Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, Szentkirályi u. 47, Budapest, 1088, Hungary.
Department of Pathology and Experimental Cancer Research, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.
BMC Oral Health. 2019 Jul 10;19(1):139. doi: 10.1186/s12903-019-0843-0.
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.
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.
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.
骨-牙骨质发育不良是一种发生于颌骨牙源性区域的良性纤维骨性病变，具有牙周韧带起源。它主要发生于黑人和亚洲中年女性。其重要性在于，它在早期半透明阶段可能类似于根尖周病变。
本报告介绍了一例罕见的家族性骨-牙骨质发育不良病例：一名 50 岁白人女性，出现唇侧麻木，下颌切牙和第一磨牙根周放射状半透明。第一磨牙周围的病变被诊断为根尖周肉芽肿，并进行了根管治疗。手术切除病变后，组织学证实为弥漫性骨-牙骨质发育不良，基于二维和三维影像学检查的诊断和治疗计划。我们对家庭成员进行了筛查——包括患者的母亲、女儿和儿子——并在女儿中发现了根尖周型骨-牙骨质发育不良。我们的病例强调了骨-牙骨质发育不良与其他根尖周病变的鉴别诊断的困难。目前骨-牙骨质发育不良分类的不一致性也进行了讨论，并提出了一种基于新方面的不同分类，这将非常有助于制定正确的治疗计划。
通过适当的临床评估和使用活力测试区分牙髓和非牙髓来源的放射透光度，并将其与解剖标志区分开来，可以有机会避免不必要的牙髓治疗。目前的骨-牙骨质发育不良分类不能涵盖遗传性弥漫性骨-牙骨质发育不良的早期阶段。与病变的解剖位置相比，临床和遗传特征可能被推荐作为骨-牙骨质发育不良分类的参数。
