Radiopaque Lesion Research Articles

Huge calcifying epithelial odontogenic tumor of the mandible and management with a teeth preserving surgical approach: a case report

BackgroundCalcifying epithelial odontogenic tumor is a rare benign tumor that predominantly occurs in posterior sites of the mandible in adults.Case presentationThis case report describes a case of calcifying epithelial odontogenic tumor in a 37-year-old Iranian female with the chief complaint of swelling in the anterior region of the mandible and tooth displacement. This paper summarized the pathological findings, radiographical features and clinical management of the patient. Clinical examinations revealed a bony hard swelling ~ 3 cm × 4 cm in size with tenderness in the chin area. Radiography revealed an expansile mixed radiolucent and radiopaque lesion with cortical borders. A minimally aggressive surgical approach is used to remove the lesion.ConclusionThis case report outlines the successful outcomes of this surgical approach and the positive outcome associated with the restoration of lost functions of displaced mobile teeth in an arranged and nonmobile way after treatment.

Prevalence of Radiolucent and Radiopaque Jawbone Lesions Using Panoramic Radiographic Analysis in Hail, Saudi Arabia: A Retrospective, Cross-Sectional, Observational Study.

Background Oral diseases are among the most prevalent public health issues worldwide, underscoring the importance of early diagnosis and effective prevention programs. Determining the prevalence of jawbone lesions is crucial for developing targeted interventions and ensuring timely treatment. Panoramic radiography, also known as orthopantomogram, has become a cornerstone in radiographic examinations, offering a comprehensive view of the dental and maxillofacial regions. Its accessibility and ability to detect a wide range of pathologies make it an invaluable diagnostic tool. This study aimed to assess the prevalence and distribution of radiolucent and radiopaque jawbone lesions in the population of Hail, Saudi Arabia, using panoramic radiographic analysis. Methodology A retrospective, cross-sectional study was conducted using pre-existing panoramic radiographs of individuals aged 18 years and older in Hail, Saudi Arabia. The radiographs were analyzed for the presence of jawbone lesions, classified as radiolucent, radiopaque, or mixed, and their anatomical distribution was recorded. Statistical analysis was performed using the chi-square test, with a significance level set at p-values <0.05. Results A total of 389 jawbone lesions were identified in 177 subjects, representing a prevalence of 45.5%. Radiolucent lesions were the most common, observed in 153 (39.3%) subjects, while radiopaque lesions were found in 18 (4.6%) subjects, and mixed lesions in six (1.5%) subjects. The mandible was more frequently affected than the maxilla, with 104 (59%) lesions occurring in the mandible and 52 (29%) lesions in the maxilla. The posterior region of the jaw was the most commonly involved site, accounting for 124 (31.9%) cases. Gender and age did not significantly influence the prevalence or type of lesions, although a higher incidence was noted in the 31-45-year age group. Conclusions This study revealed a significant prevalence of jawbone lesions in the Hail population, with radiolucent lesions being the most common type, predominantly affecting theposterior region of the mandible. The findings highlight the importance of early detection and targeted dental health initiatives in this region. Further research, particularly longitudinal studies, is recommended to explore the natural history of these lesions and their impact on oral health over time.

Incidence of Carotid Atheroma in Patients Received Radiotherapy in Neck Field-A Case Series Study

Introduction: Atheroma is a condition that affects various blood vessels, primarily forming at junctions of moderate to large vessels, such as the carotid artery, where it is known as carotid atheroma (CA). Atheroma can lead to myocardial infarction or stroke. Previous studies have shown that head and neck radiotherapy can induce CA, even in young patients. Early diagnosis of atheroma in panoramic views can help prevent ischemic attacks in the brain and potentially save lives. Case Presentation: Thirty-six patients were referred to Semnan Dental School for dental screening by a hematologist-oncologist. An oral medicine specialist ordered panoramic radiographs for each patient, and radiopaque lesions were detected in the para-spinal region in four patients. These lesions were diagnosed as Carotid Atheroma by an Oral and Maxillofacial Radiologist, and this case series was reported. Conclusions: Radiotherapy is a component of treatment for head and neck malignancies and can cause atherosclerosis in carotid junctions. Dentists should monitor panoramic views of patients receiving radiotherapy for any signs of suspicious lesions. If carotid atheroma is detected, the patient should be referred to a cardiovascular specialist for further evaluation and treatment.

