(TC44) Benign Fibro-Osseous Lesions of the Maxilla and Mandible: A Case Report

A 28-year-old female was referred to the endodontic clinic with a chief complaint of mobile maxillary anterior teeth. On intra-oral examination, 1+ mobility was noted on teeth #7-10 with tenderness to percussion and palpation. There was no expansion or fluctuance of the alveolar ridge.  The teeth tested normal to sensibility testing. A periapical radiograph revealed a radiolucency involving the apices of the aforementioned teeth. Cone beam tomography of the maxilla and mandible was obtained for further evaluation and surgical treatment planning.  Subsequently, more well-circumscribed lesions were identified in both the maxilla and mandible. The patient was referred to the Oral and Maxillofacial Clinic for evaluation. The oral surgery team recommended NSRCT be performed on the upper anterior teeth #7-10 because of the extremely high risk of the teeth being devitalized during biopsy surgery. NSRCT on teeth #7, 8, 9, 10 and splinting of teeth #6-11 was performed. The patient also underwent biopsy of all 4 lesions. Three well circumscribed lesions were identified within the maxilla, one associated with the roots of tooth #2 and the other two around the apices of #7- 8, and #9-10. The fourth expansile lesion was associated with the roots of teeth #23-28.  Aspiration of all 4 lesions contained serosanguinous fluid. Histopathologic examination revealed no evidence of epithelia lining that would otherwise represent a true cyst. All the lesions had a similar histological feature and were characteristic of a benign fibro-osseous proliferation or multiple solitary bone cysts.