Cementoblastoma: An innocuous neoplasm? A clinicopathologic study of 44 cases and review of the literature with special emphasis on recurrence

The clinicopathologic features of 44 cases of cementoblastoma were analyzed and compared with those of 74 cases from the literature with special emphasis on the clinical behavior, treatment, and recurrence rate of these relatively rare benign odontogenic neoplasms. The cases in the current series were accessioned at the Armed Forces Institute of Pathology, Washington, DC. Patient ages at diagnosis ranged from 8 years to 44 years, with a mean age of 20.7 years. The tumors affected 30 males and 14 females. The mandible was the site of occurrence in 31 cases (70.4%), with the mandibular first molar the most common tooth involved. Radiographically, more than 90% of the tumors presented as well-defined radiopaque or mixed-density masses confluent with the tooth root(s) and surrounded by a radiolucent rim. Two lesions were radiolucent. Microscopically, cementoblastomas share similar features with osteoblastomas but are unique because of their physical attachment to the tooth root(s). Follow-up was obtained in 35 of 44 cases, with a mean follow-up interval of 5.5 years. Recurrence was documented in 13 cases (37.1%), in contrast to the literature, where only 2 of 34 cases (5.9%) with adequate follow-up recurred. Jaw expansion and perforation of the cortex were noted in a higher percentage of recurrent than nonrecurrent tumors. Because recurrence and continued growth are possible if lesional tissue remains after initial surgery, appropriate treatment should consist of removal of the lesion along with the affected tooth or teeth, followed by thorough curettage or peripheral ostectomy.