Cementoma with Extremity Fracture- A Rare Non Familial Form

A 17 year old patient reported to the outpatient department with the chief complaint of unesthetic facial appearance with progressively increasing size of both the jaws. Although initially the condition appeared to be insignificant with the condition apparent as the skeletal class III facial appearance and mandibular prognathism (Figure 1a & 1b). Also intraorally angle’s class III molar relation was present. All the maxillary as well as mandibular canines were missing (Figure 2) which lead suggested us to radiograph the patient to evaluate the presence of the missing teeth. However orthopantomogram (Figure 3) revealed multiple confluent globular radiopacities with ill defined radiolucent margins at places, present in dentate region in all the four quadrants. Radiopacities were not attached to the roots. Inferior alveolar canal appeared to be displaced inferiorly with superior displacement of inferior margin of maxillary sinus. All the 4 canines were impacted and displaced apically with apparent distorted tooth shape; and dilaceration of the roots of mandibular canines was present which were displaced till the inferior border of the mandible resulting in its undulated and inferiorly expanded appearance. These findings lead to the provisional diagnosis of cemento-osseous dysplasia (Figure 4).