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Article: Volume 46 Number 1 Page 62 - January 2019

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  Dent Update 2019; 46: 62-67

Oral surgery:  Cemento-Osseous Dysplasia-Related Jaw Necrosis – a Case Report and Literature Review

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Abstract: Osteonecrosis of the jaw (ONJ) is most commonly related to medications such as anti-resorptives and anti-angiogenics or head and neck radiotherapy. However, in addition to these, alternative causes of ONJ have also been reported including; infection, chemical toxicity, trauma and vascular ischaemia, but this list is not exhaustive. It is well accepted that cemento-osseous dysplasia (COD) can increase the risk of infection, poor healing and osteomyelitis due to the reduced vascularity. However, necrotic and exposed COD has not been widely reported. This case report describes a patient with COD-related necrosis in the anterior mandible and hence provides an additional member to the ever growing list of potential predisposing factors for jaw necrosis

Clinical relevance: Cemento-osseous dysplasia is a well recognized and benign condition commonly diagnosed from radiographs. The condition carries an increased risk of osteomyelitis and slow healing following oral surgery and, at its extreme, can cause osteonecrosis of the jaw, which remains an important condition of which the general dental practitioner (GDP) should be aware.

Author notes: Tasnim Atiea, BDS, Specialty Dentist (Oral Surgery), Department of Oral Surgery, Floor 23, Tower Wing, Guy’s Dental Hospital, Marianne Henien, BDS(Hons), MFDS RCS(Ed) Specialist Registrar (Oral Surgery), Department of Oral Surgery, Floor 23, Tower Wing, Guy’s Dental Hospital, Chris Sproat, BDS(Lond), MBBS(Hons), BSc(Hons), FDS RCS, Consultant (Oral Surgery), Department of Oral Surgery, Floor 23, Tower Wing, Guy’s Dental Hospital, Selvam Thavaraj, BDS, PhD, FDS RCS, FRCPath, Consultant (Oral Pathology), Department of Head and Neck Pathology, 4th Floor, Tower Wing, Guy’s Dental Hospital and Vinod Patel, BDS(Hons), MFDS RCS(Ed), MOralSurg RCS(Eng), Consultant (Oral Surgery), Department of Oral Surgery, Floor 23, Tower Wing, Guy’s Dental Hospital, London Bridge, London, SE1 9RT, UK.

Objective: To recognize the risk of non-healing associated with cemento-osseous dysplasia following oral surgery.