Ameloblastic fibro-odontoma

The ameloblastic fibro-odontoma (AFO) is essentially a benign tumor with the features characteristic of ameloblastic fibroma along with enamel and dentin (hard tissues). Though it is generally regarded as benign, there have been cases of its malignant transformation into ameloblastic fibrosarcoma and odontogenic sarcoma. Cahn LR and Blum T, believed in "maturation theory", which suggested that AFO was an intermediate stage and eventually developed during the period of tooth formation to a complex odontoma thus, being a hamartoma.

World Health Organization (WHO) defines AFO as a neoplasm consisting of odontogenic ectomesenchyme resembling the dental papilla, epithelial strands and nest resembling dental lamina and enamel organ conjunction with the presence of dentine and enamel. There is a consensus that AFO should be grouped under Odontomas. This is because once the hard tissues start forming it will eventually lead to formation of Odontomas. The Recent WHO classification published in 2017

has grouped AFDs into odontomes. According to Tekkesin S et al, combination of age and lesion size should be used to distinguish between lesions of a true neoplastic nature and hamartomatous formation.