Factors Associated with Hypercementosis: A Cone Beam Tomography Study of Local Dental Conditions

Background: To evaluate the morphological characteristics of hypercementosis and its association with local factors using cone beam computed tomography (CBCT) in a population from Uruguay. Material and Methods: This observational, cross-sectional, retrospective study analyzed CBCT scans from 1,830 patients aged 25 and older. The study recorded the presence and type of hypercementosis (diffuse, focal, maggot-shaped), the types of teeth affected, and associated local factors, including the absence of an antagonist, dental impaction, occlusal trauma, periodontal disease, periapical processes, and endodontic or orthodontic treatments, among others. Statistical analysis included chi-square tests and multiple linear regression, with a significance level set at p < 0.05. Results: Hypercementosis was observed in 19% of the patients, affecting 595 teeth, primarily upper molars (48.6%) and lower molars (23.6%). The diffuse type was the most prevalent, accounting for 93.3% of cases. The absence of an antagonist tooth was identified as the most common local factor (24.71%), followed by dental impaction (21.01%) and idiopathic cases (13.28%). A significant association was found between the type of hypercementosis and the affected teeth (p < 0.001), as well as between local factors and morphological presentation (p < 0.001). Linear regression analysis indicated that male sex was a protective factor for fewer affected teeth (p = 0.010), whereas age had no significant effect (p = 0.273). Conclusions: The absence of an antagonist tooth was the primary local factor associated with hypercementosis, with the diffuse form predominating across all dental groups. Male sex appears to be a protective factor concerning the number of affected teeth, while age showed no significant association. These findings underscore the importance of considering functional and local factors in diagnosing and planning endodontic, orthodontic, and surgical treatments for patients with hypercementosis.