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Hypercementosis Radiograph — MFDS Part 1 MCQ

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ModerateRadiologyHypercementosis RadiographMFDS Part 1

A periapical radiograph of an asymptomatic 58-year-old patient shows incidental bulbous enlargement of the apical third of a mandibular molar root. Which associated radiographic finding would favour hypercementosis rather than ankylosis or inflammatory periapical disease?

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Correct answer: C — Continuous PDL space and lamina dura around the enlarged root

Explanation lettering: D = shown as A · A = shown as C · C = shown as D

Hypercementosis is excessive cementum deposition that produces a bulbous enlargement of part or all of the root. The periodontal ligament remains interposed between the cementum and alveolar bone, so the PDL space and lamina dura remain continuous around the altered root contour. This distinguishes it from ankylosis, in which the PDL space is locally absent and the root blends with bone (B). An apical radiolucency with loss of lamina dura suggests inflammatory periapical disease (C). Multilocular radiolucency (D) and a sunburst periosteal reaction (E) are patterns of jaw lesions rather than cemental root enlargement. The increased root bulk may make extraction more difficult.

Reference: Patterns of hypercementosis and their relationship with possible local etiological factors in radiographs of individuals from a Mexican population, 2023. https://pubmed.ncbi.nlm.nih.gov/38287996/