Florid cemento-osseous dysplasia: A case report and review of literature

Florid cemento-osseous dysplasia (FCOD) is a benign slowly growing fibro-osseous disorder, usually diagnosed accidentally through routine radiographic examination. The lesions are generally asymptomatic, but, in the most severe cases, focal enlargement and pain may occur due to infection. Here, we report the rare case of a Caucasian middle-aged woman showing, at orthopantomography performed during routine dental check-up, the presence of multiple symmetrical, dense and lobulated radiopaque bone lesions in several areas of the jaws, surrounded by a radiolucent border. The lesions were asymptomatic. Histologically, the replacement of healthy bone by metaplastic bone and fibrous tissue, typical of FCOD, was observed. The lesion remained painless, clinically and radiologically stable over two years follow-up. In asymptomatic cases, no treatment is required, but active clinical and radiographic follow-up are recommended at long-term, to reduce the risk of dental infections and oral surgery involving the area of the lesion. The avascular nature of FCOD contributes to susceptibility to severe infection, bone sequestration and osteomyelitis, limiting the in-site penetration of the antibiotics. Therefore, a careful clinical and radiographic monitoring of the lesions is recommended together with periodical dental check-up.