Peripheral odontogenic fibroma: a clinicopathologic study of 151 cases and review of the literature with special emphasis on recurrence

ObjectiveThe peripheral odontogenic fibroma (POdF) is a rare benign neoplasm of odontogenic origin with limited data on recurrence. The purpose of this study was to define the clinical and histopathologic spectrum of POdF and to investigate its recurrence rate and variables associated with its recurrence.Study designA total of 151 cases of POdF were accepted for this study, which documented clinical, histopathologic, and follow-up data. Multivariate stepwise logistic regression was used to investigate the association of categorical variables and recurrence.ResultsPOdF should be considered a mixed odontogenic tumor because it is composed of active odontogenic epithelial and ectomesenchymal components. Of the 58 cases with follow-up, 29 recurred. Budding of the basal cell layer of the surface squamous epithelium was associated with higher recurrence (P = .0186); 27 cases with recurrence which exhibited this feature. The presence of calcification in direct apposition to epithelial rests was associated with lower recurrence (P = .0076); 13 cases that did not recur exhibited this feature.ConclusionsPOdF has a 50% recurrence rate. Budding of the surface epithelium and calcification in apposition to odontogenic epithelial rests are histologic predictors of recurrence.