Focal cemento-osseous dysplasia in the maxilla mimicking periapical granuloma

doi:10.1016/S1079-2104(99)70198-8

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology

Volume 88, Issue 1, July 1999, Pages 87-89

https://doi.org/10.1016/S1079-2104(99)70198-8 Get rights and content

Abstract

A case of focal cemento-osseous dysplasia of the maxilla in a 19-year-old man is reported. Clinically, the lesion resembled periapical pathosis of odontogenic origin. The clinical and histopathologic features of cemento-osseous dysplasia are reviewed. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88: 87-9)

Section snippets

CASE REPORT

A 19-year-old man was referred for treatment of a periapical lesion in the region of the first right maxillary premolar. Endodontic treatment was initiated in another dental practice but was not completed because the patient did not cooperate and neglected subsequent appointments.

Previous radiographs were not available at the time of the current clinical examination. The patient was free of symptoms, the only complaint being a carious tooth that had been previously treated. The present

DISCUSSION

The clinical, radiographic, and histopathologic features of this case are similar to those of the 221 cases reported by Summerlin and Tomich.¹ An unusual aspect of the presentation was the occurrence of focal COD at the apex of a maxillary premolar root with a necrotic pulp in a 19-year old male patient. Focal COD occurs with greater frequency in women (88%) and in the posterior mandible (77%), and the greatest frequency is noted in patients in the fourth and fifth decades.

The histopathologic

References (5)

DJ Summerlin et al.
Focal cemento osseous dysplasia: a clinicopathologic study of 221 cases
Oral Surg Oral Med Oral Pathol
(1994)
CA. Waldron
Fibro-osseous lesions of the jaws
J Oral Maxillofac Surg
(1993)

There are more references available in the full text version of this article.

Cited by (17)

Nonendodontic lesions misdiagnosed as apical periodontitis lesions: Series of case reports and review of literature
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Citation Excerpt :
The mean age of this kind of lesion was about 37.5 years, and the posterior region was the most affected (3/4 cases). The most commonly reported lesion of this group was cemento-osseous dysplasia, which is the commonest fibro-osseous lesion found in clinical practice; it is asymptomatic and is usually found in routine radiographs (34). The group is composed of periapical osseous dysplasia, focal osseous dysplasia, and florid osseous dysplasia.
This study aimed to analyze cases referred from a reference service in oral pathology that were initially misdiagnosed as periapical lesions of endodontic origin and to perform a review of the literature regarding lesions located in the apical area of teeth with a nonendodontic source.
A survey was made of clinical cases derived from the service of oral pathology from 2002 to 2012. The pertinent literature was also reviewed using ScienceDirect and PubMed databases. The lesions were grouped into benign lesions mimicking endodontic periapical lesions (BLMEPLs), malignant lesions mimicking endodontic periapical lesions (MLMEPLs), and Stafne bone cavities. The clinical presentations were divided into lesions with swelling without pain, lesions with swelling and pain, and lesions without swelling but presenting with pain.
The results showed that 66% (37/56) of cases represented benign lesions, 29% (16/56) malignant lesions, and 5% (3/56) Stafne bone cavities. The most commonly reported BLMEPLs were ameloblastomas (21%) followed by nasopalatine duct cysts (13.5%). The most frequently cited MLMEPLs were metastatic injuries (31.5%) followed by carcinomas (25%). The main clinical presentation of BLMEPLs was pain, whereas that of MLMEPLs was swelling associated with pain; Stafne bone cavities displayed particular clinical findings.
Clinical and radiologic aspects as well as the analysis of the patients' medical history, pulp vitality tests, and aspiration are essential tools for developing a correct diagnosis of periapical lesions of endodontic origin. However, if the instruments mentioned earlier indicate a lesion of nonendodontic origin, a biopsy and subsequent histopathological analysis are mandatory.
Nonmalignant nonendodontic lesions mimicking periapical lesions of endodontic origin: A systematic review
2022, Journal of Conservative Dentistry
Unerupted Supernumerary Mandibular Fourth Premolar in a dog
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Focal cemento-osseous dysplasia
2020, Journal of Oral and Maxillofacial Pathology
Focal cemento-osseous dysplasia: An unusual case report
2019, Indian Journal of Public Health Research and Development
Difficulties in the diagnosis of periapical translucencies and in the classification of cemento-osseous dysplasia
2019, BMC Oral Health

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^☆: Reprint requests: Radojica Draz̆ić, MSc, Clinic of Oral Surgery, Faculty of Stomatology, dr Subotića 4, 11000 Belgrade, Yugoslavia

^☆☆: 1079-2104/99/$8.00 + 0 7/15/98719

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Focal cemento-osseous dysplasia in the maxilla mimicking periapical granuloma☆,☆☆

Abstract

Section snippets

CASE REPORT

DISCUSSION

Oral Surg Oral Med Oral Pathol

J Oral Maxillofac Surg