= CEMENTOMA = FIBROOSTEOMA

= nonneoplastic benign hamartoma associated with tooth apex

Histo: proliferation of connective tissue within periodontal membrane

Age: 4^th–5^th decade; in woman: black / Asian descent

• asymptomatic / dull ache

Associated with: vital nonrestored tooth + intact lamina dura

Location: mandible >>maxilla

Site: usually apex of vital tooth

• one / more, closely apposed / confluent, round / ovoid lucent lesion with varying amounts of opacity:
  • initially lytic lesion
  • later mixed lysis + sclerosis with varying amounts of opacity; little expansion
  • calcifies centrally with time
• periapical sclerotic sharply marginated area NOT fused to tooth
• ± low-attenuation halo
• adjacent lesions may coalesce

Cementoblastoma and cemento-osseous dysplasia are both periapical sclerotic sharply marginated lesions with low-attenuation halo.

DDx:

1. Cementoblastoma (in child + young adult, fuses directly to tooth root)
2. Cemento-osseous dysplasia (common in black woman + woman of Asian descent during 4^th / 5^th decade of life, does not fuse to tooth root)