Yunus Emre AŞÇI, Mustafa Seçkin YAZAR, Adnan KILINÇ

MANDİBULADA MULTİPLE FLORİD SEMENTOSSÖZ DİSPLAZİ: BİR OLGU SUNUMU

Amaç: Florid sementossöz displazi gibi çenelerin fibröz lezyonlarında ayırıcı tanı çok önemlidir. Yanlış teşhis gereksiz endodontik tedaviye, insizyonel biyopsiye veya cerrahi eksizyona neden olabilir. Florid sementossöz displazi gibi çenelerin fibröz lezyonlarının prevalansının ve klinik özelliklerinin tanınması doğru teşhis ve uygun bir tedavi planı için önemlidir. Bu vaka raporunun amacı nadir bir lezyon olan florid sementossöz displaziyi sunmak ve diğer fibröz lezyonlar ile ayırıcı tanısını vermektir. Olgu Sunumu: 30 yaşındaki kadın hasta yüzündeki şişlik nedeniyle kliniğimize başvurmuştur. Hastanın klinik muayenesinde, sol mandibula premolar-molar bölgesinde şişlik tespit edilmiştir. Ortopantomografide, mandibulanın her iki kadranında da dağılmış küresel radyoopak kitleler görüldü. Sklerotik alanların çoğunda ince radyolusent alanlar görülmüştür. Tüm bu bulgular ışığında hastadan alınan insizyonel biyopsi sonucu florid sementossöz displazi (FCOD) ön tanısı konuldu. Hastaya lokal anestezi altında kontur düzeltmesi yapılmasına ve daha sonra takip edilmesine karar verildi. Lokal anestezi altında kontur düzeltmesi yapıldı. Operasyon sonrası iyileşme bir haftada başarıyla tamamlandı. Mandibulanın her iki kadranında da dağılmış küresel radyoopak kitleler takibe alındı. Hastaya düzenli takip muayeneleri önerilmiştir. Sonuç: Klinisyenlerin Fibro-osseöz lezyonlar hakkında bilgili olması önemlidir. Fibröz lezyonların tüm özellikleri, doğru bir tanı ve tedavi planlaması için dikkatle değerlendirilmelidir. Radyografik olarak benzer lezyonlardan ayırıcı tanısının yapılması, gereksiz ve potansiyel olarak zararlı müdahaleleri önleyebilir. Anahtar Kelimeler: Fibro-osseöz lezyon, Florid sementossus displazi, Skleroz MULTİPLE FLORİD CEMENTO-OSSEOUS DYSPLASİA OF THE MANDİBLE: A CASE REPORT ABSTRACT Aim: Differential diagnosis is very important in fibrous lesions of jaws such as fluoride cemented dysplasia. Misdiagnosis may lead to unnecessary endodontic treatment, incisional biopsy or surgical excision. The recognition of the prevalence and clinical characteristics of fibrous lesions of the jaws, such as fluorid cemented dysplasia, is important for accurate diagnosis and an appropriate treatment plan. The aim of this case report is to present a rare lesion, fluoride cemented dysplasia, and to give a differential diagnosis with other fibrous lesions. Case Report: A 30-year-old female patient was admitted to our clinic with a swelling in her face. In the clinical examination of the patient, swelling was detected in the premolar-molar region of the left mandible. In orthopantomography, global radio-opaque masses scattered in both quadrants of the mandible were seen. Thin radiolucent areas were seen in most sclerotic areas. In the light of all these findings, the patient was diagnosed with fluoride cementous dysplasia (FCOD). It was decided to correct the contour under local anesthesia and then follow-up. Contour correction was performed under local anesthesia. Postoperative recovery was successfully completed in one week. Global radio-opaque masses scattered in both quadrants of the mandible were followed. Regular follow-up examinations were recommended to the patient. Conclusion: It is important that clinicians are knowledgeable about fibro-osseous lesions. All features of fibrous lesions should be carefully evaluated for an accurate diagnosis and treatment planning. The differential diagnosis of radiographically similar lesions may prevent unnecessary and potentially harmful interventions. Key Words: Fibro-osseous lesion, Florid cemento-osseous dysplasia, Sclerosis

Anahtar Kelimeler:

