A benign, asymptomatic condition affecting the development of the periapical tissues. It has a variable radiographic appearance depending on the phase at which it is diagnosed. In the initial phase, bone is lost around the apex of the tooth and replaced by fibrous connective tissue giving a radiolucent appearance similar to a periapical cyst or granuloma. In the second, cementoblastic stage, there is calcification of the radiolucent area of fibrosis and in the third phase an excessive amount of calcified tissue is laid down in the periapical area to give a markedly radiopaque appearance. There is no loss of tooth vitality. The cause is unknown, although it has been associated with chronic trauma. It is more common in females, specifically black women in their forties. The mandibular anterior teeth are most frequently affected, usually involving two or more teeth. No treatment is required. See also cementoma.