Benign fibro-osseous lesions of the cranio-maxillofacial bones: an updated review with special emphasis on molecular pathogenesis.

BACKGROUND

Benign fibro-osseous lesions (BFOLs) are a heterogeneous group of bone-forming pathologies characterized by replacement of normal bone with fibrocellular stroma and mineralized tissue. Their overlapping clinical, radiological, and histopathological features often complicate diagnosis.

OBJECTIVE

This review summarizes the clinicopathologic characteristics and recent molecular insights of BFOLs to enhance diagnostic accuracy and classification.

APPROACH: A narrative review of English-language literature available in electronic databases upto 2025 was performed, focusing on key clinical, radiologic, histologic, and molecular findings of BFOLs.

FINDINGS: BFOLs encompass bone dysplasias including fibrous dysplasia and segmental odontomaxillary dysplasia, ossifying fibroma, and cemento-osseous dysplasia, each showing distinct biological behavior. Molecular studies have revealed GNAS mutations in fibrous dysplasia and HRPT2 alterations in ossifying fibroma, providing clues to their pathogenesis.

CONCLUSION

Integrating molecular data with clinicopathologic assessment refines diagnosis, prevents misclassification, and supports more precise management of BFOLs.