Extensive ossifying fibroma of the mandible: segmental resection and free fibula flap reconstruction

Ossifying fibroma is a benign fibro-osseous neoplasm predominantly affecting young females, characterized by replacement of normal bone with fibrous tissue containing mineralized material. While smaller lesions can be managed conservatively, extensive lesions require resection to minimize recurrence. We report a 27-year-old female presenting with a large ossifying fibroma involving the right mandibular ramus, angle, and body. Clinical examination revealed facial asymmetry with firm, non-tender swelling, and buccal cortical expansion. Computed tomography demonstrated a well-defined, expansile lesion with mixed radiolucent-radiopaque internal structure. Segmental mandibulectomy with immediate free fibula flap reconstruction was performed. Microvascular anastomosis was completed under loupe magnification. Histopathology confirmed conventional ossifying fibroma. The patient was discharged on postoperative day 10 following suture removal, with excellent restoration of facial symmetry and minimal scarring. Unfortunately, the patient did not return for follow-up.