All of the following diseases can present with a “cotton wool appearance”. Paget’s is more common in older adults and mainly in the maxilla. Gardner syndrome also has multiple osteomas; epidermoid cysts; gastrointestinal polyps with a high tendency toward malignant transformation and is hereditary. Cemento-osseous dysplasia predominates in middle-aged black women and usually in the mandible. Gigantiform cementoma is hereditary and facial enlargement may be present.