Florid cemento-osseous dysplasia-related osteonecrosis: A series of cases

Ann Diagn Pathol. 2022 Oct:60:152009. doi: 10.1016/j.anndiagpath.2022.152009. Epub 2022 Jul 12.

Abstract

Objective: The aim of this study was to assess the clinicopathological features of florid cemento-osseous dysplasia (FCOD)-related osteonecrosis highlighting their histopathological aspects and bone structure.

Methods: Twenty-two FCOD-related osteonecrosis cases were evaluated retrospectively. Osteonecrosis, osteomyelitis, bacterial colonization, bone resorption, reactive bone, osteon-like structure, lamellar bone, and basophilic lines were analyzed. Specific staining and fluorescence and polarized light microscopy analyses were also performed.

Results: The mandible was more affected by FCOD-related osteonecrosis. There was a predominance of African-Brazilian women in the fifth and seventh decades of life. Osteomyelitis was present in 82 % of cases whereas bone resorption and bacterial colonization were present in 100 % of FCOD-related osteonecrosis cases. Thick basophilic lines were seen in all cases (100 %). Actinomycosis and osteoclasts were not often.

Conclusions: This study showed female adult preference, mandibular location, and some findings such as osteomyelitis, bone resorption, and bacterial colonization were histopathological features more frequent in FCOD-related osteonecrosis. In the absence of a close clinical and radiographic correlation, the morphology of the necrotized bone similar to cementum could help to recognize FCOD.

Keywords: Cemento-osseous dysplasia; Mandible; Osteonecrosis.

MeSH terms

  • Adult
  • Bone Resorption*
  • Female
  • Fibrous Dysplasia of Bone
  • Humans
  • Osteomyelitis* / pathology
  • Osteonecrosis*
  • Retrospective Studies

Supplementary concepts

  • Florid cemento-osseous dysplasia