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Synonyms:
Florid cemento-osseous dysplasia.
Gigantiform cementoma.
Familial multiple cementomas.
Disease mechanism:
Widespread form of POD.
Normal cancellous bone replaced with DENSE ,
ACELLULARE AMORPHOUS BONE.
POD 3 or 4 Quadrants FOD.
FOD:
Clinical features:
Female, middle-aged (42ys).
African Americans and Asians.
No symptoms (found incidentally during radiographic examination),
extensive lesions often associated with bony swelling.
Simple bone cyst development within the lesion may induce
low grade intermittent poorly localized pain
Imaging features:
LOCATION:
Bilateral
Mandible > maxilla.
Epicenter apical to the tooth.
Usually post. to cuspid teeth.
Above inferior alveolar canal.
PERIPHERY:
Well defined with sclerotic border.
Mature lesions ST capsule may not appear.
INTERNAL STRUCTURE:
EFFECTS ON SURROUNDING :
Differential diagnosis:
Management:
No required treatment.
Encourage the patient to maintain an effective OH
program to avoid secondary (odontogenic) infection.
It may be necessary to remove large areas of infected
amorphous bone. (if osteomylitis)
Disease mechanism:
Reactive bone lesion.
Chromosomal translocation that led to activation of USP6
gene on chromosome 17p13.
ABCs usually develop in association with other primary
lesions like:
fibrous dysplasia.
Central hemangioma.
Giant cell granuloma.
Osteosarcoma.
Clinical features:
Imaging features:
LOCATION :
Mandible > Maxilla.
Usually posterior part of the body of the
mandible and the ramus region.
PERIPHERY AND SHAPE:
Usually well defined.
Circular or hydraulic.
INTERNAL STRUCTURE:
Uni or Multilocular radiolucency.
Ballooned out appearance.
Wispy faint septa.
Law attenuation region representing fluid
density.
Differential diagnosis:
Management:
Surgical curettage. (19-50% recurrent rate)
Partial resection. (11% RR)
Careful follow up.