a 42-year - old female patient was admitted to the department of dentomaxillofacial radiology , faculty of dentistry , ankara university with a complaint of bleeding on the gums . the patient 's medical history included having undergone treatment for pernicious anemia and a gastric ulcer two years earlier . on intraoral examination , the patient was asymptomatic except for a few restored and missing teeth . a lesion was found incidentally on routine periapical radiographs taken for the restored teeth and edentulous areas ( fig . radiopaque masses were coincidentally observed in the periapical radiographs but the exact boundaries of the masses could not be seen . for further and more detailed examination , cone - beam computed tomography the panoramic radiograph and cbct revealed maxillary bilateral and symmetrical , well - defined , round , radiopaque masses in contact with the root of the maxillary right second molar and left first molar teeth . lobular , irregularly shaped radiopacities with clear radiolucent demarcation were also present in the right edentulous mandibular molar area ( figs . 2 and 3 ) . the bucco - lingual aspects of the lesions were best visualized on the axial cbct image ( fig . cbct added valuable radiographic information regarding the relationships of the lesions with significant anatomical structures , cortical plates , and tooth roots . dirty yellow , bone - hard tissues of 1 cm1 cm0.6 cm dimensions were analyzed in this examination . on the basis of the histopathologic findings , the tumor was diagnosed as fod ( fig . the patient was advised to have routine follow - up examinations at six - month intervals . the case has been followed up over the last 14 months and has remained asymptomatic . osseous dysplasias ( periapical , focal , florid osseous dysplasias , and familial gigantiform cementoma ) are a group of disorders that involve the same pathological processes.10 the clinical and radiological features of osseous dysplasia help to distinguish these lesions from others . pod is mostly confined to the anterior mandible , within the space between the canines.8 fod is a widespread form of pod and is a single lesion.1,5 the differential diagnosis of fod includes paget 's disease , chronic osteomyelitis , and gardner 's syndrome.1,10 paget 's disease is often polyostotic and shows changes in the level of serum calcium , phosphorous , and alkaline phosphatase.1,2,10 gardner 's syndrome may involve jaw bone changes similar to those with fod , but fod does not show any of the other skeletal changes that are seen in gardner 's syndrome.10 chronic osteomyelitis is a primary infection of the mandible presenting with unilateral pain , soft tissue swelling , fever , and lymphadenopathy.8,10 the secondarily infected lesion of fod has a wider radiolucent border than chronic osteomyelitis.1 steven et al reported a case that was diagnosed as chronic osteomyelitis with underlying infected fod.8 macdonald - jankowski published a systematic review on fod in 20036 that reviewed 158 cases , the mean age of which was 49 years . half of these cases had pain , swelling , and pus discharge / fistula with the frequencies of 52% , 31% , and 18% , respectively . fods can affect several areas of the jaws : posterior mandible area ( 99% ) , posterior maxilla ( 73% ) , anterior mandible ( 64% ) , and anterior maxilla ( 36% ) . the fod features observed in the present case report were in accordance with the results of that study . ong and siar provided their patient with surgical treatment to reduce the mass of the swellings.2 in rare cases , fod can be a hereditary condition with an autosomal dominant familial heredity.4 in our case , no familial aspect was observed . gndz et al7 reported a case of fod in which the lesion was seen throughout the alveolar processes of all quadrants of the maxilla and the mandible . the lesion was identified in three quadrants of the jaws in our case . while some reports have described diagnosing fod by clinical and radiological evaluation,5,7,10,13 others performed a biopsy.4,8,12 in the present case , a biopsy was also taken to confirm the diagnosis . in line with the various other reported cases , our patient was asymptomatic and the lesion was noticed incidentally on periapical radiographs taken for other purposes.4,5,7,10,13 up to now , two cases diagnosed by ct have been reported in the literature7,13 cbct images are useful diagnostic tools for identifying the location and extent of the lesion . cbct can be utilized to discriminate fod from lesions that display a similar sclerotic appearance on panoramic and periapical radiography.7 unlike the previous reports , in the diagnosis of the present case , not only clinical and radiological methods but also histological methods were used . clinicians should know the properties of such lesions and should be aware of their radiographic appearance . periapical radiographs may be insufficient to determine multifocal localization and the limits of the lesion . therefore , panoramic radiographs and ct images are preferable for a broader and more detailed examination . however , when infection of the lesion , resulting from trauma occurs , it requires surgical debridement and enucleation since antibiotics may not be effective due to the avascular nature of the lesion .