Cementoblastoma Definitive Diagnosis — ORE Part 1 MCQ

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ModerateOral PathologyCementoblastoma Definitive DiagnosisORE Part 1

A 50-year-old patient presents with a smooth-surfaced, dome-shaped, well-circumscribed radiopaque mass attached to the root of a vital lower first molar. It is causing root resorption and has a characteristic radiolucent rim. What is the diagnosis?

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Correct answer: A — Cementoblastoma

The diagnosis is cementoblastoma. All five diagnostic features are present: (1) well-defined radiopaque mass, (2) characteristic radiolucent rim, (3) attachment to a tooth root, (4) involvement of a vital tooth, and (5) root resorption. Cementoblastoma is pathognomonic for a rounded calcified growth intimately fused to the tooth root, with >90% presenting as radiopaque or mixed-density lesions surrounded by a radiolucent halo. The mandibular first molar is the most common site; 78% of cases preserve tooth vitality; root resorption occurs in 60% of cases. Hypercementosis is continuous deposition on the root, not a discrete attached mass with a radiolucent halo. Periapical cemental dysplasia affects anterior teeth in middle-aged women and associates with non-vital teeth. Idiopathic osteosclerosis is diffuse bone density, not a fused lesion with a halo. Complex odontoma is asymptomatic and does not fuse to a single root or produce a radiolucent rim.

Reference: Eversole LR et al. Cementoblastoma: an innocuous neoplasm? A clinicopathologic study of 44 cases and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 93(6):688–697. https://pubmed.ncbi.nlm.nih.gov/11925541/