PMC3763579_01
The first orthopantomography revealed the presence of three well-circumscribed, round, unilocular neoformations of radiopaque appearance with a radiotransparent edge, one of which was in close contact with the roots of the lower right second molar.
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fig1
Particularly, these lesions were thus located: three unilocular round shaped radiopaque lesions with a perilesional radio transparent rib next to the edentulous sites 3.6-4.6 and in contact with the roots of the element 4.7, whose appearance is suggestive for a neoformation (Figure 1); a rounded radiolucent lesion with radiopaque perilesional flange at the root apex of the element 4.4 whose appearance argued for a radicular cyst of endodontic origin.
TC dental scan of the mandible.
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fig2
After two months, following the resolution of acute symptomatology, in order to better analyze the lesions that were evident in the orthopantomography, the patient underwent TC dental scan of the mandible (Figure 2), which highlighted the presence of three well-circumscribed, round, unilocular neoformations of radiopaque appearance with a radiotransparent edge, one of which was in close contact with the roots of the lower right second molar. 
The surgical treatment included the full enucleation of the lesion on site 4.7 with the annexed dental element on the right jaw and the lesion corresponding to the edentulous area 4.6.
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fig3
Macroscopically the two samples presented as a nodular, hard-elastic in consistency, the largest of which was adherent to the dental element.
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fig4
Both lesions were examined in toto (Figure 4) and the two samples, macroscopically, presented as a nodular, hard-elastic in consistency, color greyish white of 2 x 1 cm and 1 x 1 cm, the largest of which was adherent to the dental element.
((a) and (b)) H&E (4x\10x) cementoblastoma closely connected with the tooth root; ((c) and (d)) H&E 20x. Cementoblastoma and residual cementoblastoma revealed the same histological appearance: dense mineralized acellular trabeculae of basophilic tissue cement-like, devoid of vessels, adhering to the root of the tooth.
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fig5
The largest lesion, closely connected with the tooth root, was diagnosed as cementoblastoma (Figure 5).
The follow-up after one year of both tumors was negative for disease recurrence.
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fig6
The features of the lesion remained in site were unchanged (Figure 6).