Ameloblastic Fibroma: A Case Report of a Rare Presentation Illustrating a Diagnostic Challenge

This case report emphasizes the diagnostic role of cone-beam computed tomography (CBCT) in identifying a rare pediatric case of ameloblastic fibroma (AF), comprising approximately 2% of odontogenic tumors. The 10-year-old patient initially presented with painless left mandibular posterior gingival swelling, resembling radicular or dentigerous cysts in clinical and conventional radiographic assessments. However, CBCT revealed a distinct periapical radiolucency linked to deciduous molar roots and an unerupted premolar, exposing mandibular lingual plate thinning and buccal plate disruption. The lesion extended beyond the unerupted premolar's enamel-cementum junction, suggesting an odontogenic tumor. Subsequent biopsy and histopathological examination confirmed AF. CBCT played a pivotal role in evaluating the lesion's interaction with surrounding bone structures, guiding treatment decisions, and contributing to an accurate diagnosis. Successful lesion excision, deciduous tooth extraction, and a disease-free year-long follow-up underscore the significance of enhancing diagnostic precision and managing uncommon odontogenic pathologies like AF.