Cementoblastoma is a rare benign odontogenic tumour characterized by its intimate fusion to the tooth root and its potential for recurrence following incomplete excision. Recurrence after tooth extraction remains exceptionally uncommon and may present significant diagnostic challenges, particularly in edentulous sites undergoing implant assessment. A 40-year-old woman was referred for implant rehabilitation at the site of tooth 46, seven years after surgical removal of a lesion associated with the same tooth. During preoperative evaluation, cone-beam computed tomography (CBCT) incidentally revealed a well-circumscribed radiopaque lesion at the edentulous mandibular site, raising suspicion of late recurrence. Surgical excision was performed using piezoelectric surgery to achieve precise osteotomy while preserving adjacent anatomical structures. Histopathological examination confirmed recurrent benign cementoblastoma. This case highlights an unusual late recurrence following tooth extraction, posing diagnostic challenges due to its atypical radiological presentation. The role of CBCT in diagnosis and surgical planning is emphasized. Piezoelectric surgery offered enhanced precision, reduced trauma and improved safety near vital structures. Late recurrence of cementoblastoma may occur several years after apparent complete excision and remain asymptomatic until incidental detection during implant planning. Long-term radiological surveillance, particularly with CBCT, should therefore be considered before implant rehabilitation in patients with a history of cementoblastoma. Piezoelectric surgery may optimize conservative management of recurrent lesions close to critical anatomical structures.