SEMENTO-OSSEÖZ DİSPLAZİNİN TANI VE TEDAVİSİNDE İKİLEMLER: GÖRSEL BİR DERLEME

Öz

Semento-osseöz displazi, genellikle çene kemiklerinde veya dişsiz alveolar kretlerde görülen benign fibro-osseöz lezyonlardan birisidir. Prensip olarak, semento-osseöz displazi tanısı yalnızca klinik ve radyolojik bulgulara dayandırılmaktadır. Enfeksiyon riski nedeniyle biyopsi, cerrahi müdahale veya diş çekimi genellikle önerilmemektedir. Semento-osseöz displazi tanısının konulamaması hastalara gereksiz ve invaziv dental tedavi prosedürlerinin uygulanmasına neden olabilmektedir. Olası komplikasyonların önlenmesi için, bu lezyonların doğru teşhis edilmesi ve diğer benzer lezyonlardan ayırıcı tanısının yapılması gerekmektedir. Bu makalede; semento-osseöz displazinin klinik ve radyolojik özellikleri, histopatolojik bulguları, ayırıcı tanısı, tedavi ve prognozu, komplikasyonları ve korunma stratejileri, doğru tanının gereksiz iatrojenik dental prosedürlerin yanı sıra hastalıkla ilgili olası komplikasyonların önlenmesindeki önemi özellikle vurgulanarak, pratik ve sistematik bir şekilde tartışılmaktadır.

Anahtar Kelimeler

• Semento-osseöz displazi
• Sınıflama
• Ayrıcı tanı
• Fibro-osseöz lezyon
• Radyografik özellikler

DIAGNOSTIC AND TREATMENT DILEMMAS OF CEMENTO-OSSEOUS DYSPLASIA: A PICTORIAL REVIEW

Abstract

Cemento-osseous dysplasia is one of the benign fibro-osseous lesions that commonly occurs in the jaws or edentulous alveolar processes. Principally, the diagnosis of cemento-osseous dysplasia is based solely on clinical and radiological findings. Biopsy, surgical intervention, or tooth extraction is generally not recommended due to the infection risk. The failure to diagnose cemento-osseous dysplasia may lead to unnecessary and invasive dental treatment procedures in patients. In order to prevent possible complications, this lesion should be diagnosed accurately and differentiated from other similar lesions. In this review, the clinical and radiological features, histopathological findings, differential diagnosis, treatment and prognosis, complications and preventive strategies of cemento-osseous dysplasia are discussed in a practical and systematic way with a particular emphasis on the importance of the accurate diagnosis in terms of preventing unnecessary iatrogenic dental procedures as well as possible disease-related complications.

Keywords

• Cemento-osseous dysplasia
• Classification
• Differential diagnosis
• Fibro-osseous lesion
• Radiological features

References

1. Chennoju SK, Pachigolla R, Govada VM, Alapati S, Balla S. Idiosyncratic presentation of cemento-osseous dysplasia - An in depth analysis using cone beam computed tomography. J Clin Diagn Res 2016;10:ZD08-10.
2. Noffke C, Raubenheimer EJ, Peranovic V. Cemento-osseous dysplasia: A diagnostic challenge. SADJ 2019;74:200-2.
3. Oh D, Samuels J, Chaw S, Zhang A, Selim D, Lalla Y, Monsour P. Cemento-osseous dysplasia: Re-visited. J Dent Oral Health 2019;1:1-11.
4. Brody A, Zalatnai A, Csomo K, Belik A, Dobo-Nagy C. Difficulties in the diagnosis of periapical translucencies and in the classification of cemento-osseous dysplasia. BMC Oral Health 2019;19:139.
5. Speight PM, Takata T. New tumour entities in the 4th edition of the World Health Organization Classification of Head and Neck tumours: Odontogenic and maxillofacial bone tumours. Virchows Arch 2018;472:331-9.
6. Bernaola-Paredes WE, Sugaya NN, Bergamini ML, Braz-Silva PH. A distinct fibro-osseous lesion of the jaws affecting the maxilla. J Oral Maxillofac Pathol 2020;24:S23-7.
7. Cavalcanti PHP, Nascimento EHL, Pontual MLDA, Pontual ADA, Marcelos PGCL, Perez DEDC, Ramos-Perez FMM. Cemento-osseous dysplasias: Imaging features based on cone beam computed tomography scans. Braz Dent J 2018;29:99-104.
8. Cankaya AB, Erdem MA, Olgac V, Firat DR. Focal cemento-osseous dysplasia of mandible. BMJ Case Rep 2012;2012:bcr2012006432.

