Differential Outcomes of Dental Implant Osseointegration in Florid Cemento-Osseous Dysplasia: A Case Report

Abstract: A 47-year-old Asian woman presented for treatment of multiple missing teeth and generalized dental attrition requiring prosthetic rehabilitation. Her dental history revealed prolonged absence of teeth 25, 36, 35 and 46,recent extraction (tooth 24, four months prior) due to vertical root fracture. Cone-beam computed tomography (CBCT) revealed mixed-density osseous changes, including apical radiolucencies at teeth 11– 23, 35– 43, a well-demarcated hyperdense mass within the tooth 36 edentulous ridge surrounded by circumferential radiolucency, and diffuse radiolucent alterations throughout the mandibular alveolar bone. The findings of CBCT images were attributable to Florid cemento-osseous dysplasia (FLCOD). The patient underwent occlusal reconstruction treatment, she opted for implant restoration to address the missing teeth (implant restoration at teeth 24, 25, 36, 45, 46), and all-ceramic crowns placed on teeth 11– 17, 21– 23, 26– 27, 35– 44, 37, and 47. One year after the placement of the implant at site 36, the patient returned with clinical symptoms of the sensation of a “loose” implant. However, the remaining implants are stable and functioning normally. The failed implant at tooth 36 penetrated completely through the lesion tissue, while the successful implants were placed away from the lesion. This case report details the causes of implant failure in patients with florid cemento-osseous dysplasia (FLCOD) and the suitable restorative methods. Keywords: dental implants, Florid cemento-osseous dysplasia, Osseous dysplasia, dental restoration failure