Roghi Marco, Scapparone Chiara, Crippa Rolando, Silvestrini-Biavati Armando, Angiero Francesca
Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Largo Rosanna Benzi 10, Pad IV, 16132, Genova, Italy.
Anticancer Res. 2014 May;34(5):2533-6.
Periapical cemento-osseous dysplasia (PCOD) is a rare benign lesion, often asymptomatic, in which fibrous tissue replaces the normal bone tissue, with metaplasic bone and neo-formed cement. We present a rare case of mandibular PCOD in a woman of 55 years, who presented with moderate swelling and mobility of teeth 32-33-34. Endoral radiography showed that these teeth had been devitalized; they had deep periodontal pockets and marked radicular radiotransparency; the root apices exhibited mixed radiotransparency and radio-opacity. Clinical and radiographical findings led to a diagnosis of periapical rarefying osteitis, and the three teeth were thus extracted. Due to the persistence of swelling and slight pain post-extraction, a cone-beam computed tomographic scan was taken; this showed a mixed radiotransparent and radio-opaque lesion in the area of the extracted teeth. A bone biopsy of the affected area was taken for histopathological evaluation; a diagnosis of PCOD was rendered. This case demonstrates the importance of a full investigation when a patient presents after tooth extraction with non-healing socket, pain, and swelling. A multidisciplinary approach is required to manage these rare cases.
根尖周牙骨质骨发育异常（PCOD）是一种罕见的良性病变，通常无症状，其中纤维组织取代正常骨组织，并伴有化生骨和新形成的牙骨质。我们报告一例55岁女性下颌PCOD罕见病例，该患者表现为32 - 33 - 34牙中度肿胀和松动。口内放射影像学显示这些牙齿已失活；有深牙周袋和明显的牙根透射影；根尖呈现混合性透射影和阻射影。临床和影像学检查结果导致诊断为根尖周骨质溶解，因此拔除了这三颗牙齿。由于拔牙后肿胀持续且有轻微疼痛，进行了锥形束计算机断层扫描；结果显示拔牙区域有混合性透射和阻射性病变。对受影响区域进行骨活检以进行组织病理学评估；诊断为PCOD。本病例表明，当患者拔牙后出现拔牙创不愈合、疼痛和肿胀时，全面检查的重要性。处理这些罕见病例需要多学科方法。
