Cementoblastoma

# A radiograph of the mandibular anterior teeth in a patient reveals radiolucencies above the apices of right lateral and central incisors. No restorations or cavities are present. There is no pain or swelling and the pulps are vital. The diagnosis is:
a) Periapical granuloma
b) Cementoblastoma
c) Radicular cyst
d) Chronic abscess

The correct answer is B. Cementoblastoma

Options A, C, and D are associated with non-vital teeth. Cementoblastoma (periapical osteofibrosis or periapical fibrous dysplasia or periapical cemental fibrous dysplasia) usually involves people of over 20 years of age and women appear to be affected for more than men. The lesion occurs in and near the periodontal ligament around the apex of the tooth, usually a mandibular incisor.  In most cases, the lesions involve the apices of several mandibular anterior teeth or bicuspids.

Note: The codition that is confusing with periapical cemental dysplasia (cementoblastoma) is Benign cementoblastoma, which is a true neoplasm of functional cementoblasts which form a large mass of cementum or cementum like tissue surrounding the tooth root. The Benign cementoblastoma occurs most frequently under the age of 25 years, with no significant gender predilection. The mandibular first permanent molar is the most frequently affected tooth.