Cementoblastoma asociado a primer molar permanente. Reporte de un caso / Cementoblastoma associated with a first permanent molar. A case report

Resumen Objetivo: El cementoblastoma es una neoplasia odontogénica benigna de origen mesenquimático relativamente poco frecuente que se asocia a las raíces de las piezas dentarias. Se considera que es la única neoplasia verdadera de origen cemental. El objetivo del presente trabajo es describir el caso clínico de un cementoblastoma de grandes dimensiones y realizar una revisión bibliográfica a fin de establecer pautas de diagnóstico y tratamiento, señalando sus diferenciales con patologías de similares características como la displasia cemento ósea y el fibroma cemento osificante. Caso clínico: Se describe el caso de un paciente pediátrico que presenta un aumento de volumen de considerables dimensiones asociado al primer molar permanente mandibular. Teniendo en cuenta las características clínicas y radiográficas, y con un diagnóstico presuntivo de cementoblastoma, se realizó la extirpación quirúrgica de la lesión junto con la pieza dentaria asociada, confirmándose el diagnóstico inicial por medio del estudio anatomopatológico.

Abstract Aim: Cementoblastoma is a relatively infrequent benign odontogenic neoplasia of mesenchymal origin that is associated with the roots of teeth. It is considered to be the only true cemental originated neoplasm. The objective of this article is to describe the clinical case of a large cementoblastoma and to carry out a bibliographical review to establish diagnostic and treatment guidelines, pointing out its differences with pathologies of similar characteristics, such as the cemento-osseous dysplasia and the cemento-ossifying fibroma. Clinical case: The case of a pediatric patient who presents a considerable increase in the volume associated with the mandibular first permanent molar is described. Considering the clinical and radiographic characteristics, and with a presumptive diagnosis of cementoblastoma, a surgical extraction of the lesion along with the associated tooth was performed, confirming the initial diagnosis by an anatomopathological study.

Cementoma Gigantiforme Mandibular en Paciente Pediátrico: Reporte de Caso y Revisión de la Literatura

RESUMEN: El cementoma gigantiforme (CG) es una lesión fibrocemento-ósea benigna de muy baja prevalencia y de etiología desconocida que se presenta con mayor frecuencia en pacientes jóvenes y que se caracteriza por generar movilidad de dientes y asimetrías faciales importantes. Radiográficamente se expresa como una lesión mixta, con presencia de áreas radiopacas y algunas radiolúcidas, bien circunscrita, que se observa principalmente en la mandíbula. El CG se comporta de manera similar a otras lesiones de los maxilares, tanto en su clínica como en la histopatología, lo que podría dificultar y confundir su diagnóstico. Debido a su comportamiento localmente agresivo y deformante, el tratamiento sugerido es la resección de la lesión con márgenes de seguridad.

ABSTRACT: The gigantiform cementoma (GC) is a benign bone-fibrocement lesion of very low prevalence and of unknown etiology that occurs more frequently in young patients and is characterized by generating mobility of teeth and significant facial asymmetries. Radiographically it is expressed as a mixed lesion, with the presence of radiopaque and some radiolucent areas, well circumscribed, which is observed mainly in the mandible. GC behaves in a similar way to other maxillary lesions, both clinically and in histopathology, which could make its diagnosis difficult and confusing. Due to its locally aggressive and deforming behavior, the suggested treatment is resection of the lesion with safety margins.

Tratamento cirúrgico de cementoblastoma assintomático em elemento hígido / Surgical treatment of asymptomatic cementoblastoma in higid element

O cementoblastoma benigno é uma lesão patológica rara, de origem odontogênica, caracterizada pela proliferação anormal de cementoblastos, o que forma, consequentemente, uma massa de tecido semelhante a cemento. Na maioria dos casos, é encontrado em associação com primeiros molares inferiores. Ocorre mais frequentemente em caucasianos, entre as 2ª e 3ª décadas de vida, afetando, assim, raramente dentes decíduos. Geralmente, apresenta sintomatologia dolorosa e expansão de corticais ósseas. Seu tratamento vai desde a remoção completa da lesão com extração do dente envolvido até o tratamento endodôntico com preservação do elemento dentário. No presente artigo, relata-se um caso de cementoblastoma benigno em uma paciente de 23 anos sem sintomatologia dolorosa e ao exame clínico nada de anormal foi observado, sendo tratada através da remoção da lesão e extração do dente... (AU)

