Periapical Cemento-osseous Dysplasia Research Articles

Case report– Periapical cemento-osseous dysplasia–CBCT findings

Case report– Periapical cemento-osseous dysplasia–CBCT findings

Periapical Cemento-Osseous Dysplasia in a Medically Compromised Patient: A Case Report

A fibro-osseous lesion is a condition where the regular bone is changed with a fibrous connective tissue matrix that includes an abnormal bone or cementum. These lesions are divided into three groups: ossifying fibroma, cemento-osseous dysplasia (COD), and fibrous dysplasia. COD is the most recurring benign fibro-osseous lesion. These lesions are usually not detected unless infected and are commonly noted accidentally on an X-ray. In this report, we demonstrate a case of periapical cemento-osseous dysplasia in a medically compromised patient with multiple systemic diseases.

Cemento-Osseous Dysplasia of the Jaw: Demographic and Clinical Analysis of 191 New Cases

Cemento-osseous dysplasia (COD) is a form of benign fibro-osseous lesion of the jaw. We sought to evaluate the demographic and clinical presentations of COD by collecting and analyzing the demographic, clinical, radiographic, and pathologic data of COD diagnosed in our institution from 2017 to 2022. Over this six-year period, the records of 191 patients with COD were reviewed. Most patients were African American and female. Eighty-five patients were diagnosed with florid COD (FLCOD), 63 with periapical COD (PCOD), and 43 with focal COD (FCOD). Twenty-eight (14.7%) patients presented symptoms. The most common symptom was pain. All the symptomatic cases of COD that were histopathologically diagnosed were osteomyelitis in the setting of COD. Symptomatic patients were older (mean of 61.3 years) than the asymptomatic patients (mean of 51.2 years). Due to the radiographic appearance of a radiolucency or a mixture of radiolucency and radiopacity, forty-five asymptomatic patients were biopsied. Most of the asymptomatic patients biopsied were patients with FCOD (n = 19, 54.3%), followed by PCOD (n = 16, 25.8%), and FLCOD (n = 10, 15.2%). FLCOD is the most common form of COD to present with symptoms. Due to the significant overlap in clinical and radiographic presentation with other entities, FCOD and PCOD remain a diagnostic challenge to dentists. In conclusion, we analyzed the demographic and clinical features of 191 new cases of COD, which reaffirms that cemento-osseous dysplasia is a condition that primarily affects middle-aged females of African descent and occurs more frequently in the mandible.

Periapical cemento-osseous dysplasia: Case report

Periapical cemento-osseous dysplasia: Case report

Clinic and Radiographic Evaluation of Cemento-osseous Dysplasia: Case Series

Aim: Cemento-osseous dysplasia (COD) is usually asymptomatic and slowly progressive benign fibro-osseous lesion characterized by the replacement of normal bone with fibrous tissue. The aim of this presentation is to evaluate the clinical and radiographical findings of six COD cases that were detected incidentally during radiographic examination.
 Case Report: Six female patients who four (%66) of them with different dental complaints and two (%33) of them for routine control examination of the previously diagnosed COD with a mean age of 38 applied to our clinic. It was learned that the patients did not have any systemic disorders in their medical anamnesis. There is not any finding on extraoral examination. In intraoral examination, teeth associated with COD lesions were vital as a result of the electric pulp test, and there is no other finding related to the lesion. In the radiography examination, different sizes radiolucent, mixed, and radiopaque lesions were detected in the mandible on control panoramic radiographs. The lesions were examined in detail with cone-beam computed tomography. Local thinning and resorption were observed in the buccal and lingual cortical bone in the relevant region. Histopathological examination revealed that the lesions were definitively diagnosed as SOD in four patients. Based on clinical, radiographic, and histopathological examinations, three (%50) of the lesions were diagnosed as periapical COD and the others (%50) were diagnosed with fluoride COD. All patients were followed up periodically for six months.
 Conclusion: The findings of this case series showed that all lesions examined were clinically asymptomatic and mixed on radiography. Due to insufficient vascular support of the bone in the COD area, there is a risk of infection and osteomyelitis may occur. Therefore, dentists should be aware of the clinical and radiographic features of COD in clinical practice and follow the patients periodically.

