Due to its nonexclusive histological features, this lesion is often confused with other entities, such as hyperplastic dental follicles
, odontogenic myxomas, and desmoplastic fibromas, which highliaght the importance of clinical pathological correlation in the diagnosis of odontogenic fibromas.
Furthermore, pathologies of the dental follicle, interfering with tooth eruption have been reported [Kim et al.
The pathology report described fibrous connective tissue with epithelial inclusions indicating a hyperplastic dental follicle as well as vital bone tissue with mild marrow fibrosis.
Defective regulation of MMPs mediating connective tissue remodelling may be responsible for abnormal tooth eruption associated with hyperplastic dental follicles [Kim et al.
The differential diagnosis of a POF includes a fibrous epulis and odontogenic gingival epithelial hamartoma, whereas for a COF one needs to consider hyperplastic dental follicles
, myxofibroma, desmoplastic fibroma, odontogenic myxoma, intraosseous neurofibroma, and possibly carcinoma.