The cementomas--a clinicopathological re-appraisal.

The aim of this study was to assess whether sub-classification of cemental tumors was warranted and to define the clinicopathological features of the definitive entities. Our sample consisted of 127 cases which were divided into the following categories; gigantiform cementoma (84 per cent), cementifying fibroma (12 per cent), benign cementoblastoma (4 per cent). Gigantiform cementoma lesions were either single, multiple or florid and ranged in size from 1 to 10 cm. Most occurred in patients in their 6th and 7th decades who were black (78 per cent) and female (96 per cent). All lesions showed typical solid sheets of acellular cementum and some (22 per cent) were characterised by peripheral proliferative areas which were often indistinguishable from lesions of cementifying fibroma and periapical cemental dysplasia. Infection and sequestration was very common (54 per cent). No cases of periapical cemental dysplasia were found and we suggest that this lesion is a variant of gigantiform cementoma. We believe cementifying fibroma to be part of the histomorphological spectrum of cemento-ossifying fibroma. Cemento-osseous dysplasia is a more accurate and appropriate term than gigantiform cementoma and we recommend the following classification for cemental 'tumors': cemento-ossifying fibroma; cementoblastoma; cemento-osseous dysplasia, single, multiple and florid sub-types.