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The ossifying fibroma (OF), with the microscopic features of trabuclae or spherules of bone or cementum-like material in a cellular
fibrous connective tissue stroma, is one of the most common benign fibro-osseous lesions in the jaw bones. The OF often occurs in
patients from 20 to 40 years of age, which is a definite female predilection. The mandibles are involved far more often than the
maxillas, especially the pre-molar and molar regions. It is slow-growing, bone producing, asymptomatic and well-demarcated. The OF
is a disorder of odontogenesis or osteogenesis ascribed to bone marrow stroma cells (BMSCs) abnormality. However, the detailed
mechanisms of OF’s oncogenesis, cytodifferentiation, and tumor progression remain unknown. In this article, we reported a huge central
OF on the anterior mandible. The lesion was enucleated and peripheral ostectomy was done via intraoral approach and reconstructed
with vascularized iliac block bone graft. After 25 months of follow up, the tumor had not recurred. This case shows that
OF may be successfully treated by conservative surgical enucleation and peripheral ostectomy.