L. Su et al., DISTINGUISHING FEATURES OF FOCAL CEMENTO-OSSEOUS DYSPLASIA AND CEMENTO-OSSIFYING FIBROMAS .1. A CLINICAL AND RADIOLOGIC SPECTRUM OF 316 CASES, Oral surgery, oral medicine, oral pathology, oral radiology and endodontics, 84(5), 1997, pp. 540-549
Citations number
16
Categorie Soggetti
Pathology,Surgery,"Dentistry,Oral Surgery & Medicine
The distinguishing histopathologic features of focal cemento-osseous d
ysplasia (FCOD) (including lesions occurring in both anterior and post
erior jaws) and cemento-ossifying fibroma (COF) (ossifying fibroma and
cementifying fibroma) were demonstrated in our earlier work. The aim
of the current study was to further refine their clinical and radiogra
phic features. We have assessed 18 clinical and radiographic parameter
s by univariate comparisons (chi-squared and Student t tests), and a m
ultivariate assessment (logistic regression) in 241 cases of FCOD and
75 of COF. These cases were diagnosed from a combination of clinical,
radiographic, and histopathologic information. FCOD was seen predomina
ntly in black women, with a peak incidence in the fourth and fifth dec
ades, whereas COF showed no female predilection except in the fourth d
ecade (p < 0.005). COF occurred in patients an average of 10 years you
nger than patients with FCOD (p < 0.0001). Most patients with FCOD wer
e asymptomatic (62%); the average lesion size was 1.8 cm. More than ha
lf of patients with COF displayed jaw expansion and a considerably lar
ger size lesion (mean 3.8 cm, p < 0.001). The mandible was the most fr
equent site for both FCOD (86%) and COF (70%). Radiographically, a wel
l-defined border was observed in 53% of cases of FCOD and 85% of cases
of COF (p < 0.01). Cases of FCOD mostly demonstrated an irregularly m
ixed radio-opacity (69%), whereas 53% of COFs presented as a radioluce
ncy (p < 0.005). In FCOD, there was a close association with tooth api
ces (70.6%, p < 0.0001) or with previous extraction sites (21%, p < 0.
05); however, the majority of COF cases (86%) showed no relationship w
ith either. Combining the radiographic feature of a periapical locatio
n with the pathology of multiple curetted fragments and ''ginger root'
' bony trabeculae, allowed 90% sensitivity and 89% specificity in a lo
gistic regression model to predict the lesion to be an FCOD. These fin
dings provide guidelines not only to distinguish these two entities cl
inically, but also to aid in reaching an accurate diagnosis histopatho
logically.