Zementoblastom

Zementoblastom is a rare benign odontogenic tumor that originates from cementoblasts, the cells responsible for forming cementum, which is the mineralized tissue covering the tooth root. It typically occurs in the jaw, most frequently affecting the mandible, particularly around the roots of molars and premolars.

Clinically, zementoblastomas often present as a slow-growing, painless swelling or expansion of the jaw. Patients may report discomfort or sensitivity if the lesion compresses adjacent structures. The tumor is usually associated with vital teeth, meaning the affected teeth remain alive, although the area may be tender or inflamed if secondary infection occurs.

Radiographically, zementoblastomas appear as well-defined, radiopaque masses with a radiolucent border, often fused to the root of a vital tooth. The radiopaque area shows a dense, calcified appearance, which can sometimes mimic other odontogenic lesions like osteoblastoma or ossifying fibroma. Cone-beam computed tomography (CBCT) can assist in delineating lesion boundaries and its relationship to surrounding tissues.

Histologically, the tumor consists of dense, mineralized cementum-like tissue with sheets of cementoblasts and periodontal ligament fibers. The tissue may show areas of vascularization and cellularity typical of benign cementoblastomas.

Treatment typically involves surgical excision of the lesion, often with the removal of the involved tooth. The prognosis is generally excellent, with low recurrence rates when adequately removed. Due to its slow growth and benign nature, accurate diagnosis and appropriate management are essential to prevent unnecessary extensive surgery or misdiagnosis.

No malignant cases of zementoblastoma have been reported to date, reinforcing its classification as a benign entity within the spectrum of odontogenic tumors.