Mandible / maxilla
Benign tumors / tumor-like conditions
Periapical cemental dysplasia

Author: Nat Pernick, M.D. (see Authors page)

Revised: 21 June 2018, last major update November 2013

Copyright: (c) 2004-2018, PathologyOutlines.com, Inc.

PubMed Search: Periapical cemental dysplasia [title]

Cite this page: Pernick, N. Benign tumors / tumor-like conditions: periapical cemental dysplasia. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/mandiblemaxillaperiapicalcementaldysplasia.html. Accessed August 16th, 2018.
Definition / general
  • Also called cemento-osseous dysplasia, cementoma, periapical osteofibrosis
  • Most frequent form of cementoma or fibro-osseous lesion of jaw, 0.3% of adults
  • Reactive lesion, may be due to reaction of bone to local low grade or chronic injury
  • Affects black women ages 20+, rarely men
  • Involves apical area of vital anterior mandibular teeth, often multiple incisors
  • Asymptomatic, no treatment required unless complicated by superimposed osteomyelitis
Case reports
Clinical images

Images hosted on other servers:
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Fig 1: Radiopaque lesion merges
with surrounding bone

Gross description
  • Tenaciously adherent to surrounding bone, so received as small, hemorrhagic, gritty fragments
Microscopic (histologic) description
  • Early osteolytic stage:
    • Has cellular, fibrous connective tissue with numerous irregularly dilated blood vessels and hemorrhage, contains small amounts of irregular woven bone and rounded droplets of cementum-like material
    • Bony trabeculae are thick, curvilinear, relatively acellular and anastomosing, resembling "ginger roots"
    • Blends into surrounding medullary bone and cortex
  • Mature stage:
    • Has excessive calcification (cementum) causing sclerosing masses, often with prominent resting and reversal lines, fibrous stroma is loosely arranged and less cellular, with less prominent vessels and hemorrhage
    • Intermediate stage has osteoblastic rimming
Microscopic (histologic) images

Images hosted on other servers:
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Fig 2: Woven bone without
osteoblastic rimming

Differential diagnosis