Cementoblastoma, or benign cementoblastoma, is a relatively rare
benign
Malignancy () is the tendency of a medical condition to become progressively worse.
Malignancy is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous benign tumor, ''benign'' tumor in that a malign ...
neoplasm
A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
of the
cementum
Cementum is a specialized calcified substance covering the root of a tooth. The cementum is the part of the periodontium that attaches the teeth to the alveolar bone by anchoring the periodontal ligament.Illustrated Dental Embryology, Histology, a ...
of the
teeth
A tooth ( : teeth) is a hard, calcified structure found in the jaws (or mouths) of many vertebrates and used to break down food. Some animals, particularly carnivores and omnivores, also use teeth to help with capturing or wounding prey, tear ...
. It is derived from ectomesenchyme of odontogenic origin. Cementoblastomas represent less than 0.69–8% of all odontogemic tumors.
Signs and symptoms
Cementoblastoma usually occurs in people under the age of 25, particularly males. It usually involves the permanent
mandibular molars or premolars.
The involved tooth usually has a vital
pulp
Pulp may refer to:
* Pulp (fruit), the inner flesh of fruit
Engineering
* Dissolving pulp, highly purified cellulose used in fibre and film manufacture
* Pulp (paper), the fibrous material used to make paper
* Molded pulp, a packaging material
...
. It is attached to the tooth root and may cause its resorption, may involve the
pulp canal, grows slowly, tends to expand the overlying cortical plates, and, except for the enlargement produced, is usually asymptomatic. This involves the buccal and lingual aspects of the alveolar ridges. But may be associated with diffuse pain and tooth mobility, but the tooth is still vital.
Since a cementoblastoma is a benign neoplasm, it grossly forms a mass of cementum-like tissue as an irregular or round mass attached to the roots of a tooth, usually the permanent mandibular first molar.
Diagnosis
A cementoblastoma in a
radiograph
Radiography is an imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical radiography ("diagnostic" and "therapeut ...
appears as a well-defined, markedly radiopaque mass, with a radiolucent peripheral line, which overlies and obliterates the tooth root. It is described as having a rounded or sunburst appearance. There is usually apparent external resorption of the root where the
tumor
A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
and the root join. Severe
hypercementosis
Hypercementosis is an idiopathic, non-neoplastic condition characterized by the excessive buildup of normal cementum (calcified tissue) on the roots of one or more teeth. A thicker layer of cementum can give the tooth an enlarged appearance, which ...
and
chronic focal
sclerosing
Sclerotherapy (the word reflects the Greek ''skleros'', meaning ''hard'')
is a procedure used to treat blood vessel malformations ( vascular malformations) and also malformations of the lymphatic system. A medicine is injected into the vessels, ...
osteomyelitis
Osteomyelitis (OM) is an infection of bone. Symptoms may include pain in a specific bone with overlying redness, fever, and weakness. The long bones of the arms and legs are most commonly involved in children e.g. the femur and humerus, while the ...
are lesions to consider in the differential
diagnosis
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
of this lesion.
Treatment
Surgical
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
enucleation of the lesion is done, and depending upon the clinical circumstances, this involve removal of the involved tooth. With incomplete removal, recurrence is common; some surgeons advocate curettage after extraction of teeth to decrease the overall rate of recurrence.
See also
*
Cementum
Cementum is a specialized calcified substance covering the root of a tooth. The cementum is the part of the periodontium that attaches the teeth to the alveolar bone by anchoring the periodontal ligament.Illustrated Dental Embryology, Histology, a ...
*
Cementogenesis Cementogenesis is the formation of cementum, one of the three mineralized substances of a tooth. Cementum covers the roots of teeth and serves to anchor gingival and periodontal fibers of the periodontal ligament by the fibers to the alveolar bone ( ...
*
Cementoblast
A cementoblast is a biological cell that forms from the follicular cells around the root of a tooth, and whose biological function is cementogenesis, which is the formation of cementum (hard tissue that covers the tooth root). The mechanism of di ...
References
External links
{{Odontogenic tumors
Odontogenic tumors