Ameloblastic fibro-odontoma

Ameloblastic fibro-odontoma (AFO) is a rare benign mixed odontogenic tumour that usually arises in the maxilla and mandible. According to the 2005 WHO classification of odontogenic tumours, it is defined as a benign tumour that resembles ameloblastic fibroma but contains enamel and dentin.

Epidemiology

Ameloblastic fibro-odontoma is most frequently diagnosed in the 1^st and 2^nd decades of life with a peak age between 8 and 12 years, and does not show any gender or anatomic site predilection.

The prevalence of ameloblastic fibro-odontoma is in the range of 0–3.4% within odontogenic tumours among different regions.

Clinical presentation

Clinical presentation is with painless swelling, usually along the posterior maxilla or mandible, and delayed tooth eruption in the affected region.

Pathology

Ameloblastic fibro-odontoma is classified into benign tumours with odontogenic epithelium with odontogenic ectomesenchyme and, with or without hard tissue formation according to the 2005 WHO classification of odontogenic tumours.

The tumour contains soft and hard tissue components, which resemble dental papilla and foci of enamel and dentin, respectively.

Radiographic features

Plain radiograph

Ameloblastic fibro-odontoma is usually a well-defined unilocular radiolucent mass having a variable amount of radiopaque material within it and is associated with the crown of an unerupted tooth/teeth.

Treatment and prognosis

Conservative surgical enucleation is the treatment of choice in well defined non-aggressive lesions. However, in destructive lesions, surgical resection with partial maxillectomy or partial mandibulectomy may be required. Recurrence is uncommon but can occur as a result of inadequate surgical removal.