Cemento-Osseous Dysplasias: Imaging Features Based on Cone Beam Computed Tomography Scans

Abstract

Imaging exams have important role in diagnosis of cemento-osseous dysplasia (COD). Cone beam computed tomography (CBCT) stands out for allowing three-dimensional image evaluation. This study aimed to assess the prevalence of cases diagnosed as COD on CBCT scans, as well identify the main imaging features related to these lesions. An analysis was performed in a database containing 22,400 radiological reports, in which all cases showing some type of COD were initially selected. These CBCT exams were reevaluated to confirm the radiographic diagnosis and determine the prevalence and distribution of the types of COD with regard to gender, age and preferred location, while describing its most common imaging aspects. Data were presented using descriptive analyses. There were 82 cases diagnosed as COD in the CBCT images (prevalence of 0.4%). The distribution of patients was 11 (13.4%) male and 71 (86.6%) female, with a mean age of 49.8 years (age-range 17-85 years). There were 47 (57.3%) cases of periapical COD, 23 (28%) of focal COD and 12 (14.6%) of florid COD. The mandible was more affected than the maxilla. In most cases, the lesions were mixed or hyperdense. All COD had well-defined limits and there were no cases of tooth displacement. In conclusion, periapical COD was the most common type and the most affected bone was the mandible. Imaging evaluation is critical for diagnosis and dentists should bear in mind all possible radiographic presentations of COD in order to prevent misleading diagnoses and consequently, inadequate treatments.

Infected Cemento-Osseous Dysplasia: Analysis of 66 Cases and Literature Review

“…In the present series, we did not identify any individuals with an Asian background. Non-white individuals were more affected, in agreement with retrospective studies on COD published elsewhere [6,9]. In addition, no difference regarding skin colour was observed in the current review.…”

“…Equivalent to this review, the case series demonstrated that osteomyelitis/infected COD has a strong predilection for female individuals, with marked occurrence of this condition among individuals in their 60 s, 50 s and 40 s. Likewise, studies about FOLs of the jaws, including COD cases have exhibited a female predilection [9]. Additionally, in a recent investigation [6] in which COD cases were assessed by cone beam computed tomography, 71 women (86.6%) were affected. Conversely, the authors of a Japanese study [58] reported that CODs more frequently affect men of more advanced ages and hormonal factors were suggested to be associated with sex predilection.…”

“…There is no consensus about the worldwide prevalence of COD. Retrospective studies in North and South America have demonstrated that PCOD is the most frequent subtype [6,49,50]. However, de Noronha Santos Netto et al [9] reporting 65 cases of FLCOD and Owosho et al [48], reporting 17 cases, stated that this subtype was the most frequent in their surveys.…”

“…CODs are not rare and usually affect women in their 40 s and 50 s, who receive the diagnosis at oral and maxillofacial radiology services or during an appointment with a general practitioner [5][6][7][8]. In clinical and pathological studies worldwide, COD has been described as the most common lesion among the FOL of the jaws, with an estimated frequency of 30% to 70% [9,10].…”

“…Analyses of a significant number of COD cases are sparse in the literature [2,6,15,47,48]. Furthermore, the existing epidemiological investigations of FOL of the jaws conducted in Asia, Europe, Africa and South America have reached divergent conclusions with respect to the occurrence and clinicopathological profile of CODs [8,9,15,[47][48][49][50][51].…”