Reactive osteocartilaginous metaplasia in denture wearers: a rare trauma-related lesion

Abstract

Objective: To present a case of reactive osteocartilaginous metaplasia (ROCM) in the anterior edentulous mandibular ridge.

Background: The ROCM secondary to chronic mechanical denture trauma is rare and appears as a focal sometimes painful mass on or near the crest of the edentulous alveolar ridge in long-term denture wearers. The literature review disclosed 24 cases involving more commonly the posterior portion of the mandible.

Materials and methods: An 80-year-old female was referred for the evaluation of a painful, submucosal nodule extending into the vestibular mucosa of the anterior edentulous mandibular region. Microscopically, cartilaginous regions exhibiting sparse hyperchromatic or binucleated chondrocytes transitioned into areas of ossification.

Results: The diagnosis was ROCM. The presence of osteocartilaginous tissue displaying bizarre histopathological features can create a diagnostic dilemma.

Conclusion: Complete conservative surgical excision of this lesion has a very good prognosis. Surgical augmentation of the sharp edentulous mandibular ridges might be needed to avoid continuous irritation and possible recurrence.

Keywords: bizarre; denture-related lesions; edentulous alveolar ridge; mandible; osteocartilaginous; parosteal proliferation; reactive metaplasia.