Fibro-osseous lesions are benign mesenchymal skeletal tumors in which mineralized tissue, blood vessels and giant cells, in varying proportions, re-place normal bone.

Ossifying fibroma (OF) is often circumscribed lesion surrounded by a fibrous capsule that can reach large dimensions. The people most affected are between the third and fourth decade of life.

The encapsulated lesions are easily removed, however, there are aggressive variants in which the risk of recurrence is higher and must be confirmed through pathological test. Radiographically, OF appears as radiolucent or radiopaque with sclerotic borders depending on tumor stage.

The treatment of OF is the complete removal of tumor preserving the adjacent bony structures that allow us to reconstruction by autologous bone grafts for subsequent placement of dental implants. Periodic follow-up ensure to identify possible recurrences.

The aim of this paper is to present a conservative treatment of extensive ossifying fibroma by an intraoral approach and immediately reconstruction with autologous iliac crest graft.

We report a case of 53 years old female patient who presented a large right mandibular OF. She was treated by an intraoral approach for total removal of tumor, surgical defect was filled with iliac crest graft and reconstruction plate was placed to prevent pathological fracture. Recurrence was not observed in 1 year.

Conflict of interest: None declared.