Localized multiple cemental excrescences: a rare presentation of hypercementosis

Hypercementosis is an abnormal thickening of cementum which may be generalized or localized. Localized hypercementosis is usually characterized by nodular enlargement of apical third of root. Hypercementosis in the form of multiple cemental spikes distributed throughout the entire length of root is a very rare finding. In this article, we report such a rare manifestation of localized hypercementosis affecting right maxillary third molar in a 24-year-old male. This finding was an accidental observation following a difficult extraction procedure as the spikes were not evident in the orthopantamogram. It is imperative that every dental practitioner be aware of several presentations of hypercementosis and ensure that such an entity is considered in the differential diagnosis of difficult extraction procedures as an Intraoral Periapical (IOPA) radiograph or even an Orthopantamogram (OPG) could not differentiate the root morphology.