Cementoblastomas are one of many mandibular lesions. It is a rare tumor of the cementum, with only approximately 100 cases reported. The key to diagnosis, both radiologically and histologically, is an attachment to the tooth root.
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Terminology
Cementoblastomas have been previously described in the literature as cementomas, true cementomas, sclerosing cementomas, periapical fibro-osteoma, and periapical fibrous dysplasia 3,4 although "cementoma" is only mentioned as "periapical cementoma", a type of osseous dysplasia in the 2005 WHO histological classification of odontogenic tumors 5.
Epidemiology
Median age is 20 years (range 8-44 years) with no sex predilection 5,6.
Pathology
The usual location is around the apex of the premolars. These tumors are found originating from (i.e. in connection with) the tooth root, and usually slowly enlarge. It, therefore, obliterates the periodontal ligament space.
Radiographic features
OPG
It is typically radiodense or mixed-density with a rounded or sunburst appearance, and a relatively radiolucent rim. Loss of the periodontal ligament space along with root resorption/loss of root outline are common 5.
Treatment and prognosis
Recurrence is common with incomplete resection 5,6.
Differential diagnosis
- ossifying (cemento-ossifying) fibromas: very similar appearance
- osteoblastoma: very similar appearance but does not attach to root 5,6
- osteosarcoma 5