Management of symptomatic florid cemento-osseous dysplasia: Literature review and a case report

Abstract

IntroductionCemento-osseous dysplasia is a jaw disorder characterized by a reactive process in which normal bone is replaced by connective tissue matrix. There are different Cemento-osseous dysplasia entities. The treatment of these lesions, once diagnosed by radiology, is not required because generally they are asymptomatic. The localization is in the tooth-bearing areas of the jaws and its distribution is symmetric.Case ReportsIn this case report, a 57-year-old Caucasian female patient was referred to our attention complaining of painful inflammatory events localized in the right angle of the jaw. The radiographic appearance, the distribution of several lesions and the positive vitality test of the involved teeth, supported the diagnosis of Florid Cemento-osseous dysplasia. Because of the symptomatology, the patient was submitted to surgery and the lesion and the second inferior right molar were removed. The histological examination of the specimens confirmed the diagnosis.DiscussionMany lesions that may exhibit a similar sclerotic appearance on conventional radiographs have to be differentiated and dental imaging can be used to discriminate between Florid COD and other lesions. Diagnosis of Florid Cemento-osseous dysplasia can be made with accurate clinical and radiographic assessment. In asymptomatic cases no treatment is required and the patient should have regular follow-up, but in this symptomatic case it was necessary to proceed with surgical intervention. The surgery treatment in the symptomatic case had a favourable prognosis and the two years follow-up has shown a complete healing. Given the abow, it is concluded that the choice of treatment must be selective according to the disease sites. Key words:Cemento-ossifying dysplasia, fibro-osseous lesions, florid cemento-osseous dysplasia, cementoma.

Florid cemento-osseous dysplasia: Report of 2 cases

“…1A,B) show different radiographic aspects that vary from radiolucent to radio-opaque images as this condition suffers progressing stages. In the first stage, both fibrous tissue and immature medullary bone replaced the healthy bone to become a compact laminar bone similar to cementum (radio-opaque cortical bone) (7,13,15).…”

Cemento-osseous dysplasia: a diagnostic challenge

“…Asymptomatic CODs which are discovered as incidental findings on radiographs require no management except for the prevention of dental infections through regular follow-up, prophylaxis and maintenance of good oral hygiene. 2,16,17 Secondary infection is usually the result of periapical infective disease, extraction of an associated tooth, an open fracture or a surgical biopsy procedure and is resistant to antibiotics due to failure to achieve therapeutic concentrations in the avascular mineralized tissue of a mature lesion. All invasive surgical procedures in asymptomatic COD, including the extraction of a tooth, should be considered only if other management options have been exhausted.…”

Florid Cemento-Osseous Dysplasia of Osteolytic Stage Showing Cyst-Like Findings on CT and MRI: A Case Report

“…In 2014, A 36-year-old Japanese woman presented to primary dental clinic with pain of lower right molar area and shows the "cotton-wool appearance" and "ground-glass appearance" aspect which are also typical of Pagetʼs diseases and fibrous dysplasia (1,16). Also, FCOD with infection shows sequestra and wider radiolucent border findings like osteomyelitis.…”