An unsual localization of maxillary periapical cemento-osseous dysplasia

An unsual localization of maxillary periapical cemento-osseous dysplasia

Implant Placement in a Cemento-Osseous Dysplasia: A case report

We present a 45-year-old black woman diagnosed with a florid cemento-osseous dysplasia (FCOD) affecting the right lower quadrant and the anterior mandibular region. The patient requested dental implants to rehabilitate the edentulous central lower incisors area (teeth # 31 and # 41) corresponding to a periapical cemento-osseous dysplasia (PCOD). Successful osseointegration of the two implants was obtained using a two-step procedure in order to limit the risk of complications associated with implant placement. Follow-up at one year showed no recurrence and good implant stability. Due to the abnormal quality of the bone in cemento-osseous dysplasia (COD), implant placement is generally avoided, and no other case reports have been reported in the literature in patients affected by PCOD. The present case suggests that in an appropriate clinical setting, implant placement may be a successful procedure.

A case report of periapical cemento-osseous dysplasia

Periapical Cemento-Osseous Dysplasia (PCOD) is one of the classified lesions of cemento-osseous dysplasia that generally consisted in middle aged black women. This article reported a case of a 36-yearold woman who was incidentally recognized with PCOD on the basis of panoramic radiograph. According to the clinical and radiographical findings of the patient, diagnosis of PCOD was done. Treatment was not considered. Regular radiographical follow-up was recommended to the patient. Keywords: Cemento-osseous dysplasia; Panoramic; Non-odontogenic tumor.

A contraindication to orthodontic and endodontic treatment: periapical cemento-osseous dysplasia.

ABSTRACTIntroduction: The dental pulp is completely normal in teeth with periapical cemento-osseous dysplasia. However, orthodontic and endodontic treatments are contraindicated in cases with this injury. Objective: Present some biological, clinical and imaging reasons opposing these contraindications and questioning which are the real ones impediments and the reasons for the lack of research on the disease, analyzing cases submitted to orthopedic treatment under controlled and ethically approved conditions. Conclusion: The clinician can act safely based in available knowledge and aware of the possible consequences of orthodontic movement in teeth with periapical cemento-osseous dysplasia, as well as in the proper way of making a safe and definitive diagnosis.

A retrospective clinico-pathologic analysis of cemento-osseous dysplasia in a South African patient population.

Cemento-osseous dysplasia (COD) is a fibro-osseous jaw bone lesion. The affected bone in COD progressively becomes sclerotic, poorly vascularized and susceptible to secondary osteomyelitis. To provide a clinico-pathologic appraisal of COD in a South African patient population. Archived records of 133 patients diagnosed with COD were reviewed for patient demographics, COD location, COD type, osteomyelitis or simple bone cyst secondary to COD. The mean age was 53.4 ± 13.5 years with a 94.7% female predilection. COD mainly affected the mandible (57.1%), followed by involvement of both jaws (38.3%) and maxilla (4.5%). Florid COD was the most prevalent (69.9%), followed by focal COD (18%) and periapical COD (12%). Florid COD showed a clear trend of increasing with age, peaking in the sixth decade and decreasing thereafter. Osteomyelitis and simple bone cyst presented as complications of COD in 74.4% and 5.3% of cases respectively, while 21.8% of all cases of jaw osteomyelitis during the study period were secondary to COD. A higher frequency of jaw osteomyelitis secondary to COD was found compared to previous studies. No significant association was shown between any of the COD types and secondary osteomyelitis.

Periapical Cemento-osseous Dysplasia Is Rarely Diagnosed on Orthopantomograms of Patients with Neurofibromatosis Type 1 and Is Not a Gender-specific Feature of the Disease.

