Familial florid cemento-osseous dysplasia in two young sisters: case report and literature review

Recently identified as a variant of cemento-osseous dysplasia, familial florid cemento-osseous dysplasia (FFCOD) differs from the sporadic florid variant in both clinical and radiographic behaviour and has an autosomal dominant inheritance pattern. The aim of this study is to describe the clinical, imaging, and histopathological findings of two white young sisters who were diagnosed with FFCOD, as well as the difficulties in diagnosing and treating this condition. Multifocal fibro-osseous lesions of the jaws with early onset and maturation, and association with multiple unerupted teeth were found in both patients. Other fibro-osseous lesions and systemic disorders, such as fibrous dysplasia, familial gigantiform cementoma, gnathodiaphyseal dysplasia, Paget's disease of bone, and hyperparathyroidism-jaw tumour syndrome, were taken into consideration and ruled out during the diagnostic procedure. Even though conservative management is the preferred course of treatment for FFCOD, the frequent association with unerupted teeth presents an additional challenge for the management of lesions and oral rehabilitation of these patients. Therefore, more research is needed to better understand this variant and develop safer therapeutic and rehabilitative strategies.