Undiagnosed benign cementoblastoma in a patient with a 6-year pain condition. Report of a case.
Symptoms in the lower first molar developed in a 15-year-old girl. The problems started with tenderness during occlusion. The first radiographic examination revealed a radiopacity at the distal root, which was considered in the radiographic report to be a cementoma. Therapy commenced with occlusal adjustment, but this was followed 20 months later by endodontic therapy, which was undertaken because of the suspicion of partial pulpal necrosis with condensing osteitis. A painful condition developed and led first to apicoectomy and then to extraction 2 1/2 years after the start of the endodontic therapy. Light microscopic examination of adjacent hard tissue revealed signs of chronic inflammation on both occasions, and a diagnosis of diffuse sclerosing osteomyelitis was made. The pain was not relieved but remained at a tolerable level for 18 months. Then a reexamination of the first radiographs led to a strong suspicion of a benign cementoblastoma. A thorough third operation revealed a small piece of hard tissue in a lacuna of the lingual part of the mandible covered buccally by granulation tissue and inflammatory affected bone. The final histopathologic diagnosis was benign cementoblastoma combined with chronic inflammation.
Forsslund
H G
HG
Department of Oral Surgery, Danderyd Hospital, Stockholm, Sweden.
Bodin
I
I
Julin
P
P
D000293:Adolescent; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008339:Mandibular Neoplasms / Q000150:complications / Q000175:diagnosis*; D009808:Odontogenic Tumors / Q000150:complications / Q000175:diagnosis*; D010019:Osteomyelitis / Q000175:diagnosis; D014098:Toothache / Q000209:etiology*