Florid Cemento-osseous Dysplasia: A Case of Misdiagnosis.

Florid cemento-osseous dysplasia (FCOD) belongs to the group of fibro-osseous lesions in which normal bone is replaced by fibrous connective tissue and calcified cementum tissue of the avascular type. Among the various types of fibro-osseous lesions, FCOD is one of the most commonly encountered diseases in clinical practice and may involve 3 or 4 of the quadrants. FCOD is located in the periapical regions of teeth, and the lesions are predominantly radiolucent (osteolytic phase), become mixed over time (cementoblast phase), and ultimately become radiopaque (osteogenic phase) with a thin radiolucent peripheral halo. The characteristics of FCOD in the initial stages are similar to those of periapical lesions of inflammatory origin, which may lead to misdiagnosis. A 38-year-old woman sought dental care because of complaints of pain on the right side of her face. A clinical examination revealed no marked alterations; a panoramic radiograph was therefore requested and revealed the presence of radiolucent lesions associated with the periapical regions of some of the lower teeth. Thus, the professional referred the patient for endodontic treatment of the associated teeth with the justification that the lesions were of endodontic origin. However, the endodontist found that the teeth responded positively to a sensitivity test. The initial diagnosis could have resulted in unnecessary root canal treatment, but after careful clinical, radiographic, and tomographic assessments by different professionals, FCOD was diagnosed, conservatively treated, and regularly monitored. It is important that dentists have a basic knowledge of the various injuries that affect the jaw bones to prevent errors in diagnosis and treatment and to promote oral health.

Mineral trioxide aggregate and Portland cement promote biomineralization in vivo.

INTRODUCTION: Mineral trioxide aggregate (MTA) and Portland cement have been shown to be bioactive because of their ability to produce biologically compatible carbonated apatite. This study analyzed the interaction of MTA and white Portland cement with dentin in vivo. METHODS: Seventy-two human dentin tubes were filled with MTA Branco, MTA BIO, and white Portland cement + 20% bismuth oxide (PC1) or PC1 + 10% of calcium chloride (PC2) and implanted subcutaneously in 18 rats at 4 sites from the dorsal area. Empty dentin tubes, implanted in rats of a pilot study, were used as control. After 30, 60, and 90 days, the animals were killed, and the dentin tubes were retrieved for scanning electron microscope analysis. RESULTS: In the periods of 30 and 60 days, the mineral deposition in the material-dentin interface (interfacial layer) and in the interior of dentinal tubules was detected in more tubes filled with MTA Branco and MTA BIO than in tubes filled with PC1 and PC2. After 90 days, the interfacial layer and intratubular mineralization were detected in all tubes except for 3 and 1 of the tubes filled with PC2, respectively. CONCLUSIONS: It was concluded that all the cements tested were bioactive. The cements released some of their components in the tissue capable of stimulating mineral deposition in the cement-dentin interface and in the interior of the dentinal tubules. MTA BIO and MTA Branco were more effective in promoting the biomineralization process than Portland cements, mainly after 30 and 60 days.

SEM evaluation of the apical external root surface of teeth with chronic periapical lesion.

The aim is to verify, under scanning electron microscopy, the occurrence of apical root resorption in anterior and posterior teeth with chronic and radiographically visible periapical lesions. Thirty-two teeth were extracted, the apical thirds (n = 39) were removed, and prepared to analyse the external apical root surface. All specimens presented irregular areas of root resorption with different depths, located mainly around the apical foramen. Teeth with chronic periapical lesions present areas of external apical root resorption with irregular surface and different depths located mainly around the apical foramen. Root resorptions may show different configurations and destroy the apical root structure more or less extensively.