# Early Intervention with a Preformed Eruption Guidance Appliance After the Excision of Cemento-Ossifying Fibroma: A Case Report

## TL;DR

A 5-year-old boy with a jaw tumor had early dental intervention using a special appliance to guide tooth growth after surgery, leading to improved tooth alignment over four years.

## Contribution

This case report demonstrates the use of a preformed eruption guidance appliance in managing post-surgical tooth development in a pediatric COF patient.

## Key findings

- The eruption guidance appliance facilitated favorable eruption of permanent teeth in the affected area.
- Improved intercuspal relationships were observed during the transition from primary to mixed dentition.
- Long-term follow-up showed positive outcomes in oral muscle function and tooth alignment.

## Abstract

Background: Cemento-ossifying fibroma (COF) is a benign, non-aggressive fibro-osseous tumor in which normal bone is replaced by fibrous tissue containing collagen fibers, bone, or cementum-like material. Although COF is rare in children, its occurrence requires careful management due to its potential impact on tooth development and occlusion. Surgical excision is the widely used treatment; however, post-operative occlusal guidance is crucial, particularly in pediatric patients. Case report: This case report presents the early intervention using a preformed eruption guidance appliance (EGA) following the excision of COF in a 5-year-old boy. The patient exhibited premature loss of the primary canine and displacement of the devel-oping permanent tooth bud. After surgical excision, an EGA was applied to facilitate proper eruption of the successor teeth and optimize oral muscle function. Over a four-year follow-up period, the permanent teeth in the affected area erupted favorably, and intercuspal relationships improved during the transition from primary to mixed dentition. Conclusions: Given the limited research on the long-term effects of COF on developing dentition, long-term follow-up and additional studies are necessary to further evaluate its impact and the effectiveness of eruption guidance appliances in pediatric patients.