Benign cementoblastoma: a clinical case of conservative surgical treatment of the involved tooth

Abstract

The benign cementoblastoma (BC) or ''true'' cementoma is a rare benign neoplasm arising from the odontogenic ectomesenchyme and representing about 1% to 6.2% of all odontogenic tumors. The BC more frequently affects young males in an age range of 20-30 years, occurring in the mandible about 3 times more than in the maxilla, and it is always physically attached to the tooth roots. This tumor is often asymptomatic until it produces pain, expansion or swelling of the jaw segment or compression of the inferior alveolar nerve. Early diagnosis is essential to save the tooth by enucleating the tumor, filling the root canals and apicectomy or curettage of the affected roots. A case of BC embedding the mandibular first right molar and resorbing the vestibular cortical bone, in a 48 year-old male, is reported. The radiographic examination showed a well-defined mixed-density unilocular mass, confluent with both the tooth roots of the mandibular first molar and surrounded by a radiolucent rim. A combined endodontic-surgical treatment was performed with the aim to remove the tumor while saving the tooth. Histological findings, differential diagnosis and surgical treatment of the tumor are discussed and compared with similar cases in the literature.