Subpontic osseous hyperplasia: Three case reports and literature review

Abstract

Subpontic osseous hyperplasia (SOH) is an ectopic growth of bone occurring on the edentulous ridge beneath a fixed partial denture. The aim of this article is to present three patients with SOH with long-term follow-up and to make a current overview of the literature. Presented maxillary SOH is the second case in the dental literature. Intraorally the lesions were bone-hard and painless swellings in the subpontic space. Radiographically, the maxillary case was a nodular bone growth having similar radiodensity and trabeculation to the adjacent bone with a thin radiopaque border. Mandibular cases were bony growths, which were more radiopaque than the adjacent alveolar ridge. Follow-up radiographs revealed regression in two of the cases. Clinicians should take care not to cause the possible etiologies of SOH such as functional stresses and chronic irritation by the prosthetic treatments and be aware of SOH does not usually require treatment or a biopsy.

A Case of Bisphosphonate-Related Osteonecrosis of the Jaw in a Patient with Subpontic Osseous Hyperplasia

“…In patients wearing FPDs, the loading of occlusal force onto abutment teeth and surrounding bone tissue is thought to induce bone formation [6], and this hypothesis is supported by the fact that the removal of FPDs sometimes leads to the reduction of SOH [3, 6]. Similar mechanisms may be involved in this study.…”

“…Since its first report by Calman et al [1] in 1971, 62 studies have investigated SOH, revealing that it commonly occurs unilaterally in the mandibular area that is missing molars and that only two maxillary cases have been reported previously [2, 3]. FPDs often develop in patients who have been wearing dentures for over 3 years, but it can occur in those wearing the denture for less than 1 year [4], with a mean duration of 13 years [5].…”

“…In simple radiography, the specific features of SOH are an increase in subpontic radiopacity, osteosclerosis of cortical bone, and a mixture of radiopacity and radiotransparency [3, 5]. Although the radiographic findings of BRONJ vary by stage, they are characterized by radiolucent, radiopaque, or mixed poorly demarcated patches.…”

Subpontic osseous hyperplasia: report of two cases

“…Save for two cases that developed in the area of the maxillary second premolar and first molar, respectively, all other published cases of SOH relate to the mandible. Clinically, there is a slow‐growing enlargement beneath the pontic that is covered by normal mucosa and has a flat or lobular surface. The size and shape of the lesion depends on the growth stage, the size of the edentulous area and the shape of the space between the pontic and the ridge.…”

“…The radiographic findings vary. In cases where removal of the lesion was performed, microscopic examination showed normal lamellar bone that in one case was in continuity with calcified hyaline cartilage.…”