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Hypercementosis

Hypercementosis
SpecialtyDentistry Edit this on Wikidata

Hypercementosis is an idiopathic, non-neoplastic condition characterized by the excessive buildup of normal cementum (calcified tissue) on the roots of one or more teeth.[1] A thicker layer of cementum can give the tooth an enlarged appearance, which mainly occurs at the apex or apices of the tooth.

Signs and symptoms

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Location of where excess cementum may appear

It is experienced as an uncomfortable sensation in the tooth, followed by an aching pain.[2] Excess amount of cementum may cause pressure onto periodontal ligaments and adjacent teeth. Teeth affected made present as asymptomatic.[3] It may be shown on radiographs as a radiopaque (or lighter) mass at each root apex to confirm diagnosis.

Cause

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Trauma and other developmental disorders such as Paget's disease may be more prone to develop hypercementosis in the maxillary region.[4] Further research is required to determine exact cause.

Local factors:

Systemic factors:

It may be one of the complications of Paget's disease of bone in the form of generalized hypercementosis.

It may also be a compensatory mechanism in response to attrition to increase occlusal tooth height.

Pathophysiology

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Research has suggested that mutations in the ENPP1 and GACI genes may contribute to the development of hypercementosis.[5] Loss of function in ENPP1 caused generalized arterial calcification of infancy (GACI) which was directly associated with individuals with hypercementosis.[6]

Diagnosis

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Periapical radiographs can locate radiopaque structures in proximity to the root which can appear as dense bone island or periapical osseous dysplasia in cases of hypercementosis. [7] Majority of affected teeth appear as club-shaped due to cemental hyperplasia diffusing in a variety of severities. Most appear in the apical third of the root. [8]

Complications

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Such deposits form bulbous enlargements on the roots and may interfere with extractions, especially if adjacent teeth become fused (concrescence). It may also result in pulpal necrosis by blocking blood supply via the apical foramen.[9]Teeth affected do not necessarily need treatment unless it causes complications to adjacent teeth and structures.

Epidemiology

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References

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  1. ^ L Napier Souza, S Monteiro Lima Júnior FJ Garcia Santos Pimenta, AC Rodrigues Antunes Souza and R Santiago Gomez. "Atypical hypercementosis versus cementoblastoma". dmfr.birjournals.org. Retrieved 2009-09-08.{{cite web}}: CS1 maint: multiple names: authors list (link)
  2. ^ "Hypercementosis or Dental Exostosis". chestofbooks.com. Retrieved 2009-09-08.
  3. ^ "Hypercementosis: Causes, Symptoms, and Diagnosis". www.medicoverhospitals.in. Retrieved 2024-11-06.
  4. ^ Rao, V. M.; Karasick, D. (1982). "Hypercementosis--an important clue to Paget disease of the maxilla". Skeletal Radiology. 9 (2): 126–128. doi:10.1007/BF00360497. ISSN 0364-2348. PMID 7163823.
  5. ^ "Hypercementosis - an overview | ScienceDirect Topics". www.sciencedirect.com. Retrieved 2024-11-06.
  6. ^ Markley, John L.; Westler, William Milo (August 2017). "Biomolecular NMR: Past and future". Archives of Biochemistry and Biophysics. 628: 3–16. doi:10.1016/j.abb.2017.05.003. ISSN 0003-9861. PMC 5701516.
  7. ^ Lam, Ernest W. N. (2014-01-01), White, Stuart C.; Pharoah, Michael J. (eds.), "Chapter 31 - Dental Anomalies", Oral Radiology (Seventh Edition), St. Louis (MO): Mosby, pp. 582–611, ISBN 978-0-323-09633-1, retrieved 2024-11-06
  8. ^ Mupparapu, Mel; Shi, Katherine Jie; Ko, Eugene (2020-01-01). "Differential Diagnosis of Periapical Radiopacities and Radiolucencies". Dental Clinics of North America. Oral Diseases for the General Dentist. 64 (1): 163–189. doi:10.1016/j.cden.2019.08.010. ISSN 0011-8532.
  9. ^ Illustrated Dental Embryology, Histology, and Anatomy, Bath-Balogh and Fehrenbach, Elsevier, 2011
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