Prevalence and Pattern of Mandibular Condensing Osteitis Lesions in Saudi Population at Qassim Region

ABSTRACT Background: Condensing osteitis (CO) is a common radiopaque lesion observed in the jaws, often detected incidentally on panoramic radiographs. Understanding the prevalence and characteristics of CO is essential for early detection and appropriate management. Objective: To determine the prevalence and characteristics of condensing osteitis among the Saudi population in the Qassim region. Methods: A retrospective study was conducted using 876 digital panoramic radiographs. The presence of CO was identified based on specific radiographic features, and data were collected regarding gender, age, lesion localization, lesion shape, and associated dental status. Results: The prevalence of CO was found to be 2.3% (n = 20) in the study population, with a higher predilection in females (1.4%) compared to males (0.9%). The most commonly affected age group was 30–39 years for males and 10–19 and 30–39 years for females. The mandibular molar region was predominantly affected (90%), with a ‘U’ shape observed in 55% of the lesions. Root canal treatment was the most commonly associated dental status (75%), followed by deep caries (20%) and large restorations (5%). Conclusion: The study highlights a 2.3% prevalence of CO in the Saudi population of the Qassim region, with a higher predilection in females and a predominant localization in the mandibular molar region. Dental practitioners should be vigilant in identifying CO, especially in at-risk populations, to facilitate timely diagnosis and appropriate management.

Thin linear radiopaque lesion is located in the center of low attenuating lesion in the liver. Speckled hyperdensity may be seen at the edges of the lesions. Toothpick is thinner than the calcification.

Thin linear radiopaque lesion is located in the center of low attenuating lesion in the liver. Speckled hyperdensity may be seen at the edges of the lesions. Toothpick is thinner than the calcification.

Osteosarcoma associated with cemento-osseous dysplasia: co-incidence or two related entities?

BackgroundOsteosarcoma of the jaws is a rare primary malignant tumor of bone. The clinical, radiological and histopathological features of a case associated with cemento-osseous dysplasia is presented.Case ReportA 57-year-old mixed-race female presented with a large, progressive, swelling of the right mandible. Radiographic examination revealed two associated lesions. Partially defined irregular radiopacities were noted in the left mandible, extending from the premolar to the molar region. The lesion had a cotton-wool appearance and resembled a fibro-osseous lesion; i.e. cemento-osseous dysplasia. A second large, expansive and irregular, radiopaque lesion was noted on the right angle of the mandible, extending beyond the inferior cortex of the mandible. The internal structure was heterogeneous and resembled irregular bone formation. The classic “sunburst” appearance of radiating bony spicules can be seen in the posterior–anterior view and the CBCT 3D reconstruction, indicating the outgrowth of the tumor matrix. Histopathological exam confirmed a final diagnosis of osteosarcoma closely associated with cemento-osseous dysplasia. The patient underwent a fludeoxyglucose-18 (FDG) positron emission tomography (PET) scan which indicated metastasis in the left lung and increased uptake in the right mandible. Chemotherapy was initially administered with a plan to resect the tumor, however, the patient demised as a result of medical complications.ConclusionThe question in the literature remains whether these two entities are coincidentally found or arise from each other. Nevertheless, it is important for clinicians to closely monitor patients with cemento-osseous dysplasia and biopsy any suspicious lesions that may develop into osteosarcoma.

Recurrent cementoblastoma with multifocal growth and cellular atypia: a case report