9. Sarmento DJ, Monteiro BV, de Medeiros AM, da Silveira EJ. Severe florid cemento-osseous dysplasia: A case report treated conservatively and literature review. Oral Maxillofac Surg 2013;17:43-6.
10. White SC, Pharoah MJ. Oral Radiology: Principles and Interpretation. 7th ed. St. Louis Missouri: Elsevier Mosby; 2014, p. 402-26.
11. Kato CNAO, Barra SG, Amaral TMP, Silva TA, Abreu LG, Brasileiro CB, Mesquita RA. Cone-beam computed tomography analysis of cemento-osseous dysplasia-induced changes in adjacent structures in a Brazilian population. Clin Oral Investig 2020;24:2899-908.
12. Huh JK, Shin SJ. Misdiagnosis of florid cemento-osseous dysplasia leading to unnecessary root canal treatment: A case report. Restor Dent Endod 2013;38:160-6.
13. Daviet-Noual V, Ejeil AL, Gossiome C, Moreau N, Salmon B. Differentiating early stage florid osseous dysplasia from periapical endodontic lesions: a radiological-based diagnostic algorithm. BMC Oral Health 2017;17:161.
14. Su L, Weathers DR, Waldron CA. Distinguishing features of focal cemento-osseous dysplasia and cemento-ossifying fibromas. II. A clinical and radiologic spectrum of 316 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84:540-9.
15. MacDonald-Jankowski DS. Florid cemento-osseous dysplasia: a systematic review. Dentomaxillofac Radiol 2003;32:141-9.
16. Nelson BL, Phillips BJ. Benign fibro-osseous lesions of the head and neck. Head Neck Pathol 2019;13:466-75.
17. Min CK, Koh KJ, Kim KA. Recurrent symptomatic cemento-osseous dysplasia: A case report. Imaging Sci Dent 2018;48:131-7.
18. Yeom HG, Yoon JH. Concomitant cemento-osseous dysplasia and aneurysmal bone cyst of the mandible: a rare case report with literature review. BMC Oral Health 2020;20:276.
19. Pereira DL, Pires FR, Lopes MA, Carlos R, Wright JM, Patel P, van Heerden W, Uys A, Vargas PA. Clinical, demographic, and radiographic analysis of 82 patients affected by florid osseous dysplasia: an international collaborative study. Oral Surg Oral Med Oral Pathol Oral Radiol 2016;122:250-7.
20. Eskandarloo A, Yousefi F. CBCT findings of periapical cemento-osseous dysplasia: A case report. Imaging Sci Dent 2013;43:215-8.
21. Benaessa MM, Mahomed F, Ngwenya SP. A retrospective clinico-pathologic analysis of cemento-osseous dysplasia in a South African patient population. Afr Health Sci 2019;19:3154-9.
22. Martinez CJH, Villafuerte KRV, Felix Silva PH, Dultra FKAA, Franco RL, Taba M Jr, de Oliveira-Santos C, Motta ACF. Periodontal and dental considerations in florid cemento-osseous dysplasia: Clinical and radiographic analysis of 11 cases. Oral Health Prev Dent 2019;17:425-31.
23. Alsufyani NA, Lam EW. Osseous (cemento-osseous) dysplasia of the jaws: clinical and radiographic analysis. J Can Dent Assoc 2011;77:b70.
24. El-Mofty SK. Fibro-osseous lesions of the craniofacial skeleton: an update. Head Neck Pathol 2014;8:432-44.
25. Chadwick JW, Alsufyani NA, Lam EW. Clinical and radiographic features of solitary and cemento-osseous dysplasia-associated simple bone cysts. Dentomaxillofac Radiol 2011;40:230-5.
26. Jacomacci WP, Veloso Perdigão JP, Veltrini VC, Farah GJ, Tolentino ES, Vessoni Iwaki LC, Iwaki Filho L. Associated aneurysmal bone cyst and cemento-osseous dysplasia: a case report and review of the literature. Gen Dent 2017;65:28-32.
27. Summerlin DJ, Tomich CE. Focal cemento-osseous dysplasia: a clinicopathologic study of 221 cases. Oral Surg Oral Med Oral Pathol 1994;78:611-20.
28. Macdonald-Jankowski DS. Focal cemento-osseous dysplasia: a systematic review. Dentomaxillofac Radiol 2008;37:350-60.
29. Sirotheau Corrêa Pontes F, Paiva Fonseca F, Souza de Jesus A, Garcia Alves AC, Marques Araújo L, Silva do Nascimento L, Rebelo Pontes HA. Nonendodontic lesions misdiagnosed as apical periodontitis lesions: series of case reports and review of literature. J Endod 2014;40:16-27.
30. Drazić R, Minić AJ. Focal cemento-osseous dysplasia in the maxilla mimicking periapical granuloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:87-9.
31. Resnick CM, Novelline RA. Cemento-osseous dysplasia, a radiological mimic of periapical dental abscess. Emerg Radiol 2008;15:367-74.
32. Bhandari R, Sandhu SV, Bansal H, Behl R, Bhullar RK. Focal cemento-osseous dysplasia masquerading as a residual cyst. Contemp Clin Dent 2012;3(Suppl 1):S60-2.
