Florid Cemento-Osseous Dysplasia Complicated By Periapical Inflammation: A Clinical Case Analysis and Systematic Review of Diagnostic Challenges

Florid cemento-osseous dysplasia (FCOD) is a rare fibro-osseous disorder characterized by the replacement of normal bone with fibrous connective tissue and mineralized material. While typically asymptomatic and noninterventional, this case report describes a 56-year-old Chinese female presenting with left mandibular swelling and intermittent dull pain initially diagnosed as acute periapical periodontitis affecting teeth #34 and #35. Comprehensive evaluation of clinical, radiographic, and demographic findings confirmed a secondary infection complicating pre-existing FCOD. Root canal therapy for #34 and #35 yielded favorable outcomes, emphasizing the importance of conservative management in such cases.