Periapical Cemental Dysplasia Symptoms, Causes, Stages, Treatment

PCD is a condition in which fibrous tissue replaces bone marrow in the periapical region of the femur. Most cases of PCD are found by accident during routine x-rays since the situation does not show any outward signs or symptoms. There are several types of Cemento-osseous dysplasia. Once detected by radiography, these asymptomatic lesions do not need treatment. The distribution is symmetrical and localized in the jaws' tooth-bearing regions.

There is no need for therapy for this lesion because it is innocuous, and just occasional monitoring is required. Radiographs make it hard to tell the difference between this lesion and a periapical granuloma. Therefore, it is necessary to examine the pulp's vitality to draw this distinction. For this ailment, there is no need for treatment.

Periapical Cemental Dysplasia Symptoms

This rare disease is mostly asymptomatic. It is distinguished by the displacement of normal bone tissue by fibrous tissue, which is followed by neo-formed cement and metaplasia bone. There are radiopaque/hyperdense areas on x-ray images of the canines, the root tips of the lower incisors, and the region of the symphysis that reveal the loss of root contour due to an opaque/dense mass on the radiograph.

Periapical Cemental Dysplasia Causes

Cemento-osseous dysplasia of the periapical area of the anterior jaw is a pathological condition emerging from an interaction between the bone and cementum. Its cause is not completely understood, however, it is connected to an abnormal response of the bone and cementum to a local stimulus. 

Periapical Cemental Dysplasia Stages

The natural history of cemental periapical dysplasia follows a distinct pattern, which explains why its radiographic appearance might vary depending on the stage at which it is detected. The first stage is known as the osteolithic phase, during which connective tissue replaces lost bone and there is localized bone destruction (radiolucence), which is comparable to periapical lesions like cysts or granulomas brought on by pulp necrosis. The radiolucent portion of the fibrosis starts to calcify during the second phase, known as cementoblastic. In the third stage, called maturation, there is too much calcified material in the center.

As a result, during the first phase of the sickness, there is a potential for some uncertainty regarding the diagnosis and management of the condition. Some individuals receive conventional endodontic therapy despite the fact that cemental periapical dysplasia is a well-defined disorder. This is because the condition was incorrectly diagnosed as a periapical cyst or granuloma in these patients. 

Periapical Cemental Dysplasia Treatment

There is no therapy for Periapical Cemento-osseous Dysplasia unless complications arise. The patient's pain is mostly caused by an occlusal imbalance, which is fixed by resetting the patient's bite. These lesions frequently resemble granulomas or periapical lesions on teeth that need endodontic treatment, however, pulp testing will reveal that these teeth are still alive and well. 

Concerns while treating a person with Periapical Cemental  Dysplasia include bone strength and the likelihood that the patient will benefit from dental implants compared to the danger of osteomyelitis from protracted denture use. PCOD results in avascular mixed cementum-ossifying lesions, rather than the normal vascular bone quality.