Fibro-osseous Lesions of the Maxillofacial Bones: A 10-Year Retrospective Histopathological Review of 123 Cases from Enugu, Nigeria, Based on the WHO 2022 Classification

Abstract

A bstract Background: The 2022 World Health Organization (WHO) classification introduced revised diagnostic criteria to address longstanding challenges in diagnosing fibro-osseous lesions (FOL). Objective: This study aimed to evaluate the pattern, demographic distribution, and anatomical location of FOL of the jaws at the University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla, Enugu, Nigeria, using the 2022 WHO classification. Materials and Methods: This retrospective observational study reviewed histopathological reports of biopsied orofacial lesions recorded in the Department of Oral and Maxillofacial Surgery, UNTH, Enugu, from January 2, 2015, to December 31, 2024. Patients’ biodata and relevant clinicopathological information were extracted. All cases that met the inclusion criteria were analyzed. Data were analyzed using the Statistical Package for the Social Sciences for Windows, version 29. Associations between variables were assessed using chi-square ( χ 2 ) tests for categorical variables and analysis of variance for continuous variables. Results: Out of 860 histopathological reports reviewed, 123 cases (14.3%) were diagnosed as fibro-osseous lesions. There was a female predominance ( n = 86, 69.9%), with a female-to-male ratio of 2.3:1. Patients’ ages ranged from 4 to 91 years, with a mean age of 29.2 years (standard error of the mean = 1.4 years). Ossifying fibroma was the most common lesion, accounting for 97 cases (78.9%). Logistic regression analysis revealed that lesion location was the only variable with a statistically significant association ( P = 0.049). Conclusion: Application of the 2022 WHO classification appears to address previous diagnostic challenges associated with FOL of the jaws and may facilitate more accurate identification and broader characterization of these lesions in clinical practice.