Dental Science

Cemento-osseous dysplasia (COD)


Cemento-osseous dysplasias (CODs) for short, are a group of relatively benign, or harmless jaw conditions, where there’s fibrous connective tissue containing abnormal calcifications within the jaw bones, in place of normal bone.

Benign fibro-osseous lesion of bone, in which normal bone is replaced by fibrous tissue, followed by calcification with osseous and cementum-like tissue.

  • M/C type of fibro-osseous lesion to affect jaw
  • Commonly seen in African-American females.


According to location:

  • Periapical COD (periapical region of anterior teeth) (M/C subtype)
  • Focal COD (associated with a single tooth)
  • Florid COD (FCOD) (lesions appear in > 1 quadrant)

Clinical features

Usually asymptomatic and occurs in the periapical area of teeth with vital pulps or in regions of extractions.

  • Local jaw expansion and mild discomfort (⅓ cases)



FCOD appears radiolucent in its early stages. As it matures, radiopacities appear within the lesion, causing them to show a mixed appearance of radiolucency and radiopacity.
A. Panoramic radiograph showing multiple mostly dense mixed radiodense/radiolucent lesions closely associated with the roots of maxillary and mandibular teeth. Note that the epicenter of the lesions is above the inferior alveolar canal; B. Vertical reconstruction at level of the lower right second premolar and first molar region; C. Occlusal radiograph showing slight buccal expansion at the molar region in the right and left side of the mandible. | Kutluay Köklü, H., Cankal, D. A., Bozkaya, S., Ergün, G., & Bar, E. (2013). Florid cemento-osseous dysplasia: Report of a case documented with clinical, radiographic, biochemical and histological findings. Journal of Clinical and Experimental Dentistry, 5(1), e58–e61.

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