Periapical cemento-osseous dysplasia in maxillary teeth suggesting apical periodontitis: case report

This article describes the case of a 34-year-old woman whose prosthodontist had referred her for root canal treatment of tooth No. 10, due to an initial diagnosis of apical periodontitis. Although periapical radiolucencies were present, teeth No. 10 and 11 responded positively to pulp vitality tests. A series of periapical radiographs revealed circumscribed periapical radiolucencies on teeth No. 21 and 28, while teeth No. 23, 24, and 27 were associated with mixed radiolucent/radiopaque periapical lesions. All teeth responded to cold stimulus. Based on the clinical and radiographic findings, a diagnosis of periapical cemento-osseous dysplasia was suggested. A re-evaluation 12 months later confirmed this diagnosis. Tooth No. 10 was restored and the patient was scheduled to return for clinical and radiographic follow-up after one year and three years.