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Cemento-osseous dysplasia in need of careful examination : a case report

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Abstract


Cemento-osseous dysplasia (COD) is a fibro-osseous lesion of the maxilla and mandible, originating from a periodontal ligament. It resembles a periapical lesion such as a periapical abscess or a cyst in its early stage. Usually, the affected tooth is vital and without symptoms.
A healthy 35-year-old female was referred to the endodontic department for evaluation and endodontic treatment of an amalgam restored mandibular first molar with an apical radiolucency. Since the tooth was sensitive to a cold stimulus, chronic apical periodontitis was suspicious at first sight. But after clinical and radiographic evaluations, multiple periapical COD involving vital teeth of the mandible was diagnosed. No specific treatment of COD was scheduled except for renewing the pre-existing restoration.
The present case is a confusing case since COD was associated with an asymptomatic tooth. Knowledge of the clinical features related to pulp vitality tests and cone-beam computed tomography (CBCT) helps determine the differential diagnosis between COD and a periapical lesion.

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cemento-osseous dysplasia; periapical lesion; differential diagnosis; cone-beam computed tomograph

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