Benign Cementoblastoma Associated with an Impacted Third Molar inside Maxillary Sinus

Abstract

Introduction Cementoblastoma is a rare and benign odontogenic mesenchymal tumor, often characterized by the formation of cementum-like tissue produced by neoplastic cementoblasts attached to or around the roots of a tooth. Case Report 22-year-old male patient was referred to the Federal University of Paraná after occasional finding on a routine panoramic radiograph. Clinical examination suggested no alterations. Medical and family history presented no alterations as well. Computed tomographic (CT) showed the presence of a radiopaque area associated with the roots of the impacted third molar measuring 15 mm × 10 mm inside the left maxillary sinus. The treatment plan suggested was to surgically remove it under general anesthesia. An intraoral approach was conducted, using the Newmann incision from the superior left first molar to the retromolar area with anterior and posterior relaxant incisions. Using a Caldwell-Luc access next to the maxillary tuberosity region, the maxillary sinus was exposed and the calcified mass attached to the roots of the tooth was reached. Pathological mass removed was sent for histopathological investigation. Examination revealed dense, mineralized, cementum-like material and vascular soft tissue areas that consisted of cementoblasts. One-year follow-up shows no recurrence and absence of symptoms.

Efficiency and Safety of Dental Implantation in the Area of Hyperdense Jaw Lesions: A Narrative Review

“…Radiographically, osteoblastoma represents a well- or poorly-defined round to oval calcified area with or without radiolucency. Surrounding reactive sclerosis is less prominent in comparison with osteoid osteoma [ 27 , 50 , 51 ].…”

“…There is a preference for the mandible rather than for the maxilla. It is revealed mainly in the area of the molars [ 50 , 51 ]. In two-thirds of cases, cementoblastoma causes pain and swelling on the buccal and lingual sides due to expansion of the alveolar ridge [ 27 ].…”

“…Regarding the effectiveness of dental implantation, the data from the literature review show that dental implantation could be successful in the area of osteoid osteoma, cementoosseous dysplasia of the odontoma, cementoma, condensing osteitis, and idiopathic osteosclerosis [ 30 , 50 , 74 ]. Inflammation, aggressive growth, and a tendency to recurrence are factors that limit dental implantation in the osteoblastoma area [ 7 , 8 , 27 , 48 ].…”

Cementoblastoma: An unusual radiographic presentation

“…Cementoblastoma, classified as odontogenic ectomesenchymal tumor, arises mostly in the permanent dentition with several incidences reported in primary or unerupted teeth [5][6][7][8][9]. Slow growing mass of cementum or cementum-like tissue is usually located in the posterior area of lower jaw (80%), and associated with permanent first molar.…”

Cementoblastoma de maxila: Reporte de caso de un tumor odontogénico raro y breve revisión de la literatura.

“…Se desarrolla predominantemente en la mandíbula, la localización más frecuente corresponde a molares y premolares mandibulares permanentes siendo la primera molar la más afectada (4,5). En maxilar superior son raros, afecta también la zona molar y premolar, en algunos casos el seno maxilar puede estar comprometido (6), existe el reporte de un cementoblastoma adherido a una tercera molar superior impactada (7). En la población pediátrica los cementoblastomas son muy raros, según la literatura hasta el 2019 solo se habían reportado 17 casos (8,9,10).…”