Can Differences in Vascularity Serve as a Diagnostic Aid in Fibro-Osseous Lesions of the Jaws?

Abstract Different lesions in the fibro-osseous group share microscopic features, thus establishing a definitive diagnosis based on microscopic features alone may be a challenge. There is a need for additional microscopic tools to serve as an aid in differentiating between these lesions. Objective To compare parameters related to vascularity between 3 lesions in the fibro-osseous group: fibrous dysplasia (FD), central ossifying fibroma (COF) and cemento-osseous dysplasia (COD). Materials and Methods The study was a cross-sectional analysis, of biopsied lesions retrieved from 3 medical centers over a 14 years period. The primary predictor variables were the vascularity parameters (number, perimeter and area). The outcome variables were the diagnoses of FD, COF and COD. The diagnosis was based on clinical microscopic and radiological correlations. From each histopathological slide, 5 representative fields were captured with a computerized digital camera. The number of blood vessels was counted, the surface area and vascular perimeter were measured by tracing the perimeter of each vessel. The data was statistically analyzed using ANOVA test with Log transformation and a Tukey adjustment. Results A total of 66 cases were included in the study, 26 FD, 26 COF and 14 COD. The mean number of vessels showed only a tendency to be higher in FD compared to COF and COD (5.4±2.6, 3.7±2.3 and 3.6±1.7, respectively), but the results did not reach the threshold for significance. The mean vascular perimeter was 1385.8±859.2 pixels in FD and 742.6±661.8 in COF, after log transformation, p=0.012. The perimeter in COD was lower (941.1±502) compared to FD but the difference did not reach the threshold for significance. The mean area was 25061± 24875.6 in FD and 11773.8± 21734.4in COF, after log transformation, p=0.004. The perimeter in COD was lower (13011.1±8338.3) compared to FD, but the difference did not reach the threshold for significance. Conclusion The vascular content of FD is significantly higher than COF. These vascular changes can aid in differentiating between the lesions microscopically.