Seven-year Follow-up of A Focal Cemento-Osseous Dysplasia Associated with Mandibular First Molar: A Case Report

Abstract

Cemento-osseous dysplasia (COD) is a benign fibro-osseous lesion with replacement of normal bone tissue by fibrous connective tissue. This case report presents an asymptomatic mixed radiolucent-radiopaque lesion in the posterior mandible of a 37-year-old female patient. Clinical and radiographic evaluation led to the diagnosis of focal cemento-ossifying dysplasia (FCOD) and regular radiographic follow-up was recommended as focal COD may progress to florid COD. The lesion was followed up for seven years with three examinations. During this time, the lesion remained asymptomatic and the associated tooth remained vital. An increase in the size of the internal hyperdense content was observed during the follow-up visits. The maturation process was well observed. A minimally increased expansion was also noted.

Keywords

• cementoosseous dysplasia
• fibroosseous dysplasia
• cone beam computed tomography
• fibroosseöz displazi
• konik ışınlı bilgisayarlı tomografi
• sementoosseöz displazi

Mandibular Birinci Molar ile İlişkili Fokal Semento-osseöz Displazinin 7 Yıllık Takibi: Bir Olgu Sunumu

Abstract

Semento-osseöz displazi (SOD), normal kemik dokusunun fibröz bağ doku ile yer değiştirdiği, iyi huylu bir fibro-osseöz lezyondur. Bu olgu raporunda 37 yaşındaki kadın hastanın posterior mandibulasında asemptomatik, mikst radyolüsent-radyoopak görünümlü lezyon sunulmuştur. Klinik ve radyografik muayene sonucunda fokal semento-osseöz displazi (FSOD) olduğu düşünülen lezyonun düzenli radyolojik takibi önerilmiştir. Lezyon yedi sene boyunca takip edilmiş ve radyografik olarak değerlendirilmiştir. Takip süreci boyunca asemptomatik olan lezyon ile ilişkili dişin de vital olduğu gözlenmiştir. Ayrıca, lezyonun içeriğindeki hiperdens alanın boyutunun arttığı ve ekspansiyonun minimal olarak arttığı izlenmiştir.

Keywords

• fibroosseöz displazi
• konik ışınlı bilgisayarlı tomografi
• sementoosseöz displazi

References

1. Alsufyani NA, Lam EW. Osseous (cemento-osseous) dysplasia of the jaws: clinical and radiographic analysis. J Can Dent Assoc. 2011;77:b70. PMID: 21683027.
2. Bhandari R, Sandhu SV, Bansal H, Behl R, Bhullar RK. Focal cemento-osseous dysplasia masquerading as a residual cyst. Contemp Clin Dent. 2012 Apr;3(Suppl 1):S60-2. doi: 10.4103/0976-237X.95107. PMID: 22629069; PMCID: PMC3354788.
3. Bulut EU, Acikgoz A, Ozan B, Zengin AZ, Gunhan O. Expansive focal cemento-osseous dysplasia. J Contemp Dent Pract. 2012 Jan 1;13(1):115-8. doi: 10.5005/jp-journals-10024-1105. PMID: 22430704.
4. Cankaya AB, Erdem MA, Olgac V, Firat DR. Focal cemento-osseous dysplasia of mandible. BMJ Case Rep. 2012 Sep 3;2012:bcr2012006432. doi: 10.1136/bcr-2012-006432. PMID: 22948991; PMCID: PMC4544464.
5. 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 Jan-Feb;29(1):99-104. doi: 10.1590/0103-6440201801621. PMID: 29267533.
6. Cho BH, Jung YH, Nah KS. The prevalence, clinical and radiographic characteristics of cemento-osseous dysplasia in korea. Korean J Oral Maxillofac Radiol. 2007;37:185-9.
7. Drazić R, Minić AJ. Focal cemento-osseous dysplasia in the maxilla mimicking periapical granuloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Jul;88(1):87-9. doi: 10.1016/s1079-2104(99)70198-8. PMID: 10442950.
8. Galgano C, Samson J, Küffer R, Lombardi T. Focal cemento-osseous dysplasia involving a mandibular lateral incisor. Int Endod J. 2003 Dec;36(12):907-11. doi: 10.1111/j.1365-2591.2003.00736.x. PMID: 14689960.

