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Clinical, radiographic, biochemical and histological findings of florid cemento-osseous dysplasia and report of a case.

Department of Diagnosis and Surgery, Faculty of Dentistry of Araraquara, São Paulo State University (UNESP), Araraquara, SP, Brazil.
Brazilian dental journal 02/2005; 16(3):247-50. DOI: 10.1590/S0103-64402005000300014
Source: PubMed

ABSTRACT Florid cemento-osseous dysplasia has been described as a condition that characteristically affects the jaws of middle-aged black women. It usually manifests as multiple radiopaque cementum-like masses distributed throughout the jaws. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. The authors present a case of an uncomplicated florid cemento-osseous dysplasia in a 48-year-old black woman. Multiple sclerotic masses with radiolucent border in the mandible were identified radiographically. Histopathologic findings revealed formation of calcified dense sclerotic masses similar to cementum. All clinical, radiographic, biochemical and histological features were suggestive of the diagnosis of florid cemento-osseous dysplasia.

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    ABSTRACT: Florid cemento-osseous dysplasia (FCOD) is a benign fibro-osseous lesion that primarily affects the jaws of middle-aged women of African ancestry. This lesion may be completely asymptomatic and in such cases the lesion is detected incidentally in radiographs. Clinical symptoms may occur due to secondary infection of exposed masses or may be due to mucosal irritation under prostheses. Radiographic features of these lesions pass from initially radiolucent (osteolytic stage), then develop into mixed radiolucent/radiopaque lesions (intermediate or cementoblastic stage) before becoming radiopaque masses (osteosclerotic or inactive phase) usually located in multiple quadrants of the jaws. Occurrence of FCOD with chronic suppurative osteomyelitis is rare. In this article a case of FCOD is reported which had evidence of infection as the first presentation. A 52-year-old Indian female patient was initially diagnosed as having chronic suppurative osteomyelitis based on clinical findings but later diagnosed with FCOD after radiological examination of a digital orthopantomogram. Histopathological findings revealed formation of calcified dense sclerotic masses of cementum suggestive of the diagnosis of FCOD. The patient was managed by periodical debridement of the area which had undergone osteomyelitic changes and with oral clindamycin 300 mg. This case emphasizes that the diagnosis of FCOD can be done on radiographic features alone. Early radiological investigations should be carried out to prevent complications in FCOD patients.
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    ABSTRACT: Case report A 30-year old male patient reported with a chief complaint of a bilateral swelling over the cheek & chin. On extraoral examination it revealed a swelling on zygomatic bone & chin about 1cm X 1cm each in dimension, hard in consistency. On intraoral examination multiple disfiguring swellings that were hard in consistency & intraosseous in nature were observed (Fig 1). Radiographic examination showed multiple radiopaque masses in both mandible and maxilla (Fig 2, 3). Provisional diagnosis given was that of fibrous dysplasia. Multiple tissues specimens were sent for histopathological examination after performing incisional biopsy. These were firm to hard in consistency, irregular in shape, white in colour measuring about 1cm X 0.5cm X.2 cm. Also 3 teeth: 2 mandibular incisors were received. Haematoxylin and eosin stained section revealed irregular concentric cementum like calcified deposits embedded in highly cellular fibrous connective tissue stroma with concentric cementum like tissues (Fig 4).

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