A dense mass of cementum is seen here.
Cementoblasts can form cords or lie singly within their lacunae.
Basophilic reversal lines are reminescent of Paget disease (of the bone).
Cellular fibrovascular stroma surrounds the cementum matrix.
Cementoblastoma is a benign tumor that lays down cementum-like material and is attached to the tooth root.
Histologically, it is composed of cementum-like matrix produced by cementoblasts. In more mature areas, basophilic "reversal lines" may lend a Paget-disease like pattern. A cellular fibrovascular stroma containing plump cementoblasts and multi-nucleated cementoclasts transverses between the bony (cementum) deposits. Note that intimate association with the tooth root leading to root resorption is virtually pathognomonic for this entity (Barnes, Thompson).
Although at the periphery, the cementoblasts and cementoclasts can exhibit plemorphism, but there is no mitotic activity. The differential diagnosis includes osteoblastoma and osteosarcoma. Osteoblastoma exhibits identical histology, but is rare in the jaw. Cementoblastoma is attached to the tooth root. Osteosarcoma is poorly circumscribed with atypical cytologic features and mitotic activity (Thompson, Huber).
These usually arise in the 2nd-3rd decade of life with equal gender distribution. Pain and swelling of the alveolar ridges may or may not be present. The mandible is a favored site.
Radiographic: A well-defined radiopaque or mixed density mass is closely associated with the root of the tooth.
Excision of the lesion and the associated tooth is necessary.
Excellent. Usually does not recur unless incompletely resected.
Barnes L, Eveson JW, Reichart P, Sidransky D. WHO Classification: Pathology and Genetics, Head and Neck Tumors Lyons, France: IARC; 2005: 318.
Huber AR, Folk GS. Cementoblastoma. Head and Neck Pathol (2009)3:133-135.
Thompson LDR, Wenig BM, eds. Diagnosis Pathology: Head and Neck. 1st Ed. Manitoba, Canada; Amirsys;2011; 6, 56-7.