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Infected Cemento-Osseous Dysplasia: Analysis of 66 Cases and Literature Review


The aim of this study was to describe a series with 66 cases of infected cemento-osseous dysplasia (COD) and to discuss the demographic distribution, clinicoradiographic features and treatment of this condition. A study looking back on the diagnoses made at a single Brazilian centre within a 28-year timeframe was performed. A literature review with searches across five databases was also conducted to identify reports on osteomyelitis/infected COD. Descriptive and statistical analyses were performed. The case series study showed a female/male ratio of 21:1. Affected individuals’ mean age was 57.4 years. Mandible was the most affected site (95.5%) and florid subtype was the most frequent infected COD (62.1%). Tooth extraction was the main factor associated with the development of infection associated within a COD lesion. The literature review retrieved 30 studies reporting 46 cases of this condition. Asian women in their 40 s and 50 s were more affected. Surgery for removal/curettage of necrotic bone was acknowledged as an appropriate approach to the treatment of this infection. The clinicodemographic data of the study were similar to data collected across the literature. Clinicians, maxillofacial surgeons and oral rehabilitation providers should be alert to the diagnosis of COD, since infection is a frequent complication whose management is challenging.

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This study was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Finance Code 001), Brazil. C.N.A.O.K. and J.A.A.A. are studentship recipients. We would like to thank Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, #305493/2018-3, #455644/2018-1), Brazil. T.A.S. and R.A.M. are research fellows at CNPq. The participation of Dr. Eduardo M. de Oliveira with patient care is greatly appreciated. We would also like to thank Ms. Melissa Carman, Dr. Marcelo Martini, Ms. Andrea Hoover, Dr. Adepitan Owosho, and Prof. Luciana Ramalho who kindly provided some information and/or full texts. Mrs. E. Greene provided English editing of the manuscript.


Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Finance Code 001), Brazil.

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Correspondence to José Alcides Almeida de Arruda.

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The study was approved by the Human Research Ethics Committee of the study institution (No. 52652016.2.0000.5149).

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Kato, C.N.A.O., de Arruda, J.A.A., Mendes, P.A. et al. Infected Cemento-Osseous Dysplasia: Analysis of 66 Cases and Literature Review. Head and Neck Pathol 14, 173–182 (2020).

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  • Bone diseases
  • Osteomyelitis
  • Infection
  • Florid cemento-osseous dysplasia
  • Oral medicine
  • Oral diagnosis