Cementoblastoma, or a benign cementoblastoma; is an uncommon neoplasm of the cementum of the teeth. This tumor was first discovered in the year 1930 by Norberg. It is derived; from ectomesenchyme cells of the odontogenic origin(capable of forming teeth). It is known to be represented by less than 0.69 to 8% among all odontogenic related tumors.
Cementoblastoma affects the mandibular molars or premolars root mostly in the 20 to 30 years age group of individuals. It is more common in males. Though it is rare, therefore it is difficult to mention any standard treatment to treat this tumor.
The true cementoblastoma neoplasms are categorized into four categories. Those categories include cementifying fibroma, benign cementoblastoma, cemental periapical dysplasia, and gigantiform cementoma.
This benign tumor is due to a bony expansion of lingual and buccal aspects of the ridges associated with the alveoli. It usually does not cause any pain.
Cementoblastoma is generally asymptomatic in the beginning. It is asymptomatic when there is no evidence of the swollen region. However, there can be some symptoms exhibited by the affected individuals. Now, what are those key symptoms? It includes swelling, either with or without pain. It may also show hypersensitivity of dentin and tooth pain in some cases. Some rare clinical presentations involve cortical perforation, re-absorption of adjacent roots, adjacent teeth displacement, paraesthesia, and pathological fracture.
Odontogenic tumors are caused by cells and tissues responsible for teeth development. Sometimes the tumor may also be caused by other cells or tissues. From a general point of view, the cause of cementoblastoma is not known. However, sometimes, the cementoblastoma or cementoma is associated with some genetic syndromes. For instance, people diagnosed with Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome lack the presence of a gene that suppresses the action of tumors. Such mutations are inherited. In this syndrome, the development of odontogenic keratocyst within the jaw takes place. It often causes multiple basal cancerous cells and is also related to the development of several characteristics consequently.
But before elaborating on the treatment methods, it is essential to know that cementoblastoma shows a high recurrence rate. That is, approximately 31.7% when the lesion is not removed from the root. For this reason, the best and effective way to prevent the lesion from developing again is to remove it along with the affected tooth present.
An alternative method is to proceed through endodontic treatment with an apicoectomy. It allows the affected tooth to perform its function as a result. Sometimes, conservative treatment is also accompanied to treat this blastoma.
Cementoblastoma vs Cementoma
By definition, cementoma refers to a benign jaw tumor that originates or derives from the periodontal ligament. While on the contrary, a cementoblastoma is derived from ectomesenchymal origin.
The treatment of both cementoblastoma and cementoma involves the removal of mass or lesions. It also includes discarding the affected area of the tooth to ensure that it does not develop later.
The pathogenesis of cementoma first appears as fibrous tissue and is often confused with granuloma. The characterization of the second stage is the accumulation of calcified materials. And the third stage involves the use of radiopaque materials.
The pathogenesis of cementoblastoma involves periapical osteolysis. It is followed by a cementoblasts stage and calcification and maturation ultimately.