A rare complication of idiopathic osteosclerosis

 

 

Luciano Marques-Silva, André Luiz Sena Guimarães, Mauro Lúcio Cardoso Dilascio, Wagner Henriques Castro, Ricardo Santiago Gomez

Department and Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

Correspondence

 

 

---

ABSTRACT

Idiopathic osteosclerosis (IO) is described as a localized no expansible radiopacity with unknown etiology. The IO is generally asymptomatic and could appear as round, elliptical or irregular in shape. The internal aspect is usually uniformly radiopaque. IO should be distinguished from condensing osteitis of dental origin, or other alveolar bone related radiopacities such as periapical cemental dysplasia. This condition may cause changes in tooth position or problems during orthodontic treatment. The purpose of the present study is to report a case of tooth resorption caused by ectopic eruption rote caused by IO.
This condition represents a rare complication of IO.

Key words: Osteosclerosis, radiopaque, orthodontic, eruption.

---

 

Introduction

Idiopathic osteosclerosis (IO) is a localized no expansible radiopacity with unknown etiology (1,2). This condition is usually asymptomatic, but it may cause changes in tooth position or problems during orthodontic treatment. The purpose of the present study is to report a case of tooth resorption caused by ectopic eruption rote caused by IO. To our knowledge, this is the firs report of this rare complication of IO.

 

Case report

A 20 –years-old girl was referred to the oral medicine service for evaluation of an unknown lesion discovered through routine radiographic exam. An intra-oral examination revealed pain in the 46 teeth that presented without restoration. The radiographic examination showed an isolated round mass with uniform radiopacity but without a surrounding radiolucent rim, below the mandibular right second premolar region. A severe root resorption of the 46 associated with the impacted 45 was also observed (Figure 1). The patient’s medical and family histories were non-contributory. The tooth 46 was removed and the patient is under control.

 

Discussion

IO is described as a localized no expansible radiopacity of unknown origin (1,2). This radiopacity can be found in most parts of the skeleton (3,4). In the jaws, studies have reported a predilection for the mandible in the posterior region (2,5-7). The IO could appear as round, elliptical or irregular in shape, generally asymptomatic and without any obvious etiological agent (8). The internal aspect is usually uniformly radiopaque, consisting of a ground glass/ stippled appearance (9) or coarse trabeculae that may extend beyond the area of increased density (10). The prevalence of this alteration ranges from 2.3% to 9.7% (5). The discrepancies between these surveys can be explained by different diagnoses criteria.

Although the cause and biologic behavior of IO is unknown, the suggested causes include retained primary root fragments, bone deposited in response to unusual occlusal forces (7) or anatomic variations analogous to tori (11,12). IO is clearly separated from the roots of the adjacent teeth and should be distinguished from condensing osteitis of dental origin, or other alveolar bone related radiopacities such as periapical cemental dysplasia and ossifying fibroma (1, 13, 14).

The local complications of IO in jaws are changes in tooth position, complication of any future orthodontic treatment (15). Inclination of teeth induced by IO was recently reported (16), but as far as we are concerned, there is no report of concomitant resorption of associated tooth.

Root resorption is observed in association with impacted teeth (16). The deviation in eruption path was suggested as the responsible factor to the resorption of the tooth 46 (17). In conclusion, the present report describes a rare case of ectopic eruption rote caused by IO that induced root resorption.

 

References

1. McDonnell D. Dense bone island. A review of 107 patients. Oral Surg Oral Med Oral Pathol 1993;76:124-8.        [ Links ]

2. Yonetsu K, Yuasa K, Kanda S. Idiopathic osteosclerosis of the jaws: panoramic radiographic and computed tomographic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:517-21.        [ Links ]

3. Park H S, Kim J R, Lee S Y, Jang KY. Symptomatic giant (10-cm) bone island of the tibia. Skeletal Radiol 2005;34:347-50.        [ Links ]

4. Onitsuka H. Roentgenologic aspects of bone islands. Radiology 1977;123:607-12.        [ Links ]

5. Kawai T, Hirakuma H, Murakami S, Fuchihata H. Radiographic investigation of idiopathic osteosclerosis of the jaws in Japanese dental outpatients. Oral Surg Oral Med Oral Pathol 1992;74:237-42.        [ Links ]

6. Farman A G, Joubert V J J, Nortje C J. Focal osteosclerosis and apical periodontal pathoses in "European" and Cape coloured dental outpatients. Int J Oral Surg 1978;7:549-57.        [ Links ]

7. Geist J R, Katz J O. The frequency and distribution of idiopathic osteosclerosis. Oral Surg Oral Med Oral Pathol 1990;69:388-93.        [ Links ]

8. Halse A, Molven O. Idiopathic osteosclerosis of the jaws followed through a period of 20-27 years. Int Endod J 2002;35:747-51.        [ Links ]

9. Austin B W, Moule A J. A comparative study of the prevalence of mandibular osteosclerosis in patients of Asiatic and Caucasian origin. Aust Dent J 1984;29:36-43.        [ Links ]

10. Petrikowski C G, Peters E. Longitudinal radiographic assessment of dense bone islands of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:627-34.        [ Links ]

11. Eselman J C. A roentgenographic investigation of enostosis. Oral Surg Oral Med Oral Pathol 1961;14:1331-8.        [ Links ]

12. Fireman S M. Osteosclerotic lesions of the jaws. Oral Health 1976;66:27-9.        [ Links ]

13. Sanchis JM, Penarrocha M, Balaguer JM, Camacho F. Cemento-ossifying mandibular fibroma: a presentation of two cases and review of the literature. Med Oral 2004;9:69-73.        [ Links ]

14. Perez-Garcia S, Berini-Aytes L, Gay-Escoda C. Ossifying fibroma of the upper jaw: report of a case and review of the literature. Med Oral 2004;9:333-9.        [ Links ]

15. Nakano K, Ogawa T, Sobue S, Ooshima T. Dense bone island: clinical features and possible complications. Int J Paediatr Dent 2002;12:433-7.        [ Links ]

16. Nute S J. Severe incisor resorption by impacted maxillary canines: case report and literature review. Int J Paediatr Dent 2004;14:451-4.        [ Links ]

17. Brin I, Becker A, Zilberman Y. Resorbed lateral incisors adjacent to impacted canines have normal crown size. Am J Orthod Dentofacial Orthop 1993;104:60-6.        [ Links ]

 

 

Correspondence:
Prof. Ricardo Santiago Gomez
Faculdade de Odontologia
Universidade Federal de Minas Gerais
Av. Antonio Carlos, 6627
Belo Horizonte-MG
Brazil CEP 31270-901
E-mail: rsgomez@ufmg.br

Received: 16-12-2005
Accepted: 22-02-2007