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Abstract：
BACKGROUND: Since there are many differential diagnoses for cemento-osseous dysplasia (COD), it is very difficult for dentists to avoid misdiagnosis. In particular, if COD is related to an embedded tooth, differential diagnosis is difficult. However, there have been no reports on the characteristics of the imaging findings of COD associated with embedded teeth. The aim of the present study was to investigate the occurrence and imaging characteristics of cemento-osseous dysplasia (COD) associated with embedded teeth, in order to appropriately diagnose COD with embedded teeth.
METHODS: The radiographs with or without histological findings of 225 patients with COD were retrospectively analyzed. A retrospective search through the picture archiving and communication system (PACS) of the Division of Oral and Maxillofacial Radiology of Kyushu Dental University Hospital was performed to identify patients with COD between 2011 and 2022.
RESULTS: Fifteen COD-associated embedded mandibular third molars were identified in 13 patients. All 13 patients were asymptomatic. On imaging, COD associated with embedded mandibular third molars appeared as masses that included calcifications around the apex of the tooth. On panoramic tomography, COD showed inconspicuous internal calcification similar to that of odontogenic cysts or simple bone cysts, especially in patients with COD only around the mandibular third molar region. Those with prominent calcification resembled cemento-ossifying fibroma, calcifying epithelial odontogenic tumor, calcifying odontogenic cyst, adenomatoid odontogenic tumor, and so on, as categories of masses that include calcifications on panoramic tomography and computed tomography.
CONCLUSIONS: The current investigation is the first to report and analyze the imaging characteristics of COD associated with embedded teeth. It is important to consider the differences between COD and other cystic lesions on panoramic tomography, and the differences between COD and masses that include calcifications on CT.
METHODS: The radiographs with or without histological findings of 225 patients with COD were retrospectively analyzed. A retrospective search through the picture archiving and communication system (PACS) of the Division of Oral and Maxillofacial Radiology of Kyushu Dental University Hospital was performed to identify patients with COD between 2011 and 2022.
RESULTS: Fifteen COD-associated embedded mandibular third molars were identified in 13 patients. All 13 patients were asymptomatic. On imaging, COD associated with embedded mandibular third molars appeared as masses that included calcifications around the apex of the tooth. On panoramic tomography, COD showed inconspicuous internal calcification similar to that of odontogenic cysts or simple bone cysts, especially in patients with COD only around the mandibular third molar region. Those with prominent calcification resembled cemento-ossifying fibroma, calcifying epithelial odontogenic tumor, calcifying odontogenic cyst, adenomatoid odontogenic tumor, and so on, as categories of masses that include calcifications on panoramic tomography and computed tomography.
CONCLUSIONS: The current investigation is the first to report and analyze the imaging characteristics of COD associated with embedded teeth. It is important to consider the differences between COD and other cystic lesions on panoramic tomography, and the differences between COD and masses that include calcifications on CT.
摘要：
背景：由于骨水泥发育不良（COD）有许多鉴别诊断，牙医很难避免误诊。特别是,如果COD与嵌入的牙齿有关，鉴别诊断是困难的。然而,没有关于与嵌入牙齿相关的COD的影像学发现特征的报道。本研究的目的是探讨与嵌入牙齿相关的骨水泥发育不良（COD）的发生和影像学特征。以便正确诊断具有嵌入牙齿的COD。
方法：对225例COD患者有无组织学表现的X线照片进行回顾性分析。通过九州牙科大学医院口腔颌面放射科的图片存档和通信系统（PACS）进行了回顾性搜索，以识别2011年至2022年之间的COD患者。
结果：在13例患者中发现了15个与COD相关的下颌第三磨牙。13例患者均无症状。在成像方面，与嵌入式下颌第三磨牙相关的COD出现为肿块，其中包括牙齿顶端周围的钙化。在全景层析成像上，COD显示不明显的内部钙化，与牙源性囊肿或单纯性骨囊肿相似，尤其是COD患者仅在下颌第三磨牙区周围。那些有明显钙化的类似于骨质骨化性纤维瘤，钙化上皮牙源性肿瘤，牙源性钙化囊肿，腺瘤样牙源性肿瘤，等等，作为肿块的类别，包括全景断层扫描和计算机断层扫描的钙化。
结论：当前的调查是首次报告和分析与嵌入牙齿相关的COD的影像学特征。重要的是要考虑在全景断层扫描中COD和其他囊性病变之间的差异，以及CT上COD和包括钙化的肿块之间的差异。
方法：对225例COD患者有无组织学表现的X线照片进行回顾性分析。通过九州牙科大学医院口腔颌面放射科的图片存档和通信系统（PACS）进行了回顾性搜索，以识别2011年至2022年之间的COD患者。
结果：在13例患者中发现了15个与COD相关的下颌第三磨牙。13例患者均无症状。在成像方面，与嵌入式下颌第三磨牙相关的COD出现为肿块，其中包括牙齿顶端周围的钙化。在全景层析成像上，COD显示不明显的内部钙化，与牙源性囊肿或单纯性骨囊肿相似，尤其是COD患者仅在下颌第三磨牙区周围。那些有明显钙化的类似于骨质骨化性纤维瘤，钙化上皮牙源性肿瘤，牙源性钙化囊肿，腺瘤样牙源性肿瘤，等等，作为肿块的类别，包括全景断层扫描和计算机断层扫描的钙化。
结论：当前的调查是首次报告和分析与嵌入牙齿相关的COD的影像学特征。重要的是要考虑在全景断层扫描中COD和其他囊性病变之间的差异，以及CT上COD和包括钙化的肿块之间的差异。
