Grün Pascal, Schneider Benedikt, Bandura Patrick, Pfaffeneder-Mantai Florian, Bytyqi Ditjon, Turhani Dritan
Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria.
Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria; Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500 Krems, Austria.
Int J Surg Case Rep. 2023 Apr;105:108074. doi: 10.1016/j.ijscr.2023.108074. Epub 2023 Mar 27.
Florid cemento-osseous dysplasia (FCOD) is a multifocal fibro-osseous tumour originating from the periodontal ligament that presents as being rare, benign and slow-growing. The lesion is characterised by the replacement of regular bone-structure with fibrous tissue and dysplastic bone. Depending on localisation, the initial characteristics of FCOD resemble those of periapical lesions of inflammatory origin.
We report on the current findings relating to the case of a 39-year-old Caucasian woman, who initially had persistent paresthesia of the right alveolaris inferior nerve (NAI) for longer than 2 weeks. The orthopantomogram showed multiple bilateral periapical radiolucency and a biopsy was indicated to rule out malignancy. Four years later, the radiolucency occurred once again in region 37, suggesting a recurrence of the lesion. Therefore, another minimally invasive surgery had to be performed, which revealed a bone cavity. Two years later, the bone of the affected region almost completely regenerated.
We were aware that an invasive treatment could lead to infection of the hypovascular lesion. Because of the paresthesia, a biopsy was essential. Unexpectedly, the second minimally invasive surgical treatment was a significant success, as the bone lesion regenerated almost completely.
The follow-up of this case was documented over more than 18 years. To date, this is the longest documented case of a FCOD. Minimally invasive surgical treatment of such lesions may lead to better bone regeneration and even a better quality of life for the patient.
florid骨化性纤维瘤（FCOD）是一种起源于牙周韧带的多灶性纤维-骨肿瘤，表现为罕见、良性且生长缓慢。该病变的特征是正常骨结构被纤维组织和发育异常的骨所替代。根据病变部位，FCOD的初始特征类似于炎症性根尖周病变。
我们报告了一名39岁白种女性患者的当前研究结果，该患者最初右侧下牙槽神经（IAN）持续感觉异常超过2周。全景片显示双侧多个根尖周透射区，因此进行了活检以排除恶性肿瘤。4年后，37区再次出现透射区，提示病变复发。因此，不得不再次进行微创手术，术中发现一个骨腔。2年后，患区骨几乎完全再生。
我们意识到侵入性治疗可能导致血供不足病变的感染。由于存在感觉异常，活检至关重要。出乎意料的是，第二次微创手术取得了显著成功，骨病变几乎完全再生。
该病例的随访记录超过18年。迄今为止，这是记录时间最长的FCOD病例。对此类病变进行微创手术治疗可能会使骨再生更好，甚至提高患者的生活质量。