The benign cementoblastoma is a rare pathologic wound, of odontogenic origin feature of the abnormal cementoblast proliferation, resulting hence a coat mass like to cement. Usually is found in association with the first bottom molars. This happen more frequently on Caucasian, between the 2ª and 3ª decade of life, affecting rarely the primary dentition . Generally show a painful symptomatic and expansion of the cortical bone. The treatment starts with the removal wound full of with the tooth extraction involved in the endodontico treatment , with preservations of the dental element. This article descrambles a cementobastoma benign case in a patient with 23 years old, asymptomatic and the clinic exam nothing abnormal was found. Was treated through the wound removal and the tooth extraction... (AU)

Cementoblastoma benigno: relato de caso / Benign Cementoblastoma: Case Report

O cementoblastoma benigno ou cementoma verdadeiro é uma neoplasia odontogênica benigna. Acredita-se que essa lesão é a única neoplasia verdadeira do cemento. Ela apresenta incidência entre 1 e 6,2% dentre os tumores odontogênicos, o que vem a tornála rara. Sendo assim, o objetivo do presente trabalho foi relatar o caso clínico de uma paciente com diagnóstico de cementoblastoma benigno, enfatizando as peculiaridades desse tumor, a importância do diagnóstico correto e o estabelecimento de um tratamento adequado, bem como ressaltar a importância da proservação do caso.

Benign cementoblastoma or true cementoma is a benign odontogenic tumour. It is believed that this lesion presents the unique true cementum neoplasm. It is a rare lesion comprising 1 to 6,2% of odontogenic tumours. Therefore, the objective of this study was to report the case of a patient diagnosed with benign cementoblastoma, emphasizing the peculiarities of this tumor, the importance of correct diagnosis and appropriate treatment setting, as well as underscoring the importance of proactive observation.

Familial gigantiform cementoma with Ehlers - Danlos syndrome: A report of 2 cases

Ehlers-Danlos syndrome is an autosomal dominant hereditary disorder of connective tissue, while familial gigantiform cementoma is a condition that usually manifests as multiple radiopaque cementum-like masses throughout the jaws. This case report discusses the oral management and prosthetic rehabilitation of two patients presenting familial gigantiform cementoma with Ehlers-Danlos Syndrome.

Familial gigantiform cementoma with Ehlers - Danlos syndrome: A report of 2 cases

Ehlers-Danlos syndrome is an autosomal dominant hereditary disorder of connective tissue, while familial gigantiform cementoma is a condition that usually manifests as multiple radiopaque cementum-like masses throughout the jaws. This case report discusses the oral management and prosthetic rehabilitation of two patients presenting familial gigantiform cementoma with Ehlers-Danlos Syndrome.

Cementoblastoma benigno na mandíbula: Relato de caso / Benign cementoblastoma in mandible: a case report

O cementoblastoma benigno (CB) é um tumor odontogênico raro, de crescimento lento e ilimitado. Ocorre mais frequentemente em caucasianos, entre as 2ª e 3ª décadas de vida, sem predileção por gênero. Mais comum na mandíbula, área de molares e pré-molares, geralmente envolve o primeiro molar permanente. Em imagem radiográfica, apresenta massa radiopaca delimitada por delgada linha radioluscente, simulando uma hipercementose. Em cortes histológicos, assemelha-se fortemente com osteoma osteoide, osteosarcoma ou osteoblastoma benigno. O objetivo do presente trabalho foi descrever um caso incomum de cementoblastoma. I.D.S., gênero masculino, melanoderma, 32 anos que compareceu ao ambulatório do Grupo de Apoio Aprendizes do Amor Cristão - GAAAC, Brasília - DF, sem queixa de dor, portando lesão na região do 2º molar mandibular esquerdo, apresentando imagem radiográfica sugestiva de cementoblastoma. O tratamento consistiu na remoção completa da lesão acompanhada de extração do dente 37. Após dois anos, observou-se a remissão dos sinais, não havendo recorrência do tumor. O caso relatado apresentou como variante incomum ter acometido indivíduo da raça negra, relacionado ao 2º molar mandibular esquerdo - 3%. O sítio de localização atípico e as discrepâncias encontradas entre o presente relato e a literatura reforçam a importância do diagnóstico e a pesquisa por novas evidências relacionadas ao cementoblastoma.

