of fibrous dysplasia are treated according to their clinical presentation, ranging from review and follow-up to surgery necessary to save the patient's sight or reduce deformity. The most important and frequent features of the FOLs differential diagnosis is discussed with assistance of a flow-chart.