Cases reported "Cementoma"

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1/9. Benign cementoblastoma.

    An unusual case of cementoblastoma is presented. It is the second case to be published demonstrating involvement of the pulp, and it is the first instance of a cementoblastoma that appears to have evolved from an impacted tooth. A review of the literature substantiates the fact that this lesion may not be so uncommon as was previously thought, and that pain and facial asymmetry may be significant clinical features.
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2/9. Florid osseous dysplasia of the mandible: report of a case.

    In 1986, a 60-year-old African American woman visited the Marquette University School of dentistry with a complaint of a vague, dull pain in her lower left quadrant. Tooth No. 19 was extracted 10 years earlier because of extensive decay, and tooth No. 18 had received root canal therapy. A panoramic radiograph revealed the presence of ill-defined, multilocular, mixed (radiopaque-radiolucent) lesions present throughout the lower jaw. She was treated with antibiotics and scheduled for follow-up visits. When the symptoms persisted, tooth No. 18 was re-treated with root canal therapy and a representative biopsy was taken from the left mandibular area. The biopsy showed the presence of chronic osteomyelitis. The patient was treated with antibiotics and was scheduled for periodic check-up visits. In February 1995, she returned with the same symptoms in the left mandible. A panoramic radiograph showed persistence of the mixed radiopaque-radiolucent lesions throughout her mandible; however, the mass on the left side was more radiopaque and had assumed a "cotton wool" appearance. Tooth No. 18 was extracted and a biopsy was taken from the area. After correlating the clinical behavior, radiographic appearance, and histopathologic features, a diagnosis of florid osseous dysplasia with osteitis was made. This case represents a classic example of the difficulty in diagnosing fibro-osseous lesions using radiographic interpretation alone and the need to correlate the clinical, radiographic, and histopathologic features to reach a diagnosis. Additionally, the present case clearly shows treatment problems of an otherwise self-limiting condition when secondary involvement with osteomyelitis is also present. A brief description of the conditions that were included in the differential diagnosis and their management is presented.
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3/9. Developing cementoblastoma: case report and update of differential diagnosis.

    The benign cementoblastoma is a rare odontogenic tumor that tends to occur in the jaws of young people. It is most commonly characterized as a circumscribed radiopaque mass attached to the tooth roots and rimmed by a thin radiolucent zone. Early lesions, however, are radiolucent and can be confused with periapical conditions resulting from nonvital teeth. The tumor is seldom recognized until it produces pain or expansion of the jaw. If the diagnosis is established early, the tooth can be saved by endodontic treatment followed by apical root resection and surgical enucleation of the tumor. This case report documents the origin, development, and unlimited growth potential of a cementoblastoma. Radiographs taken at yearly intervals reveal an initial widening of the periodontal ligament space that grew into a 3-cm mixed radiolucent and radiopaque tumor over a 4-year period. The differential diagnosis and some criteria to help distinguish the cementoblastoma from similar-appearing lesions are reviewed.
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4/9. Focal cemento-osseous dysplasia involving a mandibular lateral incisor.

    AIM: To report a case of focal cemento-osseous dysplasia (FCOD) affecting a single tooth misdiagnosed as an inflammatory periapical lesion.SUMMARY: The patient, a black 47-year-old woman complained of pain affecting the right side of the mandible. Routine X-ray examination discovered a periapical radiolucency on the mandibular left lateral incisor (tooth 32), which was otherwise normal and not carious. As the response of this tooth to a vitality test was doubtful, the lesion was diagnosed as a periapical granuloma or cyst secondary to pulpal necrosis. Endodontic treatment and curettage of the periapical lesion were performed, and histological examination of the curettage material revealed a localized osseous dysplasia. KEY learning POINTS: FCOD may rarely affect only one tooth, resembling a periapical granuloma or cyst. Careful diagnosis is of paramount importance in cases of questionable periapical lesions affecting normal-looking teeth, before beginning treatment. FCOD generally requires no treatment. biopsy is warranted in case of doubt.
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5/9. Atypical hypercementosis versus cementoblastoma.

