The benign cementoblastoma (true cementoma, osteoblastoma, giant osteoid osteoma) appears to be a true neoplasm of functional cementoblasts which proliferate at the apex of teeth to form an expansile tumor. It remains intimately attached to the tooth roots and occasionally involves the root canals themselves. Although the pulpal tissue remains vital, treatment has historically consisted of extraction of the involved tooth along with extirpation of the tumor. This mode of therapy for the benign cementoblastoma should not be confused with the entity called periapical cemental dysplasia (that is cementoma, periapical osteofibroma or osteofibrosis, cementifying fibroma, localized fibro-osteoma, and periapical fibrous dysplasia). In this latter lesion the treatment consists of simply recognizing the condition and establishing a schedule for periodic evaluation of the patient. In the case presented here enucleation of the cementoblastoma and endodontic therapy were selected as treatment modalities, despite the presence of buccal and lingual expansion of the cortical plates. There has been no recurrence of this growth during the 4-year follow-up period.