Hypercementosis Explained

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

It is experienced as an uncomfortable sensation in the tooth, followed by an aching pain.^[2]

It may be shown on radiographs as a radiopaque (or lighter) mass at each root apex.

Cause

Can be caused by many things.^[3]

Local factors:

• Occlusal trauma
• Trauma
• Non-functional tooth
• Unopposed tooth (and impacted teeth, embedded teeth, teeth without antagonists)

Systemic factors:

• Idiopathic
• Pituitary gigantism
• Paget's disease of bone
• Acromegaly
• Periapical granuloma
• Arthritis
• Calcinosis
• Rheumatic fever

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.

Complications

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.^[4]

Notes and References

1. Web site: Atypical hypercementosis versus cementoblastoma . dmfr.birjournals.org. 2009-09-08. L Napier Souza . S Monteiro Lima Júnior FJ Garcia Santos Pimenta, AC Rodrigues Antunes Souza and R Santiago Gomez.
2. Web site: Hypercementosis or Dental Exostosis. chestofbooks.com. 2009-09-08.
3. Web site: Abnormalities of Teeth . 2004 . PDF . Charles . Dunlap . 2011-10-11 . https://web.archive.org/web/20160303223746/http://dentistry.umkc.edu/Practicing_Communities/asset/AbnormalitiesofTeeth.pdf . 2016-03-03 . dead .
4. Illustrated Dental Embryology, Histology, and Anatomy, Bath-Balogh and Fehrenbach, Elsevier, 2011