A case of the multiple periapical cemental dysplasia in both the maxilla and mandible

Abstract

Periapical cemental dysplasia is generally regarded as a disease that develops al the apical region of vital teeth as a result of proliferation of the connective tissue of the periodontal membrane. The commonest type of lesion in multiple and occurs most often in middle age females. Though in Europe and America there have been many reports of the disease, there arc very few in Japan.
The author encountered a case of multiple periapical cemental dysplasia in a 53-year-old female. Because of the lack of symptoms, this case was detected incidentally on radiological examination. The radiographic findings revealed areas of radiopacity ranging in size from rice grain to the tip of the little finger, located around the apices of 54 45 65421 1267 Except for the region of upper left second biscupid, those radiopaque masses were separated by a thin radiolucent space from the surrounding normal bone and the apices of the involved teeth. The affected part around the apices of upper left second biscupid was partly radiolucent and partly radiopaque. All wisdom teeth showed retention and their roots exhibited hypercementosis-like findings.
Bone scanning with ^99mTc-MDP revealed deposition in each affected part. The right lower wisdom tooth and the growth attached to the root were removed en block and the tooth was examined following decalcification. The histopathological diagnosis was periapical cemental dysplasia accompanied by hypercementosis of the root of the left lower wisdom tooth.
The patient has been observed periodically for four years and there have been no clinical or radiological evidence of change, except for a small radiolucent area at the periphery of the lesion showing radiopacity.