Differential diagnosis and clinical management of periapical radiopaque/hyperdense jaw lesions

Abstract

Great attention has been given to the study of radiolucent periapical lesions to avert possible misdiagnosis of apical periodontitis associated with certain radiolucent non-endodontic lesions. However, there are a significant number of radiopaque lesions found in the periapical region, which could be equally relevant to endodontic practice. The diagnosis and management of these radiopaque/hyperdense lesions could be challenging to the endodontist. These bone alterations could be neoplastic, dysplastic or of metabolic origin. In the context of the more widespread use of cone-beam CT, a detailed review of radiopaque inflammatory and non-inflammatory lesions is timely and may aid clinicians perform a differential diagnosis of these lesions. Distinguishing between inflammatory and non-inflammatory lesions simplifies diagnosis and consequently aids in choosing the correct therapeutic regimen. This review discusses the literature regarding the clinical, radiographic, histological and management aspects of radiopaque/hyperdense lesions, and illustrates the differential diagnoses of these lesions.

Sclerotic Lesions of the Jaw: A Pictorial Review

“…Emphasis is on the distinction between odontogenic and non-odontogenic lesions. When a sclerotic lesion is observed in the jaw, attention should first be focused on whether and how the lesion is related to a tooth [ 1 2 3 4 5 ]. If a lesion is intimately associated with a tooth, the lesion is most likely odontogenic, and the number of possible diagnoses is limited.…”

Central giant cell granuloma of the maxilla: Long‐term follow‐up of a patient treated with an adjuvant corticosteroid

“…Thus, proper attention must be paid to the evaluation of radiolucent periapical lesions in order to avoid possible errors in the diagnosis of apical periodontitis associated with certain nonendodontic radiolucent lesions. 30 In the form of a small unilocular lesion, CGCG may be misdiagnosed as a granuloma or periapical cyst. CGCGs with a multilocular pattern are radiographically similar to other lesions of neoplastic, dysplastic, or metabolic origin.…”

“…CGCGs with a multilocular pattern are radiographically similar to other lesions of neoplastic, dysplastic, or metabolic origin. 30 Moreover, one study found that 34% of lesions perforated the cortical plate. 4 Tooth displacement and tooth impaction are uncommon, 25 but tooth root resorption as a result of the lesion's aggressive behavior may occur, as very well documented by Chuong et al 3 The classical histopathological appearance of CGCG reveals a high number of osteoclast-like multinucleated giant cells.…”

Biomarker of buccal mucosa cells damaged after exposure to panoramic radiography: a literature review

“…3,12 The formation of micronucleus in exfoliated buccal mucosa cells after exposed to panoramic radiograph was found in several research that conducted by Cerqueira et al Their publication showed that there was a significant increase in the amount of micronucleus in exposed group. [12][13][14][15][16][17] The increase in the number of micronucleus indicated a genomic instability and was thought to be associated with an increase in carcinogenic effects. The differences in the micronucleus of the samples in the same group could be caused by chromosome alteration.…”