9. Gumru B, Akkitap MP, Deveci S, Idman E. A retrospective cone beam computed tomography analysis of cemento-osseous dysplasia. J Dent Sci. 2021 Oct;16(4):1154-1161. doi: 10.1016/j.jds.2021.03.009. Epub 2021 Apr 7. PMID: 34484583; PMCID: PMC8403794.
10. 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 Mar;14(1):173-182. doi: 10.1007/s12105-019-01037-x. Epub 2019 Apr 22. PMID: 31011984; PMCID: PMC7021850.
11. Kawai T, Hiranuma H, Kishino M, Jikko A, Sakuda M. Cemento-osseous dysplasia of the jaws in 54 Japanese patients: a radiographic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Jan;87(1):107-14. doi: 10.1016/s1079-2104(99)70303-3. PMID: 9927089.
12. MacDonald DS. Classification and nomenclature of fibro-osseous lesions. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Apr;131(4):385-389. doi: 10.1016/j.oooo.2020.12.004. Epub 2021 Jan 29. Erratum in: Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Mar;133(3):358. PMID: 33518490.
13. Macdonald-Jankowski DS. Focal cemento-osseous dysplasia: a systematic review. Dentomaxillofac Radiol. 2008 Sep;37(6):350-60. doi: 10.1259/dmfr/31641295. PMID: 18757721.
14. Min CK, Koh KJ, Kim KA. Recurrent symptomatic cemento-osseous dysplasia: A case report. Imaging Sci Dent. 2018 Jun;48(2):131-137. doi: 10.5624/isd.2018.48.2.131. Epub 2018 Jun 19. PMID: 29963485; PMCID: PMC6015922.
15. Nam I, Ryu J, Shin SH, Kim YD, Lee JY. Cemento-osseous dysplasia: clinical presentation and symptoms. J Korean Assoc Oral Maxillofac Surg. 2022 Apr 30;48(2):79-84. doi: 10.5125/jkaoms.2022.48.2.79. PMID: 35491138; PMCID: PMC9065647.
16. Nelson BL, Phillips BJ. Benign Fibro-Osseous Lesions of the Head and Neck. Head Neck Pathol. 2019 Sep;13(3):466-475. doi: 10.1007/s12105-018-0992-5. Epub 2019 Mar 18. PMID: 30887390; PMCID: PMC6684826.
17. Oh D, Samuels J, Chaw S, Zhang A, Selim D, Lalla Y, Monsour P. Cemento-osseous dysplasia: Revisited. J Dent Oral Health 2019; 1:1e11
18. Ohkura K. [Clinicopathological studies on localized cemento-osseous dysplasia of the jaws]. Kokubyo Gakkai Zasshi. 2001 Mar;68(1):99-110. Japanese. doi: 10.5357/koubyou.68.99. PMID: 11321812.
19. Olgac V, Sinanoglu A, Selvi F, Soluk-Tekkesin M. A clinicopathologic analysis of 135 cases of cemento-osseous dysplasia: To operate or not to operate? J Stomatol Oral Maxillofac Surg. 2021 Jun;122(3):278-282. doi: 10.1016/j.jormas.2020.06.002. Epub 2020 Jun 18. PMID: 32565263.
20. Rao GS, Kamalapur MG, Acharya S. Focal cemento-osseous dysplasia masquerading as benign cementoblastoma: A diagnostic dilemma. J Oral Maxillofac Pathol. 2014 Jan;18(1):150. doi: 10.4103/0973-029X.131949. PMID: 24959061; PMCID: PMC4065439.
21. Ravikumar SS, Vasupradha G, Menaka TR, Sankar SP. Focal cemento-osseous dysplasia. J Oral Maxillofac Pathol. 2020 Feb;24(Suppl1):S19-S22. doi: 10.4103/jomfp.JOMFP_209_19. Epub 2020 Feb 28. PMID: 32189898; PMCID: PMC7069129.
22. Salvi AS, Patankar S, Desai K, Wankhedkar D. Focal cemento-osseous dysplasia: A case report with a review of literature. J Oral Maxillofac Pathol. 2020 Feb;24(Suppl 1):S15-S18. doi: 10.4103/jomfp.JOMFP_349_19. Epub 2020 Feb 28. PMID: 32189897; PMCID: PMC7069140.
23. Seifi S, Ghorbani H, Khakbaz O, Bijani F. Focal Cemento Osseous Dysplasia: A Case Report. J Dent (Shiraz). 2022 Jun;23(2):151-154. doi: 10.30476/DENTJODS.2022.88067.1309. PMID: 35783499; PMCID: PMC9206700.
24. Su L, Weathers DR, Waldron CA. Distinguishing features of focal cemento-osseous dysplasias and cemento-ossifying fibromas: I. A pathologic spectrum of 316 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Sep;84(3):301-9. doi: 10.1016/s1079-2104(97)90348-6. PMID: 9377196.
25. Summerlin DJ, Tomich CE. Focal cemento-osseous dysplasia: a clinicopathologic study of 221 cases. Oral Surg Oral Med Oral Pathol. 1994 Nov;78(5):611-20. doi: 10.1016/0030-4220(94)90174-0. PMID: 7838469.
26. Thakur A, Gaikwad S, Tupkari JV, Ramaswami E. Florid cemento-osseous dysplasia: A case report. Indian J Dent Res. 2021 Jan-Feb;32(1):134-136. doi: 10.4103/ijdr.IJDR_754_18. PMID: 34269253.