This document defines and describes several bone and jaw conditions, including osteoma, cemento-ossifying fibroma, and Langerhans cell histiocytosis. Osteoma is defined as a rare, benign bone tumor characterized by proliferation of compact or cancellous bone. Cemento-ossifying fibroma is a rare benign tumor of the jaw characterized by massive deposition of cementum and calcified material mixed with fibrous tissue. Langerhans cell histiocytosis is characterized by abnormal proliferation of immature dendritic cells and can present as eosinophilic granuloma, Letterer-Siwe disease, or Hand–Schuller-Christian syndrome depending on severity and site of involvement. Each condition is

2. DR.RABIA SANNAM KHAN
MSC(UK)

3. OSTEOMA

4. DEFINITION
 Rare, Benign, Osteogenic neoplasm
characterized by proliferation of either
compact or cancellous bone usually in an
endosteal or periosteal location.

5. CLASSIFICATION
 Central Osteoma Arises from the
endosteum.
 Peripheral Osteoma Arises from the
periosteum.
 Extra Skeletal Soft Tissue Osteoma Arises
within the muscle.

6. ETIOLOGY
 Traumatic,
 Inflammatory
 Embryologic
 Associated with Gardner’s Syndrome.

7. CLINICALFEATURES

8. HISTOLOGICAL
FEATURES
 Consists of mature, lamellar bone or
cancellous bone.
 Classified as Compact/ivory,
Cancellous/spongy, or Mixed on histo-
pathologically.

11. RADIOGRAPHIC FEATURES

13. COMPLICATIONS /
TREATMENT

14. DIFFERENTIAL
DIAGNOSIS
 Exostoses.
 Ostoblastoma.
 Fibrous Dysplasia.
 Osteoma.

15. CEMENTOOSSIFYING
FIBROMA

16. DEFINITION
 (COFs) are rare, benign, non-
odontogenic tumors of the jaw,
characterized by massive deposition of
cementum,calcified material admixed
with fibrous tissue.
 JOF occurs mostly in children and
adolescents.

17. TYPES
 Conventional
 Juvenile
TRABECULAR PSAMMOMATOID

18. CLINICAL FEATURES

19. HISTOLOGICAL
FEATURES
 COFs are well-circumscribed, thin
isolated trabeculae of bones.
 Spherical deposits of calcified material,
resembling cementum.
 PJOF’s presents as eosinophilic
spherical structures.

22. RADIOGRAPHIC FEATURES

24. DIFFERENTIAL
DIAGNOSIS
 Fibrous dysplasia,
 Burkitt lymphoma,
 Osteosarcoma and
 Cystic lesions.

25. LANGERHAN CELL
HISTIOCYTOSIS

26. Definition
 (LCH) is characterized by an abnormal
proliferation of immature dendritic cells.
syndrome. The term “histiocytosis” denotes
proliferation of histiocytes and other
inflammatory cells, whereas the letter “X”
denotes unknown etiology of the disease.

27. TYPES
 The nomenclature — histiocytosis X was
coined by Lichenstein in 1953 to account
for 3 clinical varieties
 1) Eosinophilic Granuloma,
 2) Letterer-Siwe Disease and
 3) Hand–Schuller-Christian syndrome

28. ETIOLOGY
 Different hypothesis which include
 1) Disorder of immune regulation with
deficiency of T suppressor lymphocytes,
 2) A neoplastic proliferation of Langerhans
cells.
 or other etiological factors like viruses,
bacteria and genetic components.

29. CLINICAL FEATURES
 Soft, tender, painful swelling
 Incidence in jaws is 7.9% with angle and
body of the mandible commom sites.
 Depends on type and severity involvement
CHRONIC FOCAL
CHRONIC DISSEMINATED
ACUTE DISSEMINATED

31. HISTOLOGICAL
FEATURES
 Tennis-racket shaped structures.
 Histiocytic cells with eoisnophilic
cytoplasm.
 Birbeck granules.

33. RADIOGRAPHIC FEATURES

35. DIFFERENTIAL
DIAGNOSIS
 Tuberculous osteomyelitis,
 Ameloblastoma,
 Odontogenic keratocyst,
 Dentigerous cyst.