Zhang Jiankang, Yu Yunbo, Tang Wei, Pan Jian, Jing Wei
Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN.
Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Chongqing Medical University, Chongqing, CHN.
Cureus. 2023 Nov 19;15(11):e49041. doi: 10.7759/cureus.49041. eCollection 2023 Nov.
The WHO substantially redefined cemento-osseous dysplasia (COD) in 2017. The descriptions of COD in the 2005 and 2017 WHO classifications are quite different. In this study, we compared the difference in COD description between the 2005 and 2017 editions of the WHO classifications in detail. There are remarkable differences in the terminology, definition, synonyms, epidemiology, classifications, clinical features, radiation/pathology, prognosis, and predictive factors of COD between the two versions. At present, the surgical treatment of COD is less defined, and there is no clear guidance for the treatment of sclerotic bone. In this study, we extracted the affected teeth without removing the sclerotic bone when the bone absorption line can be only found between the root and the lesion, and we extracted the teeth as well as the lesion and curetted the granulation tissue when a bone absorption line could be seen between the lesion and the alveolar bone. According to our observation, the position of the bone absorption line can be used as a reference for the selection of sclerotic bone treatment. Sclerotic bone preservation did not increase its volume and density after tooth extraction. Sclerotic bone was composed of highly mineralized tissue with less blood vessels and cells. The position of the bone resorption line can be used as a basis for treatment selection. The high mineralization of the lesion may weaken its anti-infection ability.
世界卫生组织（WHO）于2017年对骨化纤维瘤（COD）进行了重大重新定义。2005年和2017年WHO分类中对COD的描述有很大不同。在本研究中，我们详细比较了2005年版和2017年版WHO分类中COD描述的差异。两个版本在COD的术语、定义、同义词、流行病学、分类、临床特征、放射学/病理学、预后和预测因素等方面存在显著差异。目前，COD的外科治疗定义较少，对于硬化骨的治疗没有明确的指导。在本研究中，当仅在牙根与病变之间发现骨吸收线时，我们不拔除硬化骨而仅拔除患牙；当在病变与牙槽骨之间可见骨吸收线时，我们拔除牙齿及病变组织并刮除肉芽组织。根据我们的观察，骨吸收线的位置可作为选择硬化骨治疗方法的参考。拔牙后保留硬化骨并不会增加其体积和密度。硬化骨由矿化程度高的组织组成，血管和细胞较少。骨吸收线的位置可作为治疗选择的依据。病变的高矿化可能会削弱其抗感染能力。
