Radiological follow-up of cemento-osseous dysplasia on cone-beam computed tomography

Stefan F Nemec; Steffen Schneider; Klaus M Friedrich; Michael Weber; Ursula Schwarz-Nemec

doi:10.1016/j.jcms.2024.03.008

Radiological follow-up of cemento-osseous dysplasia on cone-beam computed tomography

J Craniomaxillofac Surg. 2024 Mar 12:S1010-5182(24)00091-X. doi: 10.1016/j.jcms.2024.03.008. Online ahead of print.

Authors

Stefan F Nemec¹, Steffen Schneider², Klaus M Friedrich³, Michael Weber¹, Ursula Schwarz-Nemec¹

Affiliations

¹ Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.
² Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Vienna, Austria.
³ Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria. Electronic address: klaus.friedrich@meduniwien.ac.at.

PMID: 38582672
DOI: 10.1016/j.jcms.2024.03.008

Abstract

This study investigated the natural course of cemento-osseous dysplasia (COD) on cone-beam computed tomography (CBCT). Retrospectively, 104 CBCT scans from 36 patients (mean age, 44.5 years; 33 female and three male) with mandibular COD (10 florid, seven focal, 19 periapical) were included, based upon clinico-radiological features, without complications such as infection and related surgery. Changes in maximum diameter and morphology (lytic, mixed lytic-sclerotic, sclerotic) were evaluated in 83 lesions, with a mean follow-up of 28.3 months. The occurrence of a diameter increase was assessed by time-to-event analysis; interreader agreement for diameter and morphological evaluation by intraclass correlation coefficient and weighted κ statistics, respectively. Fifteen of 83 (18.1%) lesions (eight florid, one focal, six periapical) in 10 patients increased in diameter; 12 of 83 (14.5%) lesions (five florid, seven periapical) in 11 patients changed morphologically. The median period until a diameter increase was longest (120 months) for periapical COD, and shortest (66 months) for florid COD (p = 0.023). There was high reader agreement (ICC = 0.891; weighted κ = 0.901). In conclusion, CBCT is an effective tool with which to follow-up COD. If any, the natural progress in uncomplicated COD is prolonged, which underlines its non-surgical character and aids in its long-term management.

Keywords: Cemento-osseous dysplasia; Cone-beam computed tomography; Follow-up; Natural progress.