Mandibular Actinomyces Osteitis Associated with Florid Cemento-Osseous Dysplasia

Abstract

Introduction: Actinomycosis is a rare chronic suppurative granulomatous infection caused by actinomyces. The Florid cemento-osseous dysplasia (FCOD) is a benign fibro-osseous lesion. We report a case of simultaneous association of these two entities with the use of PRF for the first time in this context. Case Report: A 59-year-old female with no medical history was received in our clinic for painful swelling on the right mandible. On clinical examination, we noticed a facial asymmetry caused by the swelling and bone exposure with pus on the right mandibular ridge. The panoramic radiography showed right and left posterior mandibular opacities. On the cone beam reconstructions, we noted a hyperdense posterior right mandibular image surrounded by a hypodense border and a hyperdense posterior left mandibular image surrounded by a hypodense border, in contact with the apices of tooth 36. Based on the clinical, radiographic and pathological findings, the present case was diagnosed as mandibular actinomyces osteitis associated with florid cemento-osseous dysplasia. The treatment consisted of surgical excision of the lesion, filling of the defect with PRF and prescription of antibiotics. Conclusion: Despite its rarity, practitioners should be aware of the possibility of the coexistence of these two entities simultaneously. Thus, they can initiate the appropriate treatment.