title: Florid Cemento-osseous Dysplasia: A Case of Misdiagnosis.
abstract: Florid cemento-osseous dysplasia (FCOD) belongs to the group of fibro-osseous lesions in which normal bone is replaced by fibrous connective tissue and calcified cementum tissue of the avascular type. Among the various types of fibro-osseous lesions, FCOD is one of the most commonly encountered diseases in clinical practice and may involve 3 or 4 of the quadrants. FCOD is located in the periapical regions of teeth, and the lesions are predominantly radiolucent (osteolytic phase), become mixed over time (cementoblast phase), and ultimately become radiopaque (osteogenic phase) with a thin radiolucent peripheral halo. The characteristics of FCOD in the initial stages are similar to those of periapical lesions of inflammatory origin, which may lead to misdiagnosis. A 38-year-old woman sought dental care because of complaints of pain on the right side of her face. A clinical examination revealed no marked alterations; a panoramic radiograph was therefore requested and revealed the presence of radiolucent lesions associated with the periapical regions of some of the lower teeth. Thus, the professional referred the patient for endodontic treatment of the associated teeth with the justification that the lesions were of endodontic origin. However, the endodontist found that the teeth responded positively to a sensitivity test. The initial diagnosis could have resulted in unnecessary root canal treatment, but after careful clinical, radiographic, and tomographic assessments by different professionals, FCOD was diagnosed, conservatively treated, and regularly monitored. It is important that dentists have a basic knowledge of the various injuries that affect the jaw bones to prevent errors in diagnosis and treatment and to promote oral health.
authors.affiliation: Postgraduate Program, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.
authors.forename: Débora
authors.initials: D
authors.lastname: Delai
authors.affiliation: Postgraduate Program, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.
authors.forename: Anarela
authors.initials: A
authors.lastname: Bernardi
authors.affiliation: Postgraduate Program, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.
authors.forename: Gabriela Santos
authors.initials: GS
authors.lastname: Felippe
authors.affiliation: Department of Endodontics, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.
authors.forename: Cleonice
authors.initials: C
authors.lastname: da Silveira Teixeira
authors.affiliation: Department of Endodontics, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.
authors.forename: Wilson Tadeu
authors.initials: WT
authors.lastname: Felippe
authors.affiliation: Department of Endodontics, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil. Electronic address: mcsfelippe@gmail.com.
authors.forename: Mara Cristina
authors.initials: MC
authors.lastname: Santos Felippe
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D005357:Fibrous Dysplasia of Bone / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D010019:Osteomyelitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D010485:Periapical Periodontitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D011862:Radiography, Panoramic
keywords: Differential diagnosis; florid cemento-osseous dysplasia; misdiagnosis; periapical lesion; pulp sensitivity test