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Florid cemento-osseus dysplasia (FCOD) has been described as a reactive process in which normal bone is replaced by fibrous connective tissues and cementum-like materials. Radiographically it appears as dense, lobulated masses, often occurring bilaterally with symmetric involvement. In this case report, a successful implant placement has been reported in a 62-year-old Caucasian woman with a chief complaint of mandibular partial edentulous. Radiographic images showed the bilateral radiopaque lesions in edentulous regions of mandible, and mandibular anterior teeth alike. All mandibular teeth were vital and no root resorption was detected. The findings of X-ray images were attributable to FCOD. A highly conservative step-by-step 2-stage implant surgery was performed. After 6 months the implants loaded with fixed prosthesis. 2, 4, 6, 12, and 18 months after the surgery radiographic images were taken, which revealed an optimal functional rehabilitation and complete integration of implants. This report confirms that treating the edentulous area near the FCOD lesions could be planned, if conservative step- by-step implant placement been considered. To the best of our knowledge, a case of FCOD with successful implant placement has not been reported previously. More studies in more patients are needed to confirm results of such a therapeutic modality.
Key Words: fibrous dysplasia of bone complications, fibrous dysplasia of bone diagnostic imaging, jaw diseases diagnostic imaging, dental implants, dental restoration failure, florid cemento-osseous dysplasia, osseous dysplasia
Introduction
Osseous-dysplasia (OD) refers to a group of fibroosseous conditions of bone. It arises due to the superseding of bone to fibrous connective tissue.1 Generally, 3 main classifications have been described for OD: periapical, florid, and focal cemental dysplasia.2 These lesions are reminiscent of histologic spectrum, albeit differ in their extent of jaw involvement.3 The florid cemento-osseous dysplasia (FCOD) is a disease of a rare distribution, the precise etiology of which has been remained occult.4 Basic histopathology studies unraveled the biological plausibility of reactive or dysplastic changes of the periodontal ligament.5 The epidemiologic studies point to the middle-aged black female as a predominant affected population; moreover, it also appears in Caucasians and Asians.1,2,6 The results of a systematic review by MacDonald-Jankowski in 2003 illustrated the prevalence of FCOD as following: within 158 identified cases, 97% of which were females, 59% were black;37%, Asian; and 3% were Caucasian.1
Dental panoramic...