Cementoblastoma With Bony and Soft Tissue Recurrences Following a Primary Molar Lesion: A Case Report

Cementoblastoma is a rare benign odontogenic neoplasm defined by its fusion to the root of a tooth and characterized by radiating cementoid deposition with peripheral active cementoblasts. Although recurrence is uncommon following complete excision, when it occurs, it typically arises at the original site. We report an unusual recurrent cementoblastoma associated with a primary mandibular molar in a pediatric patient. Review of records from the initial presentation documented a radiopaque mandibular lesion fused to the roots of the lower right primary first molar with cortical expansion, which was treated by extraction of the involved tooth and removal of the associated lesion. Eighteen months later, the patient presented with recurrence as multiple discrete, noncoalescent masses involving the alveolar crest, lingual cortical bone, and buccal gingival soft tissue. All recurrent lesions, including the soft tissue lesion, showed histologic features consistent with developing cementoblastoma. Each lesion demonstrated a radial growth pattern forming a well-circumscribed spherical mass. This case documents recurrence after apparently conservative initial removal of a cementoblastoma arising in the primary dentition, and supports the concept that neither persistent root attachment nor an osseous environment is required for lesion development or for maintaining the characteristic radial growth pattern. The findings highlight the importance of complete excision at initial presentation to reduce the risk of recurrence.