Surgical treatment of cementoblastoma associated with apicoectomy and endodontic therapy: Case report

Figure 1 Initial diagnosis and treatment of the lesion. A: Initial radiographic exam showing radiopaque lesion with radiolucent halo involving the distal root of tooth 46; B: Endodontic treatment; C: Radiographic aspect after the first surgical intervention, with removal of the lesion and apical third of the root involved with the lesion; D: Access to the vestibular region of tooth 46; E: Exposure of the lesion; F: Fragmentation of the lesion to facilitate its removal; G: Aspect of the lesion removed.

Figure 2 Histological analysis of the lesion. A: Central region of the lesion, where a cementoid structure with blood vessels was observed, presenting superimposed lamellae and basophilic material; B: Peripheral region of the lesion that presented irregular fibrous tissue, with tissue having a cementoid aspect and presence of blood vessels (HE-50 × magnification).

Figure 3 Tomographic aspect of tooth 46, one year after the first surgical procedure. A: General panoramic image; B: Image of the sagittal plane, in which tooth 46 is pointed out, with presence of the recurrence of cementoblastoma lesion associated with the distal root; C: Image of the coronal plane in which it is possible to observe a radiopaque alteration associated with tooth 46.

Figure 4 Second surgical intervention and follow-up one year after this procedure. A: Radiographic aspect after removal of the lesion; B: Radiographic aspect after 1 year, in which it is possible to visualize a normal radiographic aspect around the root of the previously affected tooth.