The cementoblastoma benign (CB) is a rare odontogenic tumor, slow growth and unlimited. It occurs more frequently in caucasians, between 2nd and 3rd decades of life, with no predilection for gender. More common in the mandible area of molars and premolars, usually involving the first permanent molar. In radiographic image shows a radiopaque mass bounded by thin radiolucent line simulating a hypercementosis. Using histological resembles strongly with osteoid osteoma, osteosarcoma and benign osteoblastoma. The aim of this study was to describe an unusual case of cementoblastoma. IDS, male, melanoderma, 32 years old, came to the Grupo de Apoio Aprendizes do Amor Cristão - GAAAC, Brasília - DF, without pain, with a lesion in the 2nd left molar region, presenting radiographic image suggestive of cementoblastoma. The treatment consisted of complete removal of the lesion accompanied by the extraction of the tooth 37. After two years, there was remission of signs, with no tumor recurrence. This case presents unusual variant as the fact that it involved an individual of black, related to 2nd left mandibular molar - 3%. The rarity of the condition and the discrepancies found between this case and the literature of reinforce even more the importance of any new evidence related to cementoblastoma.

CBCT findings of periapical cemento-osseous dysplasia: A case report

Periapical cemento-osseous dysplasia (PCOD) is a subtype of cemento-osseous dysplasia that usually occurs in middle-aged black women. This report described a case of a 45-year-old Iranian woman who was diagnosed with PCOD on the basis of cone beam computed tomographic (CBCT) findings. CBCT enabled detailed visualization of the bone changes. This report described the special radiographic characteristics of PCOD, including discontinuity of the lingual cortex on the CBCT sectional and three-dimensional images.

Cementoblastoma dos maxilares agressivo. Considerações sobre a escolha da terapêutica / Aggressive maxillary cementoblastoma: Considerations on the choice of therapy.

Cementoblastoma constitui-se em um neoplasma odontogênico, considerado raro por representar cerca de 1% a 6.2% de todos os tumores odontogênicos. Essa lesão tem sido descrita mais comumente em pacientes jovens, com cerca de 73% dos casos ocorrendo em idades inferiores a 30 anos. Caracteriza-se, sob o aspecto clínico e radiográfico, como uma tumefação geralmente indolor, intimamente associado à raiz de dentes multirradiculares. Geralmente, o tratamento reserva-se à remoção cirúrgica da lesão juntamente com o dente envolvido. O objetivo do presente trabalho é o de relatar o caso de cementoblastoma tratado com base na terapia combinada endodôntica e cirúrgica.

Cementoblastoma constitutes an odontogenic neoplasm, and is considered rare as it accounts for about 1% to 6.2% of all odontogenic tumors. This lesion has been described most commonly in young patients, with about 73% of cases occurring in those under 30 years of age. On the basis of its clinical and radiological features, it is characterized as a usually painless swelling, closely associated with the root of multiradicular teeth. Treatment is generally limited to the surgical removal of the lesion together with the tooth involved. The aim of this paper is to report a case of cementoblastoma treated by a combination of endodontic and surgical therapy.

Clinical, radiographic, and histological findings of florid cemento-osseous dysplasia: a case report

Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissue and involve, essentially, the same pathological process. They are usually classified into three main groups: periapical, florid, and focal cemental dysplasias depending on their extent and radiographic appearances. Radiographically, florid cementoosseous dysplasia (FCOD) appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. The best management for the asymptomatic FCOD patient consists of regular recall examinations with prophylaxis. The management of the symptomatic patient is more difficult. A case of FCOD occurring in a 52-year-old edentulous Korean female is reported which is rare with regard to race and sex.

Florid Osseous Dysplasia.

Florid osseous dysplasia is a rare non-neoplastic and asymptomatic bone disorder involving the jaws. It is commonly seen in elderly females. Discovered on routine radiographic examination it manifests as radiopacities involving multiple quadrants. Microscopically, the lesion shows a fibroblastic proliferation along with irregular trabeculae of woven bone and cementum like material. Here with presenting two such interesting cases of this rare entity presenting in a family and associated with multiple impacted teeth.

Cementoblastoma benigno: relato de caso / Benign cementoblastoma: a case report

Cementoblastoma benigno é uma neoplasia odontogênica relativamente rara caracterizada, pela formação de uma massa de tecido semelhante ao cemento, em conexão com a raiz do dente. Radiograficamente está aderido à porção apical ou lateral da raiz e se apresenta como uma massa radiopaca densa, bem delimitada e circundada por um halo radiotransparente fino e uniforme. Neste artigo, os achados clínicos e radiográficos de um caso de Cementoblastoma benigno são apresentados.

