Implant placement in a focal cemento-osseous dysplasia: A modified protocol with a successful outcome

Cemento-osseous dysplasia (COD) is defined as a condition in which normal bone is replaced by fibrous connective tissue and cementum-like deposits. It is generally asymptomatic and occurs mostly in female patients. Radiologically, it appears as an opaque, lobulated mass. When facing such lesions, it is advised to avoid performing any surgical procedures due to the decreased vascularization and healing potential. The main reported complications being poor healing, sequestrum formation, risk of infection, and fracture of the jaw. Treating posterior mandibular edentulism in presence of a COD can be a challenging situation especially when the patient requires an implant-supported fixed rehabilitation. The aim of this paper is to describe a three-stage modified protocol for implant placement in a compromised site presenting a focal cemento-osseous dysplasia.