Treatment indications for symptomatic versus asymptomatic florid cemento-osseous dysplasia in adult patients: A systematic review

The objective of this study was to identify treatment indications for symptomatic and asymptomatic florid cemento-osseous dysplasia (FCOD) in adult patients and explore relationships between clinical variables and radiographic findings (PROSPERO # CRD42023411228). A systematic review was conducted by independent investigators using databases: PubMed, ProQuest, Embase, Web of Science, Dentistry and Oral Sciences Database (DOSS), and TRIP to identify studies on FCOD treatment options in adults. Inclusion criteria for this systematic review included: originally in English; open-access; published between 2001 and 2021. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Joanna Briggs Institute (JBI) Critical Appraisal checklist were used for reporting and quality assessment of each study. From the initial 122 studies, 11 fit criteria for this systematic review. Eight studies reported symptoms as clinical presentation of FCOD, 6 reported swelling, and 3 reported infection. Five studies recommended surgical treatment in symptomatic patients with anatomic structure changes around the lesions, such as presence of necrotic bone and secondary infection. Treatment of asymptomatic FCOD was contraindicated in 10 studies. Dental prophylaxis was recommended. Dental prophylaxis and monitoring were the most common management strategies for asymptomatic and symptomatic FCOD. Surgical curettage with stimulation of bleeding, or pulp vitality testing of specific areas with periapical inflammation were treatment options for symptomatic cases. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range)