Periapical Radiopacities Flashcards
What are the periapical radiopacities?
- Periapical sclerosing osteitis
- Idiopathic Osteosclerosis
- Periapical Cemento-osseous Dysplasia
- Focal Cemento-osseous Dysplasia
- Cementoblastoma
- Hypercementosis
What are the fetaures of periapical sclerosing osteitis (condensing osteitis)?
- Apex of non-vital tooth
- Chronic inflammatory process
- Reactive bone deposition
- May be apical radiolucency
- Often asymptomatic
- Can be homogenous or heterogenous
- ill defined borders and well defined
periapical sclerosing osteitis
If you see periapical sclerosing osteitis around the apex, the tooth is…
non-vital
- requires endo or extraction
What is the treatment for periapical sclerosing osteitis?
endo or extraction
periapical sclerosing osteitis
What are the features of osteosclerosis (dense bone island)?
- Unknown etiology
- Usually solitary
- Painless, non-expansile
- Mandible – premolar/molar region
- Vital tooth
- More homogenous with well defined borders
osteosclerosis
What is the treatment for osteosclerosis?
No treatment
- tooth is vital
osteosclerosis
What is the main way to tell the difference between Osteosclerosis and Periapical Sclerosing Osteitis?
Osteosclerosis - vital tooth
Periapical Sclerosing Osteitis - nonvital tooth
Osteosclerosis
What are the types of fibro-osseous lesions (cemento-osseous dysplasia)?
- Periapical Cemento-Osseous Dysplasia
- Focal Cemento-Osseous Dysplasia
- Florid Cemento-Osseous Dysplasia (widespread type; not covered in this lecture)
What is a cemento-osseous dysplasia in stages?
- stage 1: an area of bone will be resorbed and will be filled in with fibrous connective tissue
- stage 2: radiolucent lesion will then start to fill in with areas of radiopacities (immature, abnormal bone)
- stage 3: lesion becomes almost completely radiopaque with a radiolucent border
What are the features of Periapical Cemento-Osseous Dysplasia?
- etiology unknown
- mainly involves lower incisors
- 3 stages of development
- self-limiting condition
- middle-aged African American, Asian females
- Most common in anterior mandible
- Single or multiple lesions
- Radiolucent, mixed, radiopaque
- Well-defined margins
- Radiolucent rim with possible sclerotic border
- Lamina dura discontinuous
- Larger lesions may expand cortex
- Teeth vital
Periapical Cemento-Osseous Dysplasia
What treatment is needed for Periapical Cemento-Osseous Dysplasia?
no treatment
- tooth is vital
What is the problem with a mature Periapical Cemento-Osseous Dysplasia?
the dense bone can cut off blood supply which could lead to more infections
What are the features of Focal Cemento-Osseous Dysplasia?
- Solitary lesion
- Most common in posterior mandible
- Radiolucent, mixed, radiopaque
- Most common appearance: mixed lucent/opaque
- May progress to more widespread form
_____________ may be associated with some cemento-osseous dysplasia lesions
Simple bone cysts
Focal Cemento-Osseous Dysplasia
What is the treatment for Focal Cemento-Osseous Dysplasia?
- no treatment
- if it has a simple bone cyst you should treat it
What are the features of cementoblastoma?
- Wide age range; young adults
- Males > Females
- Mandibular premolar, first molar
- Solitary lesion; expansile
- Radiopaque or mixed density with radiolucent rim
- Attached to root; external root resorption
- Vital tooth; often painful
- neoplasm
cementoblastoma
What are the features of hypercementosis?
- Etiology unknown
- Bulbous-shaped roots
- Intact PDL space, lamina dura
- Teeth are vital
hypercementosis
