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

Topic Completed: 1 November 2013

Minor changes: 8 July 2020

Copyright: 2004-2019,, Inc.

PubMed Search: Periapical cemental dysplasia [title]

Nat Pernick, M.D.
Page views in 2019: 1,758
Page views in 2020 to date: 687
Cite this page: Pernick N. Periapical cemental dysplasia. website. Accessed August 12th, 2020.
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:
Missing Image

Fig 2: Woven bone without
osteoblastic rimming

Differential diagnosis

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