Hypercementosis and Odontogenic Epithelial Hyperplasia Associated with a Tooth Root Remnant Mimicking a Neoplasm. A Case Report

Hypercementosis presents as painless, single or multiple non-neoplastic cementum formation beyond the physiological limits of the tooth. It often occurs in the apical area of the involved tooth following infection, chemical or mechanical trauma. We report on radiographic and histopathological findings in a single case of late intraosseous hypercementosis and odontogenic epithelial hyperplasia associated with a minute apical tooth root remnant years after its extraction, mimicking a tumour. Hypercementosis is characterized as non-neoplastic hyperplasia of the cementum, usually occurring in the apical area of the involved tooth following infection, chemical or mechanical trauma (1). Besides local conditions such as periapical inflammatory processes (2), continuous dental eruption (3-4) and functional stress due to occlusion forces (5-6), its possible association with systemic endocrine (thyroid disease, acromegaly (7)) or skeletal disorders (Paget's disease (8-9)) has been suggested. An excessive amount of cementum leading to abnormal thickness of the apex is easily detected both radiographically and macroscopically. Typical findings are the excessive cementum formations around all or part of the root with superficial radiopaque lamina dura and the radiolucent shadow of the periodontal membrane similarly to normal cementum (9). Root hypercementosis is a frequent asymptomatic lesion in adults (10).