Cemento-Osseous Dysplasia (COD) :
COD is a fibro-osseous lesion caracterized by a modification of the bone sturcture. Histologically, it appears as a cellular fibrous stroma with mineralizing tissues consisting of osteoid, bone and cementum-like material. The diagnosis requires a combined assessment of clinical and radiographic findings (5). In its late stages, the lesion appears as a radiopaque lobulated calcified mass surrounded by a radiolucent margin (4). The pathogenesis remains unknown.
The classification and terminology of these lesions is controversial and has drastically evolved over the years (6). The latest World Health Organization (WHO) classification published in 2017 defined three categories of COD based on their anatomic location. In fact, COD lesions have periapical, focal, and florid variants.
Periapical-COD (PCOD) mainly involves the periapical region of the anterior mandibular teeth, whereas focal-COD (FocCOD) is usually located in the mandibular molar region, often in edentulous areas. Finally the florid-COD (FCOD) has more specific and distinct clinical and radiographic signs compared to the other two variants: It involves two or more jaw quadrants and is in most cases bilateral and symmetric (7).
COD mostly affects the middle-aged African / African-American women. In fact, A systematic review published in 2003 assessed 159 cases of FCOD ; 59% occurred in blacks, 37% in Asians, and 3% in Caucasians; 97% of all patients were female (8).