Expansive Focal Cemento-Osseous Dysplasia

Abstract

Aim:To present a case of expansive focal cemento-osseous dysplasia and emphasize the importance of differential diagnosis.Background: Cemento-osseous dysplasia is categorized into three subtypes on the basis of the clinical and radiographic features: Periapical, focal and florid. The focal type exhibits a single site of involvement in any tooth-bearing or edentulous area of the jaws. These lesions are usually asymptomatic; therefore, they are frequently diagnosed incidentally during routine radiographic examinations. Lesions are usually benign, show limited growth, and do not require further surgical intervention, but periodic follow-up is recommended because occasionally, this type of dysplasia progresses into florid osseous dysplasia and simple bone cysts are formed. Case report:A 24-year-old female patient was referred to our clinic for swelling in the left edentulous mandibular premolarmolar region and felt discomfort when she wore her prosthetics. She had no pain, tenderness or paresthesia. Clinical examination showed that the swelling in the posterior mandible that was firm, nonfluctuant and covered by normal mucosa. On panoramic radiography and computed tomography, a welldefined lesion of approximately 1.5 cm in diameter of mixed density was observed.The swelling increased slightly in size over 2 years making it difficult to use prosthetics and, therefore, the lesion was totally excised under local anesthesia, and surgical specimens were submitted for histopathological examination. The histopathological diagnosis was focal cemento-osseous dysplasia. Conclusion:In the present case, because of the increasing size of the swelling making it difficult to use prosthetics, young age of the patient and localization of the lesion, in the initial examination, cemento-ossifying fibroma was suspected, and the lesion was excised surgically; the histopathological diagnosis confirmed it as focal cemento-osseous dysplasia. Clinical significance:We present a case of expansive focal cemento-osseous dysplasia. Differential diagnosis is essential because ossifying fibroma is a real neoplastic entity.

Periapical Cemento-osseous Dysplasia Is Rarely Diagnosed on Orthopantomograms of Patients with Neurofibromatosis Type 1 and Is Not a Gender-specific Feature of the Disease

“…However, COD may vary from non-expansive and asymptomatic to being expansive and symptomatic, the latter combination being quite rarely reported (45). These cases are apparently rare and cause diagnostic problems (46). The phenotype for expansive COD may vary considerably, can cause problems in identifying the correct diagnosis and may require complex surgical procedures (47).…”

Focal cemento-osseous dysplasia of mandible

“…Focal COD (FCOD) is a benign fibro-osseous lesion of the jaw. The posterior tooth-bearing regions are the usual sites of involvement; the maxilla is rarely affected 2. The lesions are typically asymptomatic and are not life threatening, but surgeons should be aware of them.…”