    hypercementosis is a non-neoplastic condition in which excessive cementum is deposited in continuation with the normal radicular cementum. Apart from the idiopathic nature of hypercementosis, this condition is associated with several local and systemic factors. Cementoblastoma is an odontogenic tumour characterized by the proliferation of functional cementoblasts that form a large mass of cementum or cementum-like tissue on the tooth root. Although hypercementosis and cementoblastoma are typical conditions with distinct clinical evolution, atypical cases may challenge their diagnosis. Because cementoblastoma is a neoplasm with unlimited growth potential, the usual treatment is complete surgical resection, whilst conservative treatment is recommended for hypercementosis. An atypical case of hypercementosis with similarities to cementoblastoma is reported and its differential diagnosis is discussed.
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6/9. Multiple osseous dysplasia arising from impacted teeth: report of a case associated with odontogenic lesions.

    We report a case of osseous dysplasia (OD) showing extremely rare clinical features. A 37-year-old Japanese woman was referred to our clinic complaining of a left alveolar bony swelling at an impacted canine. Radiographic examinations revealed a mixed radiopaque lesion involving the impacted left canine and also revealed an impacted left wisdom tooth with a cystic change and a clear radiopaque lesion suspected to be odontoma. All the extracted upper teeth and odontoma showed hypercementosis and the canine was fully involved in it. Histopathologically, they showed the same features and were diagnosed as OD. The findings of multiple OD from incompletely erupted teeth and odontoma in our case may well show that OD can arise from any tooth with periodontal ligaments and that focal OD can show expansive growth like the ossifying fibroma.
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7/9. Case of mistaken identity: periapical cemental dysplasia in an endodontically treated tooth.

    A case of a patient with a history of root canal treatment and re-treatment and a persistent periapical radiolucency is reviewed. Following surgery, biopsy material was submitted and diagnosed as periapical cemental dysplasia (PCD). With careful diagnosis, PCD should be readily differentiated from endodontic pathosis, thus avoiding unnecessary root canal treatment. In this case, surgery was necessary to rule out other inflammatory disease or benign odontogenic entities.
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8/9. Cementum-like bone production in solitary bone cysts. (so-called "cementoma" of long bones). Report of three cases. Electron microscopic observations supporting a synovial origin to the simple bone cyst.

    Three cases of simple bone cysts (S.B.C) in association with cementum-like bone production are reported. Analysis of our cases and the 2 previously reported in the literature as so-called cementomas has led us to conclude that the "cementoma" of long bone is not a distinct entity, but merely, a form of S.B.C. associated with a peculiar, poorly cellular form of bone which mimics tooth cementum by light microscopy only. Electron microscopic studies of this substance demonstrate collagen fibers and numerous matrix vesicles which form the initial sites of calcification. Matrix vesicles are a product of osteoblastic activity and are never found in the cementum of the tooth or oral cementum producing tumors. We also report the first ultramiscroscopic observations on the wall of the simple bone cyst and its lining. Two cell types constitute the lining, having features identical to those described for type A and type B synovial cells. Because of this new observation, we believe, the most reasonable explanation for the simple bone cyst is that it represents a congenital "rest" of synovial tissue displaced into the thin, cortical metaphyseal region of bones at the synovial-capsularbone reflection. Its benign nature and slow growth would explain its discovery in early childhood and the marked preponderance of its proximal humerofemoral location dependent upon the fact that these 2 bones have the largest area of capsular to metaphyseal bone reflection.
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9/9. Florid cemento-osseous dysplasia in a young Chinese man. Case report.

    Florid cemento-osseous dysplasia refers to a group of fibro-osseous lesions which are exuberant, multiquadrant and arise from the tooth-bearing area of the jaws. It is classically described as a condition occurring almost exclusively in middle-aged black women. A case of florid cemento-osseous dysplasia occurring in a young Chinese male is reported which was rare in regard to race and sex. This 20 year old Chinese man presented with huge symmetrical bony lesions in all four quadrants of the jaws. Clinical presentation, radiological findings and histological features of the excised specimens are described. Treatment of the lesions was unusual. curettage was first done with minimal benefit and it was followed by mandibular recontouring to improve facial appearance. The outcome of these procedures will be discussed.
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