Abstract
Objective To evaluate and quantify morphologic features of cementoblastoma (C), cemento-ossifying fibroma (COF), and focal cemento-osseous dysplasia (FCOD). Study Design A total of 22 C cases, 53 COF cases, and 94 FCOD cases were analyzed. Histomorphometric determinations were performed in 12 cases of each entity. Results Formation of sclerotic "cemento-osseous" trabeculae with a pagetoid appearance was observed in all 3 pathologies. Number of osteocytic lacunae was higher in tumoral "cemento-osseous" trabeculae observed in C and COF than in dysplastic "cemento-osseous" trabeculae formed in FOCD (P < .05). Trabecular necrosis (lack of osteocytes in the lacunae) was higher in FCOD (P < .05); 72% of C and 53% of COF showed cemento-osseoblastic and clastic activity, whereas only 32% of FCOD showed cement-osseous activity. C exhibited root destruction, whereas FCOD associated with a tooth showed trabecular apposition on the root surface. Conclusions Dysplastic lesions were in continuity with the root surface, and showed sparse trabeculae and more necrosis than tumor lesions. These morphologic features, which have not been described previously, would explain the greater risk of necrosis and infection in FCOD. These differences could allow establishing differential diagnosis and could prove useful to diagnose these pathologies. To evaluate and quantify morphologic features of cementoblastoma (C), cemento-ossifying fibroma (COF), and focal cemento-osseous dysplasia (FCOD). A total of 22 C cases, 53 COF cases, and 94 FCOD cases were analyzed. Histomorphometric determinations were performed in 12 cases of each entity. Formation of sclerotic "cemento-osseous" trabeculae with a pagetoid appearance was observed in all 3 pathologies. Number of osteocytic lacunae was higher in tumoral "cemento-osseous" trabeculae observed in C and COF than in dysplastic "cemento-osseous" trabeculae formed in FOCD (P < .05). Trabecular necrosis (lack of osteocytes in the lacunae) was higher in FCOD (P < .05); 72% of C and 53% of COF showed cemento-osseoblastic and clastic activity, whereas only 32% of FCOD showed cement-osseous activity. C exhibited root destruction, whereas FCOD associated with a tooth showed trabecular apposition on the root surface. Dysplastic lesions were in continuity with the root surface, and showed sparse trabeculae and more necrosis than tumor lesions. These morphologic features, which have not been described previously, would explain the greater risk of necrosis and infection in FCOD. These differences could allow establishing differential diagnosis and could prove useful to diagnose these pathologies.
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