Radiographic Interpretation of Periapical Conditions Part 2

Question 1

New bone formation on the bone surface as a result of periosteal stimulation

Answer 1

Periosteal reaction
(typical of osteomyelitis)

Question 2

Radiopaque islands of bone on a radiolucent background

Answer 2

Sequestrum

Question 3

With oseomyelitis you can have a reaction in the __ causing a layer of new bone to form

Answer 3

periosteum

Question 4

What are some anatomical features that can look like periapical inflammatory disease

Answer 4

incisive foramen
mental foramen
maxillary sinus

Question 5

Altered bone metabolism - cancellous bone is replaced by a mixture of fibrous connective tissue containing varying amounts of immature, abnormal bone

Answer 5

Periapical cemento-osseous dysplasia

Question 6

Mimic periapical inflammatory disease but teeth are vital

Answer 6

Periapical cemento-osseous dysplasia

Question 7

Periapical cemento-osseous dysplasia is most common in the

Answer 7

anterior mandible

Question 8

Periapical cemento-osseous dysplasia is most common among

Answer 8

non-caucasian women

Question 9

Periapical cemento-osseous dysplasia is symptomatic

Answer 9

False
(No treatment is needed)

Question 10

When the cemento-osseous dysplasia presents as a single lesion in posterior regions

Answer 10

Focal cemento-osseous dysplasia
(Has a radiolucent rim around it - no treatment needed)

Question 11

When the cemento-osseous dysplasia presents as multiple bilateral lesions (possibly both jaws)

Answer 11

Florid cemento-osseous dysplasia

Question 12

Florid cemento-osseous dysplasia is common in women of

Answer 12

african descent

Question 13

Florid cemento-osseous dysplasia is usually asymptomatic (usually just a radiographic finding) and in some cases __ and __ are present

Answer 13

expansion and pain

Question 14

If dysplastic bone becomes exposed __ may develop

Answer 14

osteomyelitis
(Want to avoid this bone being exposed to the oral cavity!)

Question 15

Localized growth of cortical bone into the cancellous bone space

Answer 15

Idiopathic osteosclerosis
(dense bone island / Enostosis)

Question 16

Idiopathic osteosclerosis is most commonly well-defined, located in the __

Answer 16

mandibular molar and premolar area

Question 17

Persistent radiolucency after successful endodontic therapy - dense connective tissue (radiolucent) surrounded by normal bone

Answer 17

Fibrous scar
(Does not change overtime)

Question 18

With fibrous scars the surrounding healing bone may present __ or __ patterns

Answer 18

Concentric or radiating

Question 19

What is important for diagnosing a fibrous scar

Answer 19

Clinical correlation

Question 20

What is necessary to diagnose between fibrous scar, bone healing, periapical inflammatory disease

Answer 20

Context!
(clinical exam, compare current and previous images)

Question 21

Explain the SLOB rule

Answer 21

The thing further from the camera moves in the same direction as the camera
The thing closer to the camera moves in the opposite direction
(The palatal root of a tooth cant be seen head on but is you move the tube head to the left the palatal root will be visible to the left)
Same = Lingual
Opposite = buccal