V08N02 | 2018 | Endo in Endo | Pages 9 to 9
Alberto Consolaro, Renata Bianco Consolaro, Dario A. Oliveira Miranda, Ingrid Araújo de Oliveira
Bone dysplasia, Florid cemento-osseous dysplasia, Osteomyelitis, Bone diseases,
Florid cemento-osseous dysplasia is a sclerosing bone disease that affects the alveolar process of the jawbones. In most cases, it involves the mandible bilaterally, but may affect three and even all four quadrants. If bacteria common in the oral microbiota and in the root canals reach the bone affected by florid cemento-osseous dysplasia, this disease may very likely progress to secondary osteomyelitis and result in extensive mandibular destruction and bone loss. Patients with florid cemento-osseous dysplasia should be referred to endodontists before or after a diagnosis is made. Initial periapical – and even panoramic – radiographs may suggest the presence of chronic periapical inflammation, which may lead to a misdiagnosis and to a decision to perform an inadequate endodontic intervention in a tooth whose pulp is, in fact, still vital. After a diagnosis is made, endodontic treatments should only be performed if there is no pulp vitality. All procedures should be performed under well-controlled systemic drug protection and rigorous aseptic conditions to avoid transient bacteremias and direct bacterial contamination of the periapical and periodontal bones, which may progress to secondary osteomyelitis of the mandible.
Consolaro A, Consolaro RB, Miranda DAO, Oliveira IA. Florid cemento-osseous dysplasia: care and when to do the endodontic treatment. Dental Press Endod. 2018 May-Aug;8(2):9-17. DOI: https://doi.org/10.14436/2358-2545.8.2.009-017.end