Secondary Chronic Osteomyelitis of the Mandible and Concomitant Mature Florid Cemento-Osseous Dysplasia: A Case Report

Florid osseous dysplasia and osteomyelitis are distinct disease entities that exhibit similar clinical and radiographic manifestations. The avascular nature of florid cemento-osseous dysplasia (FCOD) may predispose individuals to osteomyelitis. This case study aimed to present a patient with mature FCOD in the mandible accompanied by secondary chronic osteomyelitis. A 72-year-old East African woman was admitted to the Oral and maxillofacial radiology clinic with chronic diffuse pain in the left mandible. A panoramic image from a previous dental center shows a sequestrum and multiple sclerotic radiopaque masses in the left mandibular molar region. Intraoral examination revealed necrotic bone exposed to the oral cavity in the same region. Subsequent surgical intervention was conducted under local anesthesia with appropriate antibiotic prophylaxis to expose necrotic, irregular, and pitted bone trabeculae on histopathological examination. Cemento-osseous dysplasias, including FCOD, can attain considerable sizes and may become exposed along the alveolar mucosa. In the present case, secondary osteomyelitis developed in association with exposed bone. The diagnosis of FCOD relies on a combination of radiological and clinical findings. Following diagnosis, regular monitoring and consistent follow-up are imperative for disease management.