Difficulties in the diagnosis of periapical translucencies and in the classification of cemento-osseous dysplasia

Andrea Brody, A. Zalatnai, Krisztian Csomo, Andrea Belik, Csaba Dobo-Nagy

Research output: Contribution to journalArticle

Abstract

Background: Cemento-osseous dysplasia is a benign fibro-osseous lesion of the tooth-bearing region of the jaws with a periodontal ligament origin. It appears predominantly in Black and Asian middle-aged females. Its importance is that it could mimic a periapical lesion in the early, translucent stage. Case presentation: In this report a rare case of familial cemento-osseous dysplasia is presented: a 50-years old Caucasian woman with labial paraesthesia and radiological translucency around the roots of the mandibular incisors and the first molar teeth. The lesion around the first molar was diagnosed as periapical granuloma and a root canal treatment was carried out. The diagnosis of florid cemento-osseous dysplasia and the treatment plan based on two- and three-dimensional radiographic examinations were certified histologically after surgical removal of the lesion. We screened the family members - including the patient's mother, daughter and son - and identified a periapical version of cemento-osseous dysplasia in the daughter. Our case highlights the difficulties of differential diagnosis of cemento-osseous dysplasia and other periapical pathologies. The inconsistencies in the present classification of cemento-osseous dysplasia are also discussed with a proposal for a different classification based on new aspects that would be very helpful in setting up a correct treatment plan. Conclusion: Differentiation of endodontic and non-endodontic origin of radiolucency and distinguishing it from anatomical landmarks by appropriate clinical evaluation and using vitality testing can give an opportunity to prevent unnecessary endodontic treatment. The current categories of cemento-osseous dysplasia classification do not cover the early stage of a hereditary florid form of cemento-osseous dysplasia. Instead of anatomical location of the lesion, clinical and genetic features may be recommended as parameters of cemento-osseous dysplasia classification.

Original languageEnglish
Article number139
JournalBMC Oral Health
Volume19
Issue number1
DOIs
Publication statusPublished - Jul 10 2019

Fingerprint

Nuclear Family
Endodontics
Tooth
Periapical Granuloma
Periodontal Ligament
Paresthesia
Dental Pulp Cavity
Incisor
Therapeutics
Lip
Jaw
Differential Diagnosis
Mothers
Pathology
Florid cemento-osseous dysplasia

Keywords

  • Cemento-osseous dysplasia
  • Classification
  • Differential diagnosis
  • Familial form of COD
  • Florid
  • Misdiagnosis
  • Periapical translucencies

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Difficulties in the diagnosis of periapical translucencies and in the classification of cemento-osseous dysplasia. / Brody, Andrea; Zalatnai, A.; Csomo, Krisztian; Belik, Andrea; Dobo-Nagy, Csaba.

In: BMC Oral Health, Vol. 19, No. 1, 139, 10.07.2019.

Research output: Contribution to journalArticle

Brody, Andrea ; Zalatnai, A. ; Csomo, Krisztian ; Belik, Andrea ; Dobo-Nagy, Csaba. / Difficulties in the diagnosis of periapical translucencies and in the classification of cemento-osseous dysplasia. In: BMC Oral Health. 2019 ; Vol. 19, No. 1.
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