Summerlin D J, Tomich C E
Department of Oral and Maxillofacial Pathology, Indiana University Medical Center, Indianapolis.
Oral Surg Oral Med Oral Pathol. 1994 Nov;78(5):611-20. doi: 10.1016/0030-4220(94)90174-0.
Classification of cemento-osseous lesions of the jaws has long been a dilemma for pathologists. A group of 221 cemento-osseous lesions exhibited sufficiently distinctive clinicopathologic features to be separated into a specific category: focal cemento-osseous dysplasia. This entity presents as an asymptomatic, focal, mixed radiolucent/radiopaque lesion with ill-defined borders in the tooth-bearing areas. It was found to occur with greater frequency in women (88%) and in the posterior mandible (77%). The average age at presentation was 37 years and a relative predilection for black patients was observed. At surgery these lesions were noted to be hemorrhagic, gritty, and adherent to the surrounding bone. The gross appearance of multiple hemorrhagic fragments is of diagnostic significance. Histologic features include a cellular connective tissue stroma punctuated by irregular osseous and/or cementum-like calcifications. Focal cemento-osseous dysplasia is thought to be of periodontal ligament origin and to be non-neoplastic in nature. Further surgical intervention is not necessary, but periodic follow-up is recommended, because occasional cases were observed to progress into florid osseous dysplasia. Care must be taken to differentiate focal cemento-osseous dysplasia from central cementifying and/or ossifying fibromas, which are true neoplasms and require surgical treatment.
颌骨牙骨质-骨病变的分类长期以来一直是病理学家面临的难题。一组221例牙骨质-骨病变表现出足够独特的临床病理特征，可分为一个特定类别：局灶性牙骨质-骨发育异常。该病变表现为无症状的局灶性、混合性透射线/阻射线病变，在牙列区边界不清。研究发现，该病变在女性中发生率更高（88%），且多见于下颌骨后部（77%）。出现症状的平均年龄为37岁，且观察到黑人患者相对更易患病。手术时发现这些病变有出血、质地粗糙，并与周围骨组织粘连。多个出血性碎片的大体外观具有诊断意义。组织学特征包括细胞性结缔组织基质，其间有不规则的骨样和/或牙骨质样钙化。局灶性牙骨质-骨发育异常被认为起源于牙周膜，本质上是非肿瘤性的。无需进一步手术干预，但建议定期随访，因为观察到偶尔有病例会进展为 florid骨发育异常。必须注意将局灶性牙骨质-骨发育异常与中心性牙骨质化和/或骨化性纤维瘤相鉴别，后者是真正的肿瘤，需要手术治疗。
