Radiographic study of osteoma: experiences from two dental schools

Objectives: Osteoma is a rare, benign bone-forming tumor. Clinicians may be unfamiliar with this lesion. This study aimed to evaluate the clinical and radiographic features of osteomas to aid accurate diagnosis. Methods: Osteomas diagnosed in the oral and maxillofacial region at two dental schools between January 2012 and October 2023 were analyzed. Clinical, radiographic features, and histopathologic variants were evaluated. Results: Twelve patients (8 females, 4 males) with a total of 13 osteomas were identified. Four were central (1 mandibular, 2 maxillary, 1 glenoid fossa) and 9 were periosteal (7 mandibular, 1 maxillary, 1 maxillary sinus floor). Mandibular lesions included 3 in the posterior region, 1 anterior involving the genial tubercle and body, 2 at the angle, 1 at the ramus, and 1 at the condyle. Two maxillary lesions were in the posterior region, and 1 extended from the canine to the molar region with impacted teeth. Central osteomas typically appeared as irregular, dense radiopaque masses with blending borders, whereas periosteal osteomas presented as round/oval or irregular radiopaque masses with well-defined borders. Central osteoma may be difficult to distinguish from fibro-osseous lesions, whereas the diagnosis of periosteal osteoma is often straightforward. Osteomas in the maxilla associated with impacted teeth, the glenoid fossa, and the genial tubercle each represent the fourth reported cases in the literature. Conclusions: Osteomas in the oral and maxillofacial region are rare and may present in uncommon locations. These findings contribute to a broader understanding of osteomas and may assist healthcare professionals in making accurate diagnoses.