Benign cementoblastoma is a relatively rare odontogenic neoplasm characterized by the formation of a mass of cementum-like tissue, connected to the root of the tooth. Radiographically, it is attached to the apical or lateral root and presents as a well-defined, dense radiopaque mass, surrounded by a thin and uniform radiolucent halo. In this article, the clinical, radiographic and therapeutic features of a case of benign cementoblastoma are presented.

Florid cemento-osseous dysplasia: a case report

Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. It usually exhibits as multiple radiopaque cemetum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This paper presents the case of a patient who was diagnosed with FCOD on the basis of clinical and radiographic findings.

A displasia cemento-óssea florida (DCOF) tem sido descrita como uma condição que afeta tipicamente os maxilares de mulheres negras de meia idade, geralmente exibindo massas radiopacas semelhantes ao cemento, distribuídas nos ossos maxilares. Radiograficamente, a DCOF apresenta-se como densas masas lobuladas, frequentemente distribuídas simetricamente em diversas regiões dos maxilares. A tomografia computadorizada, que oferece vistas axial, sagital e frontal, é útil na avaliação dessas lesões. Este artigo apresenta o caso de uma paciente em que a DCOF foi diagnoasticada com base nos achados clínicos e radiográficos.

The prevalence, clinical and radiographic characteristics of cemento-osseous dysplasia in Korea / 대한구강악안면방사선학회지

PURPOSE: This study was intended to estimate the prevalence of cemento-osseous dysplasia (COD) in the Korean population and to assess the clinical and radiographic characteristics of this condition. MATERIALS AND METHODS: Panoramic radiographs from 10,646 patients (4,982 males and 5,664 females, age range from 6 to 91 years) were reviewed for evidence of COD. Their demographics, clinical characteristics, and radiographic features were retrospectively assessed. RESULTS: Of 10,646 panoramic radiographs, 33 radiographs (0.31%) exhibited evidence of COD. The prevalence of COD increased to over 1% in women over 40-years old. Of these 33 patients, 16 had florid cemento-osseous dysplasia (FCOD) and 17 had focal COD. Due to the multiplicity of FCOD, a total of 63 COD lesions were assessed. These lesions were most common in the mandibular molar area. Most of the COD lesions examined (61.9%) were less than 10 mm and the majority (82.5%) showed radiopacity. CONCLUSION: COD has a predilection for the mandibular molar area of middle-aged and older women.

Familial gigantiform cementoma / 대한구강악안면방사선학회지

Familial gigantiform cementoma is a rare fibro-cemento-osseous disease of the jaws which appears to be transmitted as an autosomal dominant trait with variable expressivity of the phenotype. A 7-year-old girl visited DKUDH complaining of the painless facial deformity. Clinically, significant facio-lingual expansion was observed at the left maxilla, left mandibular body and symphysis portion. Malposition of lower anterior teeth was found. Panoramic radiograph and CT scan showed the extensive expansile mixed lesion at maxilla and mandible. Bone scan revealed hot spot at the maxilla and left side of mandible. Histologic examination revealed moderately dense fibrous connective tissue with scattered masses resembling cementum. The patient's mother had a history of the mandibular resection due to benign tumor. Her younger brother had buccal expansion of right mandible. We report our finding of a family that has exhibited clinical, radiographic and histologic findings consistent with the familial gigantiform cementoma.

