Description, Causes and Risk Factors:
Benign cementoblastoma is a rare odontogenic tumor characterized by the formation of a mass of cementum or cementum-like tissue attached to the roots of a tooth. Cementoblastoma are distinctive but relatively uncommon tumors. The clinical, radiographic, and histopathologic features of a case of benign cementoblastoma are presented in this paper along with a brief review of the literature.
The cementoblastoma has been classified as a benign tumor of odontogenic origin derived from ectomesenchyme. It is an uncommon tumor comprising less than 0.69%-8% of all odontogenic tumors. The World Health Organization (WHO) has classified benign cementoblastoma and cementifying fibroma as the only true cemental neoplasms. The tumor arises mostly in the permanent dentition with a few incidences being reported in primary teeth. The most common site for occurrence of cementoblastoma is mandibular molar area with 50% of the cases involving the mandibular first molar teeth. Symptoms may be totally absent and when they occur pain and swelling are frequent findings.
This tumor primarily affects adults with a mean age of 20.7 years. The male to female ratio has been reported to be 2.1:1 with a higher predilection for males. The mandible is more involved than maxilla. It is usually associated with roots of mandibular molar followed by mandibular premolar. This tumor is also associated with multiple teeth, impacted molars and deciduous teeth. The associated tooth is vital unless involved coincidentally.
The cementoblastoma is distinguished from the osteoblastoma by its location in intimate association with a tooth root. The osteoblastoma arises in the medullary cavity of many bones, including the long bones, vertebrae and jaws. The prognosis is excellent, as the tumor does not recur after total excision.
The lesion is slow growing and usually asymptomatic;however, pain and swelling have been reported in a numberof cases. Corticalexpansion and facial asymmetry are common.Radiographically, the lesion usually shows a radiopaque massoften fused with a root or roots of a tooth and surrounded andlimited peripherally by a radiolucent halo.
The differential diagnosis for the periapical radiopacity includes condensing osteitis, osteoblastoma, odontoma, periapical cemental dysplasia, and hypercementosis.
The condition is usually diagnosed with a common x-ray, in which the mass is clearly visible at the root of the affected tooth. Further procedures, such as a CT scan, can confirm the diagnosis. In some cases, a biopsy (a small sample of tissue collected from the mass and examined under a microscope) is done.
Histologically, the tumor presents cementum-like tissue with numerous reversal lines.
The most effective method of treatment is extracting the affected tooth and mass. Surgical excision of the mass with root amputation and endodontic treatment of the involved tooth is another option. The mass does grow slowly, but can cause discomfort for the patient as it gets larger. If left untreated, or if the mass is not removed completely, it will likely expand and affect other teeth and impact the healthy tissue.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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