Cementoblastoma

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Synonyms and keywords: Synonym 1; Synonym 2; Synonym 3

Overview

Cementoblastoma (also known as benign cementoblastoma) is a relatively rare benign neoplasm of the cementum of the teeth. Cementoblastoma is derived from ectomesenchyme of odontogenic origin.

Historical Perspective

• Cementoblastoma was first discovered by Norberg in 1930.

Classification

• According to the World Health Organization, cementoblastoma is classified as a true cemental neoplasm.

Pathophysiology

• The pathogenesis of cementoblastoma is characterized by the involvement of the tooth vital pulp.
• Cementoblastoma is commonly located in the mandibular molar area.
• There are no genetic mutations associated with the development of cementoblastoma.
• On gross pathology, characteristic findings of cementoblastoma, include:

• Dense homogenous, irregular, and spherical mass.
• Tooth root

• On microscopic histopathological analysis, characteristic findings of cementoblastoma, include:

• Large globules fused to form a mass
• Composed of proliferative fibrovascular stroma
• Trabeculae lined by plump osteoblasts

Causes

• Common causes of cementoblastoma, include:

Differentiating Cementoblastoma from Other Diseases

• Cementoblastoma must be differentiated from other diseases that cause tooth pain, or swelling, such as:

• Sclerosing osteomyelitis
• Osteoblastoma
• Periapical cemental dysplasia
• Osteitis
• Hypercementosis

Epidemiology and Demographics

• Cementoblastoma is uncommon.
• Cementoblastoma accounts less than 0.69%–8% of all odontogenic tumors.

Age

• Cementoblastoma is more commonly observed among patients aged 20 to 25 years old.
• Cementoblastoma is more commonly observed among young adults.

Gender

• Cementoblastoma affects men and women equally.

Race

• There is no racial predilection for cementoblastoma.

Risk Factors

• Common risk factors in the development of cementoblastoma, include:

Natural History, Complications and Prognosis

• The majority of patients with cementoblastoma are initially asymptomatic.
• Early clinical features include tooth pain, swelling, and
• If left untreated, patients with cementoblastoma may progress to develop
• Common complications of cementoblastoma, include:
• Prognosis is generally good, and the recurrence rate of patients with cementoblastoma is approximately

Diagnosis

Symptoms

• Cementoblastoma is usually asymptomatic.
• Symptoms of cementoblastoma may include the following:

• [symptom 1]
• [symptom 2]
• [symptom 3]
• [symptom 4]
• [symptom 5]
• [symptom 6]

Physical Examination

• Patients with cementoblastoma usually are well-appearing.
• Oral examination may be remarkable for:

• [finding 1]
• [finding 2]
• [finding 3]
• [finding 4]
• [finding 5]
• [finding 6]

Laboratory Findings

• There are no specific laboratory findings associated with cementoblastoma.

Imaging Findings

• Conventional radiograph is the imaging modality of choice for cementoblastoma.
• On conventional radiograph, characteristic findings of cementoblastoma, include:

• Well defined, markedly radiopaque mass,
• Radiolucent peripheral "line", which overlies and obliterates the tooth root.
• There is usually apparent external resorption of the root where the tumor and the root join.
• Severe hypercementosis may be present

Treatment

Medical Therapy

• There is no treatment for cementoblastoma; the mainstay of therapy is surgery.

Surgery

• Surgery is the mainstay of therapy for cementoblastoma.
• Surgical tooth extraction in conjunction with post-surgery biopsy is the most common approach to the treatment of cementoblastoma.

Prevention

• There are no primary preventive measures available for cementoblastoma.