INTRODUCTION: Odontogenic fibroma is a rare benign neoplasm of ectomesenchymal origin. The intraosseous variant, "central odontogenic fibroma" (COF), occurs across a wide age range (4-80 years), with a female predominance. It primarily affects the posterior mandible, particularly the premolar and molar regions. This report presents a case of mandibular COF in a 27-year-old female and discusses diagnostic and treatment options alongside a literature review.
METHODS: A 27-year-old female patient presented for a routine dental examination, during which swelling of the lingual cortex was noted. Radiographic examination performed with RX-OPT and CT imaging revealed a multilocular radiolucent lesion extending from teeth 4.3 to 4.6. All teeth in the involved area were vital. An incisional biopsy was firstly performed, leading to the diagnosis of central odontogenic fibroma (COF). The lesion was subsequently treated with complete surgical excision, curettage, and extraction of teeth 4.4 and 4.5. Histological examination confirmed the diagnosis of COF. A literature review was conducted to analyze data from 2008 to 2024 concerning all mandibular COF cases published, analyzing patient age, lesion localization, treatment modalities, and recurrence rates.

RESULTS: The histological examination confirmed the diagnosis of COF. We also found papers reporting nine cases of COF occurring in the mandible. Seven patients were young and two were old. Two patients were asymptomatic and six showed swelling. Among the lesions, five were unilocular and four were multilocular in nature. Treatment varied between the patients: five were treated with enucleation and four with surgical excision. No recurrences were observed in the literature and in our presented case.

CONCLUSIONS: The significance of this study is seen in the need to further expand clinicians' awareness about both the diagnosis and treatment of asymptomatic bone lesions. Such findings emphasize the critical importance of radiographic examination within routine dental checkups as a means of early identification and appropriate intervention at any age.