Pathology Post: Hypercementosis

Hypercementosis is a nonneoplastic deposition of excessive cementum that is continuous with the normal radicular cementum¹.

Hypercementosis: Diagnostic imaging by radiograph, cone-beam computed  tomography, and magnetic resonance imaging Pinto AS, Carvalho MS, de Farias  AL, da Silva Firmino B, da Silva Dias LP, Neto JM, da Silva AM,
Radiograph showing hypercementosis of distal root of tooth number nineteen²

What is Hypercementosis?

Hypercementosis is a thickening or blunting of the root due to excess cementum, surrounded by an intact PDL space, as evidenced in the photo above. Hypercementosis was found to be most common in the mandibular molars, but can occur in all teeth (either isolated or multiple)¹. It can be confused with a cementoblastoma, though a cementoblastoma is usually associated with pain and continual growth.

What causes Hypercementosis?

There are multiple, weak factors that are associated with causing hypercementosis, including occlusal trauma, adjacent inflammation such as that seen with rarifying osteitis, and teeth that are unopposed. However, it is seen that there is a strong relationship between hypercementosis and Paget’s disease of the bone. If generalized hypercementosis is evidenced by a patient, it may indicate a discussion that the patient is suffering from Paget’s, as well¹.

Is treatment required for Hypercementosis?

No treatment is required, though treatment planning for extraction of the affected tooth may require modifications. Teeth affected by hypercementosis often require surgical extraction due to the large thickening of the root, and caution should be applied on any tooth that exhibits the appearance of hypercementosis.

To summarize:

  • Hypercementosis is a deposition of excess cementum that makes the root appear blunted
  • Hypercementosis is weakly associated with occlusal trauma and local inflammation
  • Paget’s disease of the bone is strongly associated with hypercementosis
  • Hypercementosis does not require treatment

References:

¹Chi, A., Neville, B., Damm, D., Allen, C. (052015). Oral and Maxillofacial Pathology, 4th Edition. [VitalSource Bookshelf 9.4.0]. Retrieved from vbk://9781455770526

²Pinto AS, Carvalho MS, de Farias AL, da Silva Firmino B, da Silva Dias LP, Neto JM, da Silva AM, Castro FA, Costa AL, De Castro Lopes SL. Hypercementosis: Diagnostic imaging by radiograph, cone-beam computed tomography, and magnetic resonance imaging. J Oral Maxillofac Radiol 2017;5:90-3

Liability Statement:

The medical advice given in this blog should only be utilized by a medical professional who has received a medical degree. I am not responsible for the medical advice given in this blog and each case should be reviewed extensively with sources outside my blog. This blog is for education purposes only and is not meant as a substitute for an academic institution.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: