Radiology · single question
A vital tooth presents with a radiopacity AT THE APEX, surrounded by a radiolucent halo, and with expanded cortical plates. What is the most likely diagnosis?
Show answer and explanation
Correct answer: D. Cementoblastoma
D) Cementoblastoma — CORRECT.
Classic cementoblastoma presentation: (1) VITAL tooth, (2) radiopaque mass FUSED to the root apex, (3) surrounded by a RADIOLUCENT halo/capsule, (4) cortical expansion, (5) often associated with mandibular first molar, (6) patient is typically young (< 25 years), (7) may cause pain. The fusion to the root and radiolucent peripheral zone are pathognomonic.
A) Cemento-osseous dysplasia: Mature stage is radiopaque but NOT fused to the root, NOT associated with cortical expansion, associated with non-vital areas in middle-aged Black women — different presentation.
B) Idiopathic osteosclerosis: Radiopaque, no halo, no expansion, no root fusion — dense bone focus without symptoms.
C) Hypercementosis: Excess cementum deposition — root appears bulbous, but has a normal PDL space surrounding it — no radiolucent halo, no cortical expansion.
Classic cementoblastoma presentation: (1) VITAL tooth, (2) radiopaque mass FUSED to the root apex, (3) surrounded by a RADIOLUCENT halo/capsule, (4) cortical expansion, (5) often associated with mandibular first molar, (6) patient is typically young (< 25 years), (7) may cause pain. The fusion to the root and radiolucent peripheral zone are pathognomonic.
A) Cemento-osseous dysplasia: Mature stage is radiopaque but NOT fused to the root, NOT associated with cortical expansion, associated with non-vital areas in middle-aged Black women — different presentation.
B) Idiopathic osteosclerosis: Radiopaque, no halo, no expansion, no root fusion — dense bone focus without symptoms.
C) Hypercementosis: Excess cementum deposition — root appears bulbous, but has a normal PDL space surrounding it — no radiolucent halo, no cortical expansion.