Abstract
Cementoblastomas are rare, benign, odontogenic tumors that are intimately associated with tooth roots. Since incomplete removal often leads to recurrence, radical surgeries, such as segmental resection, are often used for the treatment of large cementoblastomas that extend to the inferior border of the mandible. Herein, we describe a case of a giant mandibular cementoblastoma treated conservatively using excision and curettage. An 18-year-old Japanese man with a radiopaque lesion apparent on a panoramic X-ray was referred to our hospital by a nearby dental clinic. Initial examination revealed a bone-like hard mass continuous with the mandibular bone under the mucosa of the floor of the mouth. Panoramic X-ray and computed tomography examination showed a radiopaque circular mass measuring 32×30×28mm associated with the root of the right mandibular first molar. A clinical diagnosis of cementoblastoma was made and removal and curettage of the tumor and placement of an iliac cancellous bone graft was performed under general anesthesia. Histopathological examination showed calcified cementum-like tissue deposited in thick trabeculae on the intact root, and these were rimmed by cementoblasts present in the fibrovascular stroma. Thus, a final diagnosis of cementoblastoma was made. No evidence of recurrence was seen two years after the operation. As these tumors frequently affect young people, treatment strategies should aim to prevent recurrence and also preserve the morphology of the mandible to maintain the quality of life of the patient. Careful follow-up will be continued in consideration of the risk of recurrence in this case.
