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

• Main Authors: Brunno Santos Freitas SILVA, Mike Reis BUENO, Fernanda P. YAMAMOTO-SILVA, Ricardo Santiago GOMEZ, Ove Andreas PETERS, Carlos ESTRELA
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Pesquisa Odontológica 2017-07-01
• Series: Brazilian Oral Research
• Subjects: Periapical Peridodontitis; Diagnosis, Differential
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-83242017000100250&lng=en&tlng=en

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.