The orthopantomograms (OPGs) of 179 patients with a confirmed diagnosis of NF1 were analyzed for COD. The results were compared to radiographic findings obtained in OPGs of age- and sex-matched controls. The NF1 patient group was further differentiated according to the evidence of facial plexiform neurofibroma. COD was a very rare finding in both groups. The extension of the diagnostic criteria including radiologically-healthy teeth and a widened periodontal gap in the periapical area only marginally increased the number of considered cases. Although there was a somewhat more common occurrence of such changes in the patient group compared to the control group and the number of affected women was greater than the number of men, none of these differences reached statistical significance. Furthermore, COD or widening of the periradicular periodontal space was not found to be associated with facial tumor type in NF1. The investigation revealed that COD is not a diagnostic feature of NF1. There is no clear association of the rare finding of COD with gender. These studies should be compared with patient groups of other ethnic backgrounds.

Cemento-Osseous Dysplasia of the Maxilla Treated with Subtotal Maxillectomy

Cemento-osseous dysplasias are non-neoplastic, reactive fibro-osseous lesions of tooth-bearing areas. Lesions in anterior mandible and localised only a few adjacent teeth termed as periapical cemento-osseous dysplasia or limited lesion occurring in a posterior jaw quadrant called focal cemento-osseous dysplasia are the same lesions. A 47-year-old male patient was complaining of flux after extraction of a tooth. A panoramic radiograph displayed lobular, irregularly shaped radiopacities involving right maxilla extending from the maxillary alveolus to the inferior orbital border and right maxillary tuberosity. Microscopic examination showed unencapsulated, extensive irregularly shaped cementum-like calcifications continious with normal bone lamella and in fibrous tissue.

Periapical cemento-osseous dysplasia – a series of three cases diagnosed on the basis of various imaging methods

Periapical cemento-osseous dysplasia – a series of three cases diagnosed on the basis of various imaging methods

Periapical Cemento-Osseous Dysplasia: Report of an Unusual Case Compromising The Cortical Buccal Area

Periapical cemento-osseous dysplasia is a fibro-osseous lesion associated with a vital tooth apex, especially in the anterior lower jaw, for which it has a predilection. It commonly affects black women around age 40 years and is usually asymptomatic, self-limiting, and does not expand cortical bone. White man, 25, in October 2002 presented radiolucent images associated with the apex of the left mandibular canine and inferior incisors, all of which were vital on sensitivity testing and without a history of pain. The lesions were diagnosed as periapical cemento-osseous dysplasia. At an annual visit in August 2011, he complained of discomfort in the region of the left mandibular canine and lateral incisor. Cone-beam computed tomography showed the lesions extent had increased and the buccal cortical bone was disrupted. Close follow-up of cases of periapical cemento-osseous dysplasia is essential.

Evaluation of Orthodontist's Perception in Identifying Intra-Osseous Lesions in Panoramic Radiographs

The degree of orthodontists' perception was measured with respect to the identification of common intra-osseous lesions in panoramic radiographs. Study Design: Dentists randomly evaluated six panoramic radiographs individually over the course of 2 minutes. In images 1 and 4 there were no lesions to be seen; in image 2, there was an intra-osseous lesion suggestive of dentigerous cyst, in image 3 there was a composite odontoma, in image 5 there was a periapical cemento-osseous dysplasia, and in image 6 there was a lesion suggestive of ameloblastoma.

Periapical cemento-osseous dysplasia: case report

Periapical cemento-osseous dysplasia is a pathologic entity resulting from bone and cementum reactional process which affects the periapical region of the anterior mandible. Its etiology is not fully understood, but possibly it is related to an unusual bone and cementum response to some local factor. Objective: The aim of this study is to present a case of periapical cemento-osseous dysplasia. Case report: A 50 years-old female patient sought for dental care due to pain in the lower right premolar region. The panoramic radiography revealed the presence of an extensive radiolucent lesion with radiopaque areas located between the roots of the teeth #43 and #35. Teeth presented vitality and it was not observed any changes involving the periodontal ligament. Periapical cemento-osseous dysplasia diagnosis was established through clinical and radiographic features. Periapical cemento-osseous dysplasia does not require any treatment unless complications occur. Patient’s complaint of discomfort was related to occlusal imbalance and was solved after the occlusion reestablishment. The patient was radiographically followed-up for 12 months and the lesion exhibits satisfactory signs of healing. Conclusion: The dentists need to be aware of asymptomatic intra-osseous lesions affecting the anterior region of mandible not to misconduct the diagnosis that could compromise the patient’s oral health.

