FLORID CEMENTO-OSSEOUS DYSPLASIA IN PATIENTS WITH MULTIPLE MYELOMA

Abstract

Bone disease of multiple myeloma (MM) results in osteolytic lesions. In florid cemento-osseous dysplasia (FCOD), normal bone is replaced by fibrocemento-osseous lesions, resulting mainly in sclerotic aspect. Dental infections in patients with FCOD or MM using bisphosphonates may have important clinical implications. This study reports 2 female individuals with MM, 49 and 59 years old, who were submitted to oral clinical and imaging assessment with panoramic radiograph and cone beam computed tomography. Both patients presented diffuse sclerotic lesions in the 4 quadrants of the jawbones in tooth-bearing areas, suggestive of FCOD. One of the patients also presented multiple irregular osteolytic lesions in the angle and condyle of the mandible, suggestive of plasmacytomas and punched-out lesions of MM. Patients received oral care with scaling, fillings, and endodontic treatment and were followed up for 4.5 years with no complications. Appropriate oral management may have avoided complications in these patients with MM and FCOD.