Cemento-osseous dysplasia: Re-visited

Objectives: Cemento-osseous dysplasia is a benign fibro-osseous lesion characterised by a radiological presentation that varies as it matures through three distinct stages: early, intermediate and late stages. It encompasses a wide range of radiographic appearances, and its presence in the tooth-bearing regions of the jaws may cause confusion with many other types of entities with radiolucent, mixed or radiopaque appearances. The aim of this paper is to evaluate and review the common radiographic features of cemento-osseous dysplasia on cone-beam computed tomography to allow for better assessment and recognition of this condition. Methods: A series of cone-beam computed tomography datasets with findings of cemento-osseous dysplasia was reviewed using dedicated software. Radiographic features of cemento-osseous dysplasia were recorded. Results: Cemento-osseous dysplasia was more common in females (82.3%) than in males (17.7%). The posterior mandible was the most favoured site (61.3%) for all types of cemento-osseous dysplasia. Cortical expansion (51.6%) and cortical thinning (88.7%) were prevalent radiographic features. Conclusions: Cortical thinning and cortical expansion are not commonly reported features of COD, and our study is the first to present that these features are prevalent regardless of the COD type. It is therefore critical for all dental practitioners to recognise COD and to avoid confusion with other expansile lesions in the head and neck region, such as odontogenic tumours and cysts.