Fibro-osseöz lezyon, Florid sementossus displazi, Skleroz

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1 Mangala, M., Ramesh, D., Surekha, P. & Santosh, P. Florid cemento-osseous dysplasia: Review and report of two cases. Indian journal of dental research 17, 131 (2006).
2 Melrose, R. J., Abrams, A. M. & Mills, B. G. Florid osseous dysplasia: a clinical-pathologic study of thirty-four cases. Oral Surgery, Oral Medicine, Oral Pathology 41, 62-82 (1976).
3 Das, B. K., Das, S. N., Gupta, A. & Nayak, S. Florid cemento-osseous dysplasia. Journal of oral and maxillofacial pathology: JOMFP 17, 150 (2013).
4 Koury, M. E., Regezi, J. A., Perrott, D. H. & Kaban, L. B. “Atypical” fibro-osseous lesions: diagnostic challenges and treatment concepts. International journal of oral and maxillofacial surgery 24, 162-169 (1995).
5 Pereira, D. L. et al. Clinical, demographic, and radiographic analysis of 82 patients affected by florid osseous dysplasia: an international collaborative study. Oral surgery, oral medicine, oral pathology and oral radiology 122, 250-257 (2016).
6 Beylouni, I., Farge, P., Mazoyer, J. & Coudert, J. Florid cemento-osseous dysplasia: report of a case documented with computed tomography and 3D imaging. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 85, 707-711 (1998).
7 Waldron, C. Odontogenic tumors. Oral and maxillofacial pathology. Neville BW, Damm DD, Allen CM, Bouquot JE, editors. Philadelphia: WB Saunders Company, 611 (2002).
8 Önder, B., Kurşun, Ş., Öztaş, B., Barış, E. & Erdem, E. Florid osseous dysplasia in a middle-aged Turkish woman: A case report. Imaging science in dentistry 43, 197-200 (2013).
9 DiFiore, P. & Bowen, S. Cemento-osseous dysplasia in African-American men: a report of two clinical cases. The Journal of the Tennessee Dental Association 90, 26-28; quiz 28-29 (2010).
10 Fenerty, S. et al. Florid cemento-osseous dysplasia: review of an uncommon fibro-osseous lesion of the jaw with important clinical implications. Skeletal radiology 46, 581-590 (2017).
11 Waldron, C. A. Fibro-osseous lesions of the jaws. Journal of Oral and Maxillofacial Surgery 51, 828-835 (1993).
12 Kramer, I. R. H., Pindborg, J. J. & Shear, M. in Histological typing of odontogenic tumours 7-9 (Springer, 1992).
13 de Santana Sarmento, D. J., de Brito Monteiro, B. V., de Medeiros, A. M. C. & da Silveira, E. J. D. Severe florid cemento-osseous dysplasia: a case report treated conservatively and literature review. Oral and maxillofacial surgery 17, 43-46 (2013).
14 Köse, T. E., Köse, O. D., Karabas, H. C., Erdem, T. L. & Özcan, İ. Findings of florid cemento-osseous dysplasia: a report of three cases. Journal of oral & maxillofacial research 4 (2013).
15 Lopes, M. A. et al. Clinico-pathologic conference: case 1. Head and neck pathology 4, 329-333 (2010).
16 Schneider, L. C., Dolinsky, H. B., Grodjesk, J. E., Mesa, M. L. & Doyle, J. L. Malignant spindle cell tumor arising in the mandible of a patient with florid osseous dysplasia. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 88, 69-73 (1999).
17 Suei, Y., Tanimoto, K., Miyauchi, M. & Ishikawa, T. Partial resection of the mandible for the treatment of diffuse sclerosing osteomyelitis: report of four cases. Journal of oral and maxillofacial surgery 55, 410-414 (1997).
18 Payne, M., Anderson, J. & Cook, J. Gardner's syndrome–a case report. British dental journal 193, 383 (2002).
19 Lew, D., DeWitt, A., Hicks, R. J. & Cavalcanti, M. G. Osteomas of the condyle associated with Gardner's syndrome causing limited mandibular movement. Journal of oral and maxillofacial surgery 57, 1004-1009 (1999).
20 Costa, A., Costa, R. & Grossmann, S. Multiple oral radiopaque masses leading to Gardner's syndrome diagnosis. General dentistry 61, e12-14 (2013).
21 MacDonald-Jankowski, D. Fibrous dysplasia: a systematic review. Dentomaxillofacial Radiology 38, 196-215 (2009).
22 Petrikowski, C. G., Pharoah, M. J., Lee, L. & Grace, M. G. Radiographic differentiation of osteogenic sarcoma, osteomyelitis, and fibrous dysplasia of the jaws. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 80, 744-750 (1995).
23 Eversole, L., Sabes, W. R. & Rovin, S. Fibrous dysplasia: A nosologic problem in the diagnosis of fibro‐osseous lesions of the jaws. Journal of Oral Pathology & Medicine 1, 189-220 (1972).
24 Schneider, L. C. & Mesa, M. L. Differences between florid osseous dysplasia and chronic diffuse sclerosing osteomyelitis. Oral surgery, oral medicine, oral pathology 70, 308-312 (1990).
25 Groot, R., Van Merkesteyn, J. & Bras, J. Diffuse sclerosing osteomyelitis and florid osseous dysplasia. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 81, 333-342 (1996).
26 Urvasizoğlu G, Aşçı Ye, Gönül Ko. Pyojenik Granülomdan Gelişen Periferal Ossifiye Fibroma: Olgu Sunumu. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi. 30(3):481-485 (2020).