Cementoma - causes, symptoms, diagnosis and treatment
Cementoma - The formation of odontogenic origin, growing from connective tissue. The disease is asymptomatic. Upon reaching large sizes cementoma causes deformation of the jaw. Due to the thinning of the cortical plate appears unsharp soreness. Diagnosis cementoma includes the collection of complaints, physical examination, X-rays, EDI. Confirmation of the diagnosis can be obtained after the histological examination. Treatment true cementoma and cementing fibroma surgery. When periapical dysplasia and gigantoformnoy cementoma shown dynamic observation.
Cementoma
dentistry are 4 main types of cement:
1. True cementoma . The tumor develops without the expressed clinic. The most common tumor diagnosed by chance during a dental x-ray associated with cementoma or adjacent teeth. Histological examination reveals cementoma coarse-fibered connective tissue with varying degrees of calcification. The tumor is surrounded by a shell delimiting diseased tissue from healthy bone. Microscopically the tumor is similar to osteoid osteoma, Paget's disease.
2. Cementing fibroma . The disease occurs with the erased symptoms. When Pumping cementoma cortical bone thins, the pressure on the periosteum appears unsharp soreness. Histologically cementing fibroma is a benign tumor composed of intertwined cells and fibers of the connective tissue with significant mineralization zones. Cementing fibroma as true cementoma, an outer capsule.
3. Periapical cement dysplasia . Most localized in the anterior mandible. It characterized by the appearance of multiple lesions, which do not exceed 1 cm in diameter and does not extend to the cortical plate. In its development, the tumor passes 3 stages: osteolytic, calcification and mature. On radiographs, along with the destruction of bone identify areas of high mineralization.
4. Gigantoformnaya cementoma . Characterized by an intense transformation of the connective tissue in the cement. On radiographs show a portion of a round or oval shape, adherent to the tooth root. The degree of density gigantoformnoy cementoma is very similar to the structure of hard dental tissues. Periodontal the gap can not be traced, cellular elements are virtually absent.
sinusitis.
dentist detects facial asymmetry. The skin does not change color, mouth opening free. The mucous pale pink. On palpation there slaboboleznennaya deformation of the affected area of bone. As a result, the germination of the tumor in the respective mucosal localization cementoma anastomosis may occur. If cementoma small size, there are no specific clinical symptoms of the disease.
The only possible way to diagnose is the X-ray examination. Two types of changes are typical for cementoma. In the first case, X-ray determined the correct round shape plus-tissue density resembling tooth tissue is closely related to its root part. On the periphery cementoma localized thin strip of enlightenment, the corresponding area of bone loss. Periodontal slot on the circumference of the root is absent. In the second case, X-ray negatives diagnose tissue. At the same time against the backdrop of increased bone loss identify mineralized zone.
For the purpose of differential diagnosis of periapical cement dysplasia inflammatory periapical changes using EDI. Unlike with periodontitis cementoma pulp retained viability, as evidenced EDI data in the range from 2 to 6 mA. Crucial in the diagnosis cementoma are the results of histological examination. Identification of cement-like tissue without signs of atypia confirms the development cementoma. The disease is differentiated with chronic periodontitis, odontogenic benign and malignant tumors. The patient was examined by maxillofacial surgeon.
removal of oral cancer with resection of the affected bone. The tooth involved in the pathological process, is also subject to removal. Treatment of periapical dysplasia cement has its own characteristics. As the trend for active tumor growth is not observed, this type of cement does not require removal. Also, do not use the operative treatment method for diagnosing gigantoformnoy cementoma. The patient is prescribed a regular check-ups to monitor the nature of the changes in the dynamics for the early detection of complications. Due to increased ossification tissue trophism broken, which further leads to the appearance of necrotic changes.
When the cement periapical dysplasia avoid tooth extraction. Rejection sclerotic cement-like mass takes place over a long period of time and leads to recovery. Forming recesses in the saucer-shaped section of the affected bone may speed up the recovery process. Since pulp vitality maintained, endolechenie not carried out. Forecast of cement-bone dysplasia good. Later, revealing the true cementoma and cementing fibroma leads to the development of complications: a violation of the integrity of bones, the spread of tumor of the maxillary sinus, the appearance of perforations in the oral mucosa.