Central odontogenic fibroma (COF) is a rare odontogenic tumor, the primary treatment of which is tumor ablation with extraction of related teeth. We report a case of COF that developed in the left maxilla in a 24-year-old woman. There were no subjective symptoms, however, she had noticed malposition of the second premolar to the palatal side and slight swelling of the buccal gingiva around the tooth since nine years old. The swelling had recently become larger, and she was referred to our clinic. A biopsy of the lesion showed a histological diagnosis of COF. CT images revealed resorption of the alveolar bone around the tumor, and expansion to the roots of the premolars and first molar. Reconstruction of the alveolar ridge using iliac particulate cancellous bone and marrow was carried out immediately after tumor ablation with extraction of the premolars and first molar. Five months later, there was no evidence suggesting tumor recurrence, and alveolar ridge augmentation was clearly apparent on CT images. The serial dental implant treatment was thus completed. The occlusion was restored by an implant prosthesis, and no evidence of tumor recurrence was found during four years of follow-up.
