Signs, Symptoms, and Clinical Presentation
- Thickening of cementum around the roots of the teeth
- Involvement of deciduous and permanent teeth, impacted molars, and premolars
- Benign and painless growth
- Dull pain and dentin hypersensitivity as growth increases
- Distortion/swelling to the face and surrounding areas, along with tooth displacement
- Cementoma is often asymptomatic
- Pain and swelling may occur in advanced cases
- A well-defined radiopaque mass surrounded by a radiolucent halo is a typical finding on radiographic imaging
- Histopathological examination confirms the diagnosis of cementoma
Complications and Prognosis
- Bleeding
- Nerve damage
- Malocclusion
- Cementoma has a good prognosis after complete surgical removal
- Recurrence rates are low, but long-term follow-up is necessary
- Complications can include root resorption and displacement of adjacent teeth
- Delayed eruption of permanent teeth may occur in pediatric cases
- Rare cases of malignant transformation have been reported but are extremely rare
Causes and Pathophysiology
- Exact cause of cementomas is unknown
- Uncontrolled growth of cementum cells at the apex of a tooth root
- Linked to trauma, local irritation, infection, endocrine imbalance, cell proliferation, and vitamin deficiency
- Uncontrolled proliferation of cementoblasts at the apex of a tooth root
- Excessive production of cementum leading to destruction of the periodontal ligament and mandible
- Pathogenesis occurs in three stages: periapical osteolysis, active cementoblasts creating radiopaque matter, and maturation and calcification of the entire lesion
Diagnosis and Differential Diagnosis
- Cementoma can be seen on a radiograph or x-ray as a radiopaque mass
- Appearance changes depending on the stage and mass within the lower dental arch
- Misdiagnosis can lead to unnecessary root canal
- Differential diagnosis includes odontoma, hypercementosis, cemental dysplasia, and condensing osteitis
- Complexity of diagnosis increases as the lesion enlarges
Treatment, Prevention, and Research
- No preventative measures available for cementomas
- Surgical removal of the mass and affected area and/or teeth is the treatment
- Surgical removal without damage to surrounding teeth is limited
- Growth will continue if left untreated, affecting tooth function
- Risk of reoccurrence increases if growth and affected teeth are not completely removed
- Studies have shown that bone morphogenetic protein-2 inhibits cementoblast differentiation and mineralization
- Research aims to understand the molecular mechanisms underlying cementoma development
- Rare case presentations contribute to expanding knowledge about cementoma
- Advances in diagnostic imaging techniques improve early detection
- Ongoing research focuses on developing targeted therapies for cementoma treatment
This article needs additional citations for verification. (October 2018) |
Cementoma is an odontogenic tumor of cementum. It is usually observed as a benign spherical mass of hard tissue fused to the root of a tooth. It is found most commonly in the mandible in the region of the lower molar teeth, occurring between the ages of 8 and 30 in both sexes with equal frequency . It causes distortion of surrounding areas but is usually a painless growth, at least initially. Considerable thickening of the cementum can often be observed. A periapical form is also recognized. Cementoma is not exclusive to the mandible as it can infrequently occur in the maxilla and other parts of the body such as the long bones.
| Cementoma | |
|---|---|
| Specialty | Dentistry |
