Table 2.

Compare and contrast benign cementoblastoma with other lesions

Common features	Osteoblastoma	Cementoblastoma
Clinical features	Clinical features	Clinical features
Arises in young adults	Not associated with tooth roots	Intimately associated with the tooth roots
Slowly progressive	Arises in the medullary cavity	Arises from the cementoblasts in the PDL
Shows bony expansion
	Radiographic features	Radiographic features
	Absence of peripheral radiolucent rim	Radiopaque masses attached to teeth and surrounded by a radiolucent periphery
Histopathological features	Histopathological features	Histopathological features
Cellular and vascular stroma with sheets of bone/cemental tissue and multinucleated giant cells	Reversal lines absent	Reversal lines present
Common features	Odontomes	Cementoblastoma
Radiographic features	Radiographic features	Radiographic features
Both are usually sharply marginated, and sclerotic, with a low-attenuation halo	They are usually pericoronal	Appear periapically directly fusing to the root of the tooth
Histopathological features	Histopathological features	Histopathological features
Cemental tissue with reversal lines	Presence of dentin and pulp also	Presence of only cemental tissue
Common features	FCOD	Cementoblastoma
Clinical features	Clinical features	Clinical features
Both cementoblastoma and FCOD are periapical, sclerotic, sharply marginated lesions with a low-attenuation halo	Reactive lesion usually asymptomatic More common in the 4th or 5th decade of life Does not fuse to tooth roots	Neoplastic lesion that maybe associated with pain and bony expansion  More common in children and young adults  Fuses with the tooth roots
	Radiographic features	Radiographic features
	Mature stage is radio-opaque with poorly defined margins	Lesion is radio-opaque with well-defined radiolucent margins
	Histopathological features  Bone and cementum like tissue	Histopathological features  Only cemental tissue
Common features	Condensing Osteitis	Cementoblastoma
Clinical features	Radiographic features	Radiographic features
Both occur in younger age group  Both are usually seen in premolar molar region  Both are sclerotic lesions	Periapical, poorly marginated, nonexpansile, sclerotic lesion associated with a carious nonvital tooth, and it may be unifocal or multifocal  It does not show a peripheral radiolucent rim	Periapical, sharply marginated, expansile and sclerotic lesion  Shows a peripheral radiolucent rim  No thickening of the PDL space  Tooth is vital
	The adjacent tooth usually has a thickened PDL space or periapical inflammatory lesion (e.g., granuloma, cyst or abscess)
Common features	Hypercementosis	Cementoblastoma
Clinical features	Clinical features	Clinical features
Both appear as periapical radiopacities	No clinical signs or symptoms	Painful swelling at the buccal and lingual/palatal aspect of the alveolar ridges; occasionally, it may be asymptomatic
	Radiographic features	Radiographic features
	The radiolucent shadow of the periodontal membrane and the radiopaque lamina dura are always seen on the outer border of hypercementosis, enveloping it as seen in normal cementum	The calcified mass is attached to the tooth root, with loss of root contour due to root resorption and fusion with the tumor
Histopathological features	Histopathological features	Histopathological features
Disproportional acellular cementum deposit attached to the root of the tooth, associated with a thin connective tissue	Absence of active cementoblasts	Presence of active cementoblasts

FCOD: Focal cemento-osseous dysplasia, PDL: Periodontal ligament