Expansive focal cemento-osseous dysplasia

Familial florid cemento-osseous dysplasia: a report of three cases and review of the literature

Familial cases of benign fibro-osseous lesions of the jaws are rare and have been described under numerous terms including familial gigantiform cementoma, multiple cemento-ossifying fibromas, sclerotic cemental masses and familial florid cemento-osseous dysplasia. The synonymous and interchangeable use of these terms to describe distinct entities with overlapping features has resulted in confusion and inaccurate categorisation of these lesions. This study highlights three family members with diffuse fibro-osseous jaw lesions with areas of significant expansion. In the pursuit of finding the best clinicopathological categorisation for the reported cases, familial florid cemento-osseous dysplasia and familial gigantiform cementoma were investigated. The final consensus of these three cases was that of familial florid cemento-osseous dysplasia, and one patient presented with a concurrent "ossifying fibromatoid lesion". A literature review on the above entities was performed in an attempt to provide clarification and delineate distinguishing features of the individual diseases.

Focal cemento-osseous dysplasia: A case report with a review of literature

Cemento-osseous dysplasia (COD) is the most prevalent lesion and presents as an asymptomatic, mixed radiolucent/radiopaque lesion in the tooth-bearing region of the jawbones. Histological features of COD include a cellular connective tissue stroma interspersed by the islands of woven or lamellar bone and cementum-like calcifications. Radiographically, the early COD lesions appear radiolucent, whereas in the mature lesions, radiopacities are observed surrounded by a thin rim of radiolucency. Early lesions tend to get misdiagnosed as their radiographic appearance mimics periapical cyst or granuloma. In the mixed radiolucent-radiopaque stage, the lesion could be confused with chronic sclerosing osteomyelitis, cemento-ossifying fibroma, odontoma and osteoblastoma. A correct diagnosis is of utmost importance as most of the CODs are self-limiting and nonneoplastic and do not require surgical intervention. However, periodic follow-up is recommended because occasional cases of focal COD are known to progress into florid COD. Here, we present the case of focal COD in a 27-year-old male patient.

Idiosyncratic Presentation of Cemento-Osseous Dysplasia - An in Depth Analysis Using Cone Beam Computed Tomography

Bone dysplasias comprise of a condition where the normal bone is replaced with fibrous tissue. Periapical Cemento-Osseous Dysplasia (PCOD) is a benign fibro-osseous condition where bone tissue is supplanted with fibrous tissue and cementum-like material. This condition affects mostly mandibular anterior region and rarely occurs in the maxilla. PCOD is seen above 30 years of age and has slight female predilection. Generally the teeth related to such lesions appear to be vital and are usually asymptomatic. These lesions are mostly seen during routine radiographic examination whose presentation may vary from complete radiolucency to dense radiopacity. The advent of Cone Beam Computed Tomography (CBCT) has brought a massive change in the field of dentistry which has become an important tool for diagnosis. Hence we hereby present an unusual case of cemento-osseous dysplasia in an unfamiliar location with an atypical presentation. The shape of the pathology was completely idiosyncratic and different from an orthodox lesion of COD, as the lesion was observed to grow out of the palatal surface with a prominent palatal expansion. This case highlights the importance of CBCT in radiographic diagnosis and in evaluating the characteristics of such lesion, which present with high diagnostic dilemma.