Cemento osseous Dysplasia
Periapical cemental dysplasia is a benign condition mostly seen in patients over 20 years of age and is more common in women. The lesion occurs in and near the periodontal ligament around the apex of a tooth, usually a mandibular incisior. Most cases usually present with multiple lesions involving the apices of several mandibular anterior teeth or bicuspids. Since the lesion is asymptomatic, it is often accidentally discovered during routine intraoral roentgenographic examination. In the early stage of development, the lesion appears as a periapical radiolucency resembling periapical granuloma or cyst. The second stage in the development of the lesion is the beginning of calcification in the radiolucent area. The third stage appears on the roentgenogram as a well-defined radiopacity that is usually bordered by a thin radiolucent line. No treatment is required, as it is harmless, and only periodic observation is required. It is difficult to radiographically distinguish this lesion from a periapical granuloma. Hence to make this distinction, vitality testing of the pulp should be done. No treatment is required for this condition.