CBCT findings of periapical cemento-osseous dysplasia: A case report

Periapical cemento-osseous dysplasia (PCOD) is a subtype of cemento-osseous dysplasia that usually occurs in middle-aged black women. This report described a case of a 45-year-old Iranian woman who was diagnosed with PCOD on the basis of cone beam computed tomographic (CBCT) findings. CBCT enabled detailed visualization of the bone changes. This report described the special radiographic characteristics of PCOD, including discontinuity of the lingual cortex on the CBCT sectional and three-dimensional images.

Cemento-osseous dysplasia in an elderly Asian male: a case report

Cemento-osseous dysplasia is a disorder typically found in middle-aged black women. However, the present report describes a case in a 61-year-old Vietnamese male. Without proper pulp testing and diagnosis, the radiographic presentation can easily be misdiagnosed as periapical periodontitis. On the basis of pulp vitality, lack of clinical symptoms and radiographic features, the diagnosis in this case was periapical cemento-osseous dysplasia at the mixed stage, which generally requires no treatment. At the 18-month follow-up, the patient was still asymptomatic and none of the clinical signs had changed. This case highlights the importance of careful clinical examination, including a pulp vitality test, and of having an unbiased view of age, gender, and ethnicity when diagnosing this condition.

P.036 Fibrous dysplasia and tuberous sclerosis

Focally expressed cemento-osseous dysplasia (periapical cemento-osseous dysplasia and focal cemento-osseous dysplasia) and cemento-ossifying fibroma (ossifying fibroma and cementifying fibroma) are two clinically recognized entities that are not easily differentiated histopathologically because of the lack of recognition of specific microscopic features. We have assessed 20 pathologic parameters for their ability to distinguish reliably between the two. Included in this study were 241 cases of focally expressed cemento-osseous dysplasia and 75 cases of cemento-osseous fibroma diagnosed from a combination of clinical, radiographic, and histopathologic information. Results revealed that 92.5% of focally expressed cemento-osseous dysplasia were composed of multiple small fragments of tissue whereas 88.0% of cemento-osseous fibromas showed a large intact specimen. Thick curvilinear trabeculae (“ginger root” pattern) or irregularly shaped cementum-like masses were typically seen in focally expressed cemento-osseous dysplasia, whereas thin isolated trabeculae with prominent osteoblastic rimming were more commonly observed in cemento-osseous fibroma. The stroma of focally expressed cemento-osseous dysplasia often displayed characteristic cavernous-like vascularity that was almost always associated with bony trabeculae. Free hemorrhage was frequently interspersed in the artifactual spaces throughout focally expressed cemento-osseous dysplasia. In contrast, the cases of cemento-osseous fibroma showed more cellularity in the stroma in which a storiform pattern was present in more than half the lesions studied. Giant cells, when present in cemento-osseous fibroma, were clustered in the center of the cellular stroma. The features described here allowed distinction histopathologically in 94% of cases studied. Three progressive stages of focally expressed cemento-osseous dysplasia and subtypes of cemento-osseous fibroma may be recognizable microscopically.

Cemento-osseous dysplasia in Jamaica: review of six cases

Six cases of cemento-osseous dysplasia (COD) of the jaw bone in Jamaicans are reviewed. Five were documented over a 15-year period (1980-1995). These include a case of florid cemento-osseous dysplasia (previously called gigantiform cementoma). Three of the initial cases were histologically diagnosed as gigantiform cementoma. There was no indication in the patient's case file whether these were familial or non-familial. The other two cases were diagnosed histologically as periapical cemento-osseous dysplasia and cementoblastoma respectively. Based on the current understanding of the nature of florid-cemento-osseous dysplasia (FLCOD), a new case was diagnosed as such solely on radiological findings. This single case of FLCOD is reported and discussed against the background of other cemento-osseous lesions. Special emphasis is placed on the radiology of COD in this paper. The confirmative role of radiology without the need for histophathology and treatment for asymptomatic FLCOD is emphasized.