Focal Osseous Dysplasia

Abstract

Focal osseous dysplasia (FOD) is one of the benign fibro-osseous lesions of the jaw bones and the most commonly occuring benign fibro-osseous lesion. This entity occurs more commonly in females and has a predilection for African Americans. Radiographically, the lesion has a variable appearance depending on the duration but may appear as a radiolucent to radiopaque lesion that can be well to poorly defined. Hisotologically, when biopsied, there are fragments of bony trabeculae intermixed with fibrous stroma with incomplete stromal vasculature. The main differential diagnosis is with ossifying fibroma, which is neoplastic while FOD is considered a reactive process. Most patients with FOD may be followed clinically without surgical intervention.Keywords Osseous dysplasia Á Focal osseous dysplasia Á Focal cemento-osseous dysplasia Á Benign fibro-osseous lesions Á Jaw History A 43-year-old male had a history of an incidentally identified lesion in the posterior mandible. Over time, the lesion became more radiopaque, as observed during routine radiographic follow-up examinations. Radiographic FeaturesPanorex view of the oral cavity showed a non-expansile, mixed radiolucent-radiopaque, moderately well-defined lesion in the posterior mandible distal to the #18 tooth (Fig. 1). DiagnosisGrossly, the resected surgical specimen presented as multiple gritty fragments of tan-brown hemorrhagic tissue. Histologic examination on low magnification showed multiple fragments of curvilinear woven bone with intervening moderately cellular fibroblastic stroma in roughly equal proportions and scattered hemorrhagic foci (Fig. 2). Higher magnification revealed thick bony trabeculae without osteoblastic or cementoblastic rimming. There were no foci of inflammation. The stromal fibroblastic spindle cells were loosely arranged with oval nuclei and eosinophilic to clear cytoplasm (Fig. 3). DiscussionBenign fibro-osseous lesions of the jaw encompass a range of clinicopathologic entities, a select few of which can be differentiated by histopathology alone. Knowledge of clinical and radiographic information in conjunction with histopathology is exceedingly important for accurate distinction. As the name implies, fibro-osseous lesions are

Focal osseous dysplasia with an unusual and rare clinical feature of numbness

“…[8] Occasionally, FocOD can lead to secondary pulpal and periodontal infection and progress to necrosis. [10] The mandible is the most frequent site of occurrences (86%). Secondly, it shows a close association with tooth apices (70.6%) or with previous extraction sites (21%).…”

“…Biopsy is recommended when lesions become symptomatic, show radiological features similar to ossifying fibroma, or occur at a site that will be used for an implant. [10] Recall visits are enviable because according to one school of thought there are the possibility of transformation of FocOD into FOD. [14] …”

Focal Cemento- Osseous Dysplasia - A Case Report

“…Waldron, observing its localized nature, first reported it as the "localized fibro-osseous-cemental lesion," whereas Summerlin and Tomich renamed it as "focal cemento-osseous dysplasia." [12] FCOD commonly seen in female patients with age incidence of third to fifth decade, especially the Africans-Americans [13].It is usually asymptomatic, self-limiting lesion related to vital tooth and reaching an average size of 1.5 cm [14]. Most frequent site of occurrence was mandible (86%) and it occurs commonly in the extractions site.…”