Cementoma

Este estudio se realizó con el objetivo de recopilar información acerca de los cementomas enfatizando en sus características clínicas, radiográficas e histológicas. La bibliografía fue tomada de las Bibliotecas del ISCM de Camagüey y del Hospital Provincial Docente "Manuel Ascunce Domenech" y se utilizó además la Base de Datos MedLine en una revisión realizada de septiembre de 1995 a marzo de 1996. La selección de estudios se realizó por varios revisores independientes tomándose como criterio de selección aquellos que se relacionaban con el tema y abordaban los tópicos objeto de la presente investigación. Los cementomas son lesiones constituidas por tejidos semejantes al cemento y existen cuatro tipos diferentes: displasia fibrosa cemental periapical, cementoblastoma benigno, fibrocementoma y cementoma gigantiforme múltiple familiar. Radiográficamente se presentan como imágenes radiopacas que dependen del grado de evolución del tumor. La histogénesis no está perfectamente aclarada aún y la histología es variada. La displasia fibrosa cemental periapical es más común en la raza negra y el sexo femenino el más afectado presentándose con mayor frecuencia en edad mediana. Se afectan más las incisivos y premolares y sobre todo la mandíbula. El cementoblastoma benigno es más común en menores de 25 años generalmente en la mandíbula y siempre está asociado a la raíz de un diente, provocando expansión ósea externa e interna. El fibrocementoma, entidad definida que puede aparecer a cualquier edad y con predilección por el sexo femenino y raza blanca, aparece frecuentemente en la mandíbula provocando desplazamiento dentario. El cementoma gigantiforme es el más infrecuente, más común en mujeres de raza negra y edad intermedia, se presenta como masas radiopacas distribuidas simétricamente en las cuatro hemiarcadas. No existe reabsorción ni desplazamiento visible.

The objectives of the study were gather information about cementomas emphasizing in its clinical, radiographical and hystological characteristics. Bibliography was taken from libraries of the Superior Medical Institute of Camagüey and "Manuel Ascunce Domenech" Provincial Hospital, and moreover, computed data bases (MEDLINE) in a review carried out from September 1995 to March 1996 were used. The study selection was performed by some independent reviewers, taking as a selection criterion those related with the topic chosen and they explained the topics, targets of this research. Within the synthesis of data it was analyzed that cementomas are lesions composed of cemento-like tissues, which are of four different types:- periapical fibrous cementum dysplasia,- benign cementoblastoma,- fibrocementoma and - multiple-familiar giant-like cementoma. They present radiographically as radiopaque images that depend on the evolution stage of the tumour. Hystogenesis is yet uncertain. Hystology is diverse. Concluding, there are four types of lesions derived from cementum -forming cells:- periapical fibrous cementum dysplasia, - benign cementoblastoma, -fibrocementoma, and -multiple-familiar giant-like cementoma. The periapical fibrous dysplasia is common in blacks, being the femenine sex the most affected one; and it frequently occurs in middle age. Incisive and premolar teeth are more affected; and mainly the jaw. Benign cementoblastoma is common in patients younger than 25 years old, generally at the jaw and it is always associated with the tooth root, causing external and internal bone expansion. Fibrocementoma, defined entity that may occur at any age and mainly in the femenine sex and white race, frequently in the jaw, causes tooth displacement. The giant-like cementoma occurs less frequently, common in middle aged- black women, it presents as radiopaque masses symmetrically distributed in the dental arches. Reabsorption and visible displacement are not present.

Fibrocementoma. Presentación de un caso

El fibrocementoma es una neoplasia de hueso que ha causado notables controversias en cuanto a la terminología y criterios diagnósticos. En estos momentos representa una entidad definida que puede ser separada de las displasias fibrosas del hueso y de otras lesiones osteofibrosas que no son verdaderas neoplasias. Se presenta un paciente de 42 años, masculino, blanco con antecedentes de hipertensión arterial, que presentó en su examen físico inicial aumento de volumen en región mandibular derecha que se extiende desde región molar hasta la región canina, de consistencia duropétrea. Al estudio radiográfico se aprecia extensa imagen osteolítica bien definida con desplazamiento de diente y expansión de corticales óseas. Al realizar la extirpación conservadora previa biopsia, se confirma el diagnóstico por estudio histopatológico. La evolución clínico-radiográfica al año de intervenida es satisfactoria. Este constituye el primer caso de esta entidad reportado en esta Provincia y el segundo en Cuba.

Fibrocementoma is a bone neoplasia wich has brought about controversies as to the terminology and dignostic criteria. At these moments it represents a defined entity that can be put apart from fibrous bone dysplasias and other osteofibrous lesions wich are real neoplasias. We present a 42 years old, masculine white race patient a history of arterial hypertension. In his initial physical examination a volume increase is observed in the right mandibular zone wich develops from the molar region to the canine zone of duropetrosal consistency. Radiographically, a well-defined wide osteolytic image is observed with displacement of tooth and expansion of oseous corticals. When performing previous biopsy, the diagnosis is confirmed by histophatologic study. The clinical and radiographical evolution after one year of intervention is successful. This is the first case of this entity reported in this province and the second one in Cuba.