Florid Cemento-Osseous Dysplasia and Simple Bone Cyst Association: Co-Occurrence or Evolution of the Disease? Two Case Reports and Literature Review.

Abstract

Objectives: Cemento-osseous dysplasia (COD) is the most common benign fibro-osseous lesion of the jaws, typically asymptomatic and identified through characteristic radiographic features. However, its rare association with simple bone cysts (SBCs) can significantly alter its presentation, mimicking more aggressive jaw lesions. This study aims to report additional cases of COD-associated SBCs and to review the literature to evaluate whether such lesions may represent a specific manifestation of the COD spectrum.

Materials and methods: Two cases of florid COD with atypical radiolucencies were described, both exhibiting cortical thinning and focal perforation, as well as bone expansion.

Results: Surgical exploration was performed to rule out a more serious aggressive odontogenic pathology and revealed empty bone cavities, consistent with SBCs.

Conclusions: These cases support the concept of secondary SBCs as part of the COD spectrum. A review of the literature highlights differences in age, sex, location, clinical and radiological features, as well as healing patterns compared to solitary SBCs.