HYPERCEMENTOSIS

ROSHAN TOM THOMAS

THIRD YEAR
DEFINITION
Hypercementosis is s nonneoplastic deposition of
excessive cementum on the root surface. It is
also called as cemental hyperplasia.
Etiology / Factors associated with Hypercementosis
Local factors Systemic factors
 Abnormal occlusal trauma  Calcinosis
 Adjacent inflammation(eg;  Rheumatic fever
pulpal,periapical,periodontal)
 Pagets disease of bone
 Unopposed teeth(eg:
 Vitamin A deficiency
impacted,embedded,without
antagonist)  Acromegaly or pituitary gigantism.
 Repair of vital root fracture.
CLINICAL FEATURES

Occurs predominantly in adulthood, and the frequency increases with age.

Its occurrence has been reported in younger patients and many suggesting
hereditary influence.
It may be isolated or involve multiple tooth. Mandibular molars are more
frequently affected followed by mandibular and maxillary second premolar
and mandibular first premolar.
 Hypercementosis produces no significant clinical signs or symptoms
indicative of its presence.
 There is no increase or decrease in tooth sensitivity, no sensitivity to
percussion unless periapical inflammation is present and no visible changes
in gross appearance in situ.
When the tooth with hypercementosis is extracted, the roots or roots appear
larger in diameter than normal and present rounded apices.
RADIOGRAPHIC FEATURES
 On the periapical radiograph, most cases of
hypercementosis, at least of any significant
degree, are distinguished by the thickening and
apparent blunting of the roots.

 The enlarged root surrounded by the radiolucent

PDL space and the adjacent intact lamina dura.
 The roots lose their typical sharpened or spiked
appearance and exhibit rounding of apex.
 It is generally impossible to differentiate the root
dentin from the primary or secondary cementum
radiographically ; therefore the diagnosis of
hypercementosis is established by the shape or
outline of the root rather than by any differences
in the radiodensity of tooth structure.
HISTOLOGICAL FEATURES
 The microscopic appearance of
hypercementosis is a characteristic one in
which an excessive amount of secondary or
cellular cementum is found deposited
directly over the typically thin layer of
primary acellular cementum.
 The area involved may be the entire root or
only a portion, typically the apical region.
 The secondary cementum has been termed
‘osteocementum’ because of its cellular
nature and its resemblance to bone.
 This cementum typically is arranged in
concentric layers around the root and
frequently shows numerous resting lines,
indicated by deeply staining
haematoxyphilic lines parallel to root
surface.
TREATMENT AND PROGNOSIS

No treatment is indicated for teeth exhibiting hypercementosis, since the

condition itself is innocuous.
In those cases, in which the overproduction of cementum is due to
inflammation of pulpal orgin treatment of the primary condition is obviously
necessary.
Ocassional problems has been reported during the extraction of an affected
tooth with hypercementosis. Sectioning of the tooth may be necessary in
certain cases to aid in removal.
THANKU