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 paediatric 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