33. Köseoğlu Seçgin C, Günhan Ö, Gülşahı A. Benign fibroosseöz lezyonlar. Acta Odontol Turc 2016;33:95-101.
34. Singer SR, Creanga AG, Vyas R, Mupparapu M. Florid expansile cemento-osseous dysplasia of the jaws: Cone beam computed tomography study and review of the literature. J Orofac Sci 2017;9:114-7.
35. Eversole R, Su L, ElMofty S. Benign fibro-osseous lesions of the craniofacial complex. A review. Head Neck Pathol 2008;2:177-202.
36. Akkitap MP, Gumru B, Idman E, Erdem NF, Gumuser Z, Aksakalli FN. Cemento-ossifying fibroma: Clinical, radiological and histopathological findings. Clin Exp Health Sci 2020;10:468-72.
37. Kato H, Nomura J, Matsumura Y, Yanase S, Ito T, Tagawa T. A case of florid osseous dysplasia associated with chronic sclerosing osteomyelitis requiring segmental resection. J Oral Maxillofa Surg Med Pathol 2014;26:158-62.
38. Chhabra N, Chhabra A. The diagnostic dilemma of multiquadrant nonexpansile fibro cemento osseous lesion: A case report. Int J Clin Prev Dent 2016;12:111-4.
39. Kato CNAO, de Arruda JAA, Mendes PA, Neiva IM, Abreu LG, Moreno A, Silva TA, Souza LN, Mesquita RA. Infected cemento-osseous dysplasia: Analysis of 66 cases and literature review. Head Neck Pathol 2020;14:173-82.
40. Bencharit S, Schardt-Sacco D, Zuniga JR, Minsley GE. Surgical and prosthodontic rehabilitation for a patient with aggressive florid cemento-osseous dysplasia: a clinical report. J Prosthet Dent 2003;90:220-4.
41. Singer SR, Mupparapu M, Rinaggio J. Florid cemento-osseous dysplasia and chronic diffuse osteomyelitis. Report of a simultaneous presentation and review of the literature. J Am Dent Assoc 2005;136:927-31.
42. Martini MZ, de Carvalho Júnior JP, Soares HA. Surgical management of an infected aggressive florid cemento-osseous dysplasia. Report of a case. Minerva Stomatol 2006;55:515-21.
43. Smith MH, Harms PW, Newton DW, Lebar B, Edwards SP, Aronoff DM. Mandibular Actinomyces osteomyelitis complicating florid cemento-osseous dysplasia: case report. BMC Oral Health 2011;11:21.
44. Carvalho CHP, Lima ENA, Pereira JS, Medeiros AMC, da Silveira EJD. Florid cemento-osseous dysplasia and osteomyelitis: a case report of a simultaneous presentation. Rev Odonto Cienc 2012;27:166-9.
45. Mohammed RB, Kumar YP, Pattipati S, Pakki SK. Florid cemento-osseous dysplasia complicated by chronic difuse osteomyelitis in the maxilla. J Stomat Occ Med 2013;6:38-41.
46. Meddeb M, Chokri A, Hammedi F, Sameh S, Hentati H, Selmi J. Co-occurrence of florid cemento-osseous dysplasia and chronic difuse osteomyelitis. Int J Health Sci Res 2015;5:605-9.
47. Cavalcante MB, de Oliveira Lima AL, Júnior MA, Santos MB. Florid cemento-osseous dysplasia simultaneous the chronic suppurative osteomyelitis in mandible. J Craniofac Surg 2016;27:2173-6.
48. Gerlach RC, Dixon DR, Goksel T, Castle JT, Henry WA. Case presentation of florid cemento-osseous dysplasia with concomitant cemento-ossifying fibroma discovered during implant explantation. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:44-52.
49. Shin HS, Kim BC, Lim HJ, Jo SY, Lee J. Chronic osteomyelitis induced by the placement of dental implants on cemento-osseous dysplasia. Br J Oral Maxillofac Surg 2019;57:268-70.
50. Mupparapu M, Singer SR, Milles M, Rinaggio J. Simultaneous presentation of focal cemento-osseous dysplasia and simple bone cyst of the mandible masquerading as a multilocular radiolucency. Dentomaxillofac Radiol 2005;34:39-43.
51. Peacock ME, Krishna R, Gustin JW, Stevens MR, Arce RM, Abdelsayed RA. Retrospective study on idiopathic bone cavity and its association with cementoosseous dysplasia. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119:246-51.
52. Kojima I, Nishioka T, Sakamoto M, Sai Y, Ezoe Y, Iikubo M, Kumamoto H, Takahashi T. Florid cemento-osseous dysplasia-associated simple bone cyst showing marked irregular border and high apparent diffusion coefficient value. Case Rep Dent 2020;2020:8854428.
53. Yuen VH, Jordan DR, Jabi M, Agbi C. Aneurysmal bone cyst associated with fibrous dysplasia. Ophthalmic Plast Reconstr Surg 2002;18:471-4.
54. Rau LH, Reinheimer A, Meurer MI, Marodin AL, Espezim CS, Klüppel LE, Dos Santos Vaz Fernandes PC, Rivero ERC. Fibrous dysplasia with secondary aneurysmal bone cyst-a rare case report and literature review. Oral Maxillofac Surg 2019;23:101-7.