Odontogenic fibroma like lesions: Clinico-pathological considerations

Radiographically enlarged dental follicle is observed in many cases associated with delayed tooth eruption. Pericoronal radiolucencies are seen in neoplasms (odontogenic fibroma), developmental anomalies (regional odontodysplasia), hamartomatous lesions (odontogenic epithelial hamartoma), opercula of third molars, in follicles associated with unerupted third molars, regional odontodysplasia, in dental follicles around impacted teeth of enamel dysplasia with hypodontia syndrome and amelogenesis imperfecta cases with multiple impactions. Interestingly, operculum and the follicle of these lesions histopathologically are identical to odontogenic fibroma (WHO) type. However, the lack of universally accepted clinic-pathological features for such lesions may hinder their recognition. We report a case of regional odontodysplasia wherein (in which) the impacted canine is surrounded by radiolucency measuring about 1.5–2 cm, histopathologic examination of the excised opercula revealed features reminiscent of central odontogenic fibroma (WHO type) with an abundance of odontogenic epithelium and calcifications. The aim of this paper is to discuss various lesions exhibiting histopathological features similar to odontogenic fibroma, as awareness of the clinicopathological features of such lesions is very important to plan proper treatment.