Focal cemento-osseous dysplasia involving a mandibular lateral incisor.
OBJECTIVE
To report a case of focal cemento-osseous dysplasia (FCOD) affecting a single tooth misdiagnosed as an inflammatory periapical lesion.


CONCLUSIONS
The patient, a black 47-year-old woman complained of pain affecting the right side of the mandible. Routine X-ray examination discovered a periapical radiolucency on the mandibular left lateral incisor (tooth 32), which was otherwise normal and not carious. As the response of this tooth to a vitality test was doubtful, the lesion was diagnosed as a periapical granuloma or cyst secondary to pulpal necrosis. Endodontic treatment and curettage of the periapical lesion were performed, and histological examination of the curettage material revealed a localized osseous dysplasia.


CONCLUSIONS
FCOD may rarely affect only one tooth, resembling a periapical granuloma or cyst. Careful diagnosis is of paramount importance in cases of questionable periapical lesions affecting normal-looking teeth, before beginning treatment. FCOD generally requires no treatment. Biopsy is warranted in case of doubt.
Galgano
C
C
Private Practice Cagliari, Italy.
Samson
J
J
Küffer
R
R
Lombardi
T
T
D002485:Cementoma / Q000145:classification / Q000175:diagnosis; D003790:Dental Pulp Necrosis / Q000150:complications* / Q000628:therapy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D005358:Fibrous Dysplasia, Monostotic / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007180:Incisor; D008336:Mandibular Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008339:Mandibular Neoplasms / Q000145:classification / Q000175:diagnosis; D008875:Middle Aged; D010484:Periapical Granuloma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery