Florid Cemento-osseous Dysplasia: A Case of Misdiagnosis

Delai, Débora; Bernardi, Anarela Vassen; Felippe, Gabriela Santos; Teixeira, Cleonice da Silveira; Felippe, Wilson Tadeu; Felippe, Mara Cristina Santos

doi:10.1016/j.joen.2015.08.016

Cited by 28 publications

(30 citation statements)

References 22 publications

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“…The combination of clinical, radiographic and histological data may contribute significantly to the final diagnosis of CODs. Careful observation of the characteristics of the lesion and a definitive diagnosis avoid unnecessary treatments [10,18,19]. In the present case, biopsy and histopathological exam was necessary to confirm the diagnosis of FCOD.…”

Section: Discussionmentioning

confidence: 68%

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Oral management of a patient with cemento-osseous dysplasia: a case report

Kato

Sampaio

Amaral

et al. 2019

RGO, Rev. Gaúch. Odontol.

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Florid cemento-osseous dysplasia is a subtype of fibrous-osseous lesion that commonly appears in the jaws of middle-aged black women. Clinically, the florid cemento-osseous dysplasia is asymptomatic. The radiographic aspect shows a radiolucent area with several masses of radiopaque structures, typically found in the toothbearing areas. Usually, the diagnosis is made during routine radiographic examination. The treatment is required when infection occurs due to exposure of the lesion in the oral cavity. In these severe cases, pain and facial deformity may be present. Commitment oral hygiene and routine dental visits for check-up are recommended for individuals affected. The objective of this study was to present a clinical case of a 24-year-old white woman with florid cemento-osseous dysplasia, who had been under surveillance for 13 years. Some changes in the radiographic pattern were observed as the orthodontic treatment was carried out in a private service. No tooth extraction was performed. This change is expected because florid cemento-osseous dysplasia has different radiographic aspects that correspond to the different developmental stages of the lesion. It is suggested, however, that the presence of florid cemento-osseous dysplasia did not preclude the success of the orthodontic treatment.Indexing terms: Oral pathology. Orthodontics. Radiography. RESUMOA displasia cemento-óssea florida é um subtipo de lesão fibro-óssea que geralmente aparece nos ossos gnáticos de mulheres negras de meia idade. Clinicamente a displasia cemento-óssea florida é assintomática. Os aspectos radiográficos mostram uma área radiolucente

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Section: Discussionmentioning

confidence: 68%

“…Cone-beam computed tomography provides images from the axial, sagittal and frontal planes, and is indicated to evaluate the location and extent of the lesion [19,23,24]. Buccal and lingual expansion as well as a relationship with the anatomic structure was easily identified in the current case.…”

Section: Discussionmentioning

confidence: 79%

Oral management of a patient with cemento-osseous dysplasia: a case report

Kato

Sampaio

Amaral

et al. 2019

RGO, Rev. Gaúch. Odontol.

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“…Previous studies found that experience was vital to the process of decision making 30,31 and that personally experiencing different diagnoses increased understanding of the conditions being identified and enhanced the provider's ability to correctly recognize them in the future. 34 The participants also noted that dentists may fail to detect a condition or miss a diagnosis completely. A misdiagnosis could be due to misinterpretation of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Without a complete assessment and vitality test, the condition may be misdiagnosed as a lesion of endodontic origin and result in unnecessary root canal treatment. 34 The participants also noted that dentists may fail to detect a condition or miss a diagnosis completely. Delayed diagnosis, while accepted as an occurrence in dentistry, was believed by the interviewees to potentially result from misdiagnosing a condition and later identifying the correct diagnosis when the symptoms failed to subside.…”

Section: Discussionmentioning

confidence: 99%

Clinical Dental Faculty Members’ Perceptions of Diagnostic Errors and How to Avoid Them

Nikdel¹,

Nikdel²,

Ibarra-Noriega³

et al. 2018

Journal of Dental Education

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Diagnostic errors are increasingly recognized as a source of preventable harm in medicine, yet little is known about their occurrence in dentistry. The aim of this study was to gain a deeper understanding of clinical dental faculty members' perceptions of diagnostic errors, types of errors that may occur, and possible contributing factors. The authors conducted semi-structured interviews with ten domain experts at one U.S. dental school in May-August 2016 about their perceptions of diagnostic errors and their causes. The interviews were analyzed using an inductive process to identify themes and key findings. The results showed that the participants varied in their definitions of diagnostic errors. While all identified missed diagnosis and wrong diagnosis, only four participants perceived that a delay in diagnosis was a diagnostic error. Some participants perceived that an error occurs only when the choice of treatment leads to harm. Contributing factors associated with diagnostic errors included the knowledge and skills of the dentist, not taking adequate time, lack of communication among colleagues, and cognitive biases such as premature closure based on previous experience. Strategies suggested by the participants to prevent these errors were taking adequate time when investigating a case, forming study groups, increasing communication, and putting more emphasis on differential diagnosis. These interviews revealed differing perceptions of dental diagnostic errors among clinical dental faculty members. To address the variations, the authors recommend adopting shared language developed by the medical profession to increase understanding.

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“…Although the etiology and the triggering factors were not identified [8], Florid osseous dysplasia could result from abnormal activity of the periodontal ligament explaining its near-exclusive location in the dental region, with cemento-osseous lesions identified in relation to dental apices and dental anatomy in radiographic examinations [9]. It is generally asymptomatic and the teeth in relation to the lesions are unaffected Med Buccale Chir Buccale 2017; 23:196-199 A.-C. Melka et al [10][11][12]. Florid osseous dysplasia becomes symptomatic when lesions are accompanied by infection, or if cortical fenestrations occur [3].…”

Section: Commentsmentioning

confidence: 99%

Florid osseous dysplasia causing sensory disturbances in the area supplied by the inferior alveolar nerve

Melka

Barthélémy

Cousson

et al. 2017

Med Buccale Chir Buccale

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--Introduction: Florid osseous dysplasia is a rare benign pathology, characterized by a multifocal extension, and possibly affecting the four maxillo-mandibular quartors. It is often a fortuitous discovery, and only becomes symptomatic when the lesions are voluminous, deforming mandible or maxillary, or when secondary infections occur. Observation: A 45-year-old African patient is referred for diagnosis of a florid osseous dysplasia. Mandibular lesions are revealed by a CBCT scan. As the patient is asymptomatic, an annual follow-up was established. Six months later, the patient shows neuropathic pain signs on the right side of the chin and the inferior lip: the inferior alveolar nerve seems to be affected. A surgical treatment is then proposed to the patient. Discussion: Affection of the alveolo-dental nerve due to florid osseous dysplasia has never yet been reported in literature. However, our patient showed neuropathic pain symptoms, with no sign of infection, and the CBCT revealed a great proximity of the nerve and the lesions. The surgery was a success: removing the calcified masses has allowed us to amend the neuropathic pain. We can then suppose that the bone lesions were directly responsible for our patient's pain symptoms. Conclusion: Florid osseous dysplasia lesions, when close to the inferior alveolar nerve, can cause a nerve illness, by compression, on its intracanal trajectory or by its foramen.

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Florid Cemento-osseous Dysplasia: A Case of Misdiagnosis

Cited by 28 publications

References 22 publications

Oral management of a patient with cemento-osseous dysplasia: a case report

Oral management of a patient with cemento-osseous dysplasia: a case report

Clinical Dental Faculty Members’ Perceptions of Diagnostic Errors and How to Avoid Them

Florid osseous dysplasia causing sensory disturbances in the area supplied by the inferior alveolar nerve

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