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).