title: Case presentation of florid cemento-osseous dysplasia with concomitant cemento-ossifying fibroma discovered during implant explantation.
abstract: A 39-year-old African American woman presented for treatment of a symptomatic mandibular right first molar with a large, periapical radiolucency. After initial attempts at endodontic therapy, this tooth was ultimately extracted owing to unabated symptoms. The extraction site underwent ridge preservation grafting, implant placement, and restoration. After 26 months of implant function, the patient returned with clinical symptoms of pain, buccal swelling, and the sensation of a "loose" implant. This case report details a diagnosis of 2 distinct disease entities associated with the implant site, a cemento-ossifying fibroma and florid cemento-osseous dysplasia of the mandible. This diagnosis was determined from clinical, surgical, radiographic, and histopathologic evidence after biopsy and removal of the previously osseointegrated implant following postinsertion failure by fibrous encapsulation. Before implant therapy, it is essential to conduct a thorough radiographic evaluation of any dental arch with suspected bony lesions to prevent implant failure.
authors.affiliation: US Army Advanced Education Programs in Periodontic, Oral Surgery, and Oral Pathology, Fort Gordon, Georgia 309058, USA. robert.campbell.gerlach@us.army.mil
authors.forename: Robert C
authors.initials: RC
authors.lastname: Gerlach
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Dixon
authors.forename: Tamer
authors.initials: T
authors.lastname: Goksel
authors.forename: James T
authors.initials: JT
authors.lastname: Castle
authors.forename: Walter A
authors.initials: WA
authors.lastname: Henry
mesh_terms: D000328:Adult; D001706:Biopsy; D002485:Cementoma / Q000175:diagnosis*; D054893:Cone-Beam Computed Tomography; D015921:Dental Implants; D019232:Dental Restoration Failure; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008339:Mandibular Neoplasms / Q000175:diagnosis*; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis*; D009808:Odontogenic Tumors / Q000175:diagnosis*; D011862:Radiography, Panoramic
chemical_list: D015921:Dental Implants