Dilemma with implant placement in patients with florid cemento-osseous dysplasia: A literature review

Abstract

Florid cemento-osseous dysplasia (FCOD) is a reactive bony lesion in which normal bone is replaced by fibrous and cementum like tissue. The differential diagnosis of this condition includes solitary bone cyst, solitary ossifying fibroma, and chronic diffuse osteomyelitis. It is often an incidental finding on a radiograph. Radiographically, it presents as a bilateral radiolucent lesion or lobulated radio-opaque masses with an affinity for tooth-bearing areas. Mostly, it progresses asymptomatically, usually diagnosed on a routine radiographic examination. Periodontal surgeries, extractions along with surgical invasive procedures have been determined to be a contraindication in these patients. There is a scarcity of literature to determine if patients with these lesions could be considered for prosthetic rehabilitative procedures like dental implants. The purpose of this literature review was to determine if dental implants could be considered as a treatment modality in patients with FCOD. Methodology An electronic search was done in PUBMED, SCOPUS, and a hand search was done in radiology, periodontology, and oral surgery journals. The search yielded 428 results, from which only 6 articles were selected for this literature review. Both prospective and retrospective studies were included. Clinical studies with information on the pre-implant condition of the site, detailed implant procedure, and follow-up after implant placement of more than 6 months were only considered for this review. Results and conclusion Limited clinical studies, shorter follow-up periods were the shortcomings of this review. However, it can be summarized that dental implants should not be placed at the site of FCOD, however can be placed at adjacent sites. Variations in implant type or the implant length had no bearing on the survival of implants at the sites of FCOD.