The Importance of the Three-Dimensional Image in the Early Diagnosis of Cementoblastoma

The cementoblastoma is a very rare odontogenic neoplasm characterised by the formation of cementum-like tissue in connection with the root of a tooth. An 18-year-old boy was referred to the Clinic of Oral Pathology of the School of Dentistry, Universidade Federal de Minas Gerais, Brazil, complaining of an irradiating, itching pain from the region of the lower right first molar. He reported that the symptoms began three months prior, with a gradual increase in intensity during this period. The pain episodes were of short duration, with characteristics of toothache originating from the pulp. Upon intra-oral clinical examination, an open bite and slight increase in volume at the buccal alveolar region of the lower right first molar was observed. He also reported palpation and percussion pain symptoms in this region. Electrical, heat and cold pulp vitality tests were performed, and the tooth was vital. Periapical and panoramic radiographs showed radiolucent images with diffuse, poorly defined borders at the mesial root periapex extending to the interradicular region suggesting an inflammatory periapical lesion. In this early presentation, the three-dimensional image was fundamental to the final diagnosis of cementoblastoma.