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Florid Cemento-osseous Dysplasia — MFDS Part 1 MCQ

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HardOral PathologyFlorid Cemento-osseous DysplasiaMFDS Part 1

An asymptomatic 52-year-old woman has incidental jaw lesions adjacent to teeth that respond normally to sensibility testing. Which radiographic pattern most strongly distinguishes florid cemento-osseous dysplasia from other fibro-osseous and sclerotic jaw lesions?

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Correct answer: D — Bilateral multifocal mixed-density masses in tooth-bearing alveolar bone, with thin radiolucent rims

Explanation lettering: B = shown as A · D = shown as B · A = shown as D

A is correct. Florid cemento-osseous dysplasia is distinguished by multifocal involvement of tooth-bearing jaw regions, usually affecting two or more quadrants and often occurring bilaterally. Lesions mature from radiolucent through mixed-density to densely mineralised masses, commonly retaining a thin radiolucent peripheral rim. Associated teeth are usually vital, and marked concentric expansion is not typical. Option B is more consistent with cemento-ossifying fibroma. Option C describes cementoblastoma, which is fused to a tooth root. Option D suggests inflammatory osteomyelitis or another aggressive sclerotic process rather than uncomplicated cemento-osseous dysplasia. Option E is characteristic of a destructive systemic process such as multiple myeloma. Maxillary involvement can occur, but disease in both jaws is not required.

Reference: Alsufyani NA, Lam EWN. Cemento-osseous dysplasia of the jaw bones: key radiographic features. Dentomaxillofacial Radiology. 2011;40(3):141-146. https://pubmed.ncbi.nlm.nih.gov/21346079/