BackgroundCementoblastoma is a rare odontogenic tumor characterized by the formation of osteocementum-like tissue on a tooth root directly by neoplastic cementoblasts. Although it is categorized as benign, it has a high potential for growth with a certain degree of recurrence risk. However, there are only a few studies describing the features of recurrent cementoblastoma. The diagnosis of recurrent cementoblastoma is challenging not only due to its cytological atypia but also because of its large size and multicentric growth pattern. These characteristics suggest a potential for malignancy.Case presentationA 29-year-old woman was transferred to our university dental hospital complaining of swelling of the right mandible. She had a history of enucleation of cementoblastoma associated with the third molar of the right mandible. Five years after the initial treatment, imaging demonstrated well-circumscribed multicentric radiopaque lesions in the same area. Histologically, the lesion consisted of osteocementum-like tissue rimmed with polygonal or plump tumor cells. Several cells were large epithelioid cells with bizarre nucleoli, which may be reminiscent of malignant tumors. Otherwise, there were no apparent malignant findings, including proliferative activity or atypical mitotic figure. Besides, tumor cells were positive for c-FOS, a marker of osteoblastoma and cementoblastoma. Eventually, the patient was diagnosed with recurrent cementoblastoma.ConclusionsPathological analyses of this case suggested that the recurrent event in the cementoblastoma altered its growth pattern and tumor cell shape. Moreover, in the case of enucleation surgery, long-term follow-up is important because there is some recurrent risk of cementoblastoma, although it is not high.

Spyttstein i munngulvet – en kasuistikk

English summary Nor Tannlegeforen Tid. 2024; 134: 216-9. Sialolithiasis, or salivary gland stones, is a common condition that affects the salivary glands, often causing pain and functional issues. This article discusses a clinical case at the specialist clinic at University of Oslo, highlighting the challenges and considerations in diagnosing and treating sialolithiasis. The case involves a 45-year-old woman with a radiopaque lesion in the floor of her mouth. Based on clinical and radiological examination the diagnosis was sialolithiasis, and a sialolithotomy procedure was performed to remove the stone. The discussion covers the causes, radiological features, and treatment options for sialolithiasis.

Performance of a deep learning system for simultaneously diagnosing radiolucent and radiopaque lesions in the anterior maxilla on panoramic radiographs

AbstractAimTo validate the performance of a deep learning system with detection and classification functions for a mix of radiolucent and radiopaque lesions in the anterior maxilla on panoramic radiographs.MethodsPatients with radiolucent or radiopaque lesions in the anterior maxilla on panoramic radiographs were selected retroactively from May 2022 until Feb 2002 to obtain 100 preoperative radiographs each for nasopalatine duct cysts (NDCs), radicular cysts (RCs), and impacted supernumerary teeth (ISTs). An additional 100 patients with no lesions in the anterior maxilla were selected. Two deep learning systems (Systems 1 and 2) were created and tested. For System 1, the models were created and tested using datasets of radiolucent lesions (NDCs and RCs) and No lesions. For developing System 2, the data of radiopaque lesions (ISTs) were added to those used in System 1. The neural network used was You Only Look Once ver. 7 (YOLOv7). The recall, precision, F1 score, and accuracy calculated from the confusion matrix were used to evaluate diagnostic performance.ResultsThe performance of System 2, which included the IST data, was worse than that of System 1. Even when NDCs and RCs were addressed as a joint category of radiolucent lesions, the addition of IST data resulted in a worse performance than that of System 1.ConclusionOur results indicate that combined use of radiopaque lesions (ISTs) with radiolucent lesions (NDCs and RCs) reduces the deep learning performance for radiolucent lesions with the volume of data used in the present study.

Late recurrence of calcifying odontogenic cyst: Report of a rare case and review of the literature

AbstractCalcifying odontogenic cyst (COC) is a relatively uncommon cyst of odontogenic origin, occurring in the second decade of life, with no jaw predilection. Radiographically, it typically appears as a well‐defined unilocular radiolucency containing irregular calcifications of varying size and opacity. Treatment consists of conservative surgical excisions with low recurrence rates. The purpose of this paper is to report a rare case of late COC recurrence and review the pertinent literature. A 42‐year‐old female patient presented for evaluation of a painless swelling in the palate, which had been present for 5 years with a gradual, slow increase in dimensions. Twenty years before, a lesion at the same site was surgically excised with a diagnosis of COC. Clinical examination revealed a hard‐in‐consistency swelling in the anterior segment of the hard palate. Radiographically, a radiopaque lesion with an irregular outline was noticed in the left palate adjacent to the left maxillary canine and first premolar, along with a well‐defined radiolucent lesion between the maxillary central incisors. Both lesions were surgically excised, and histopathological examination revealed that the main lesion in the left palate was consistent with recurrent COC, while the lesion between the central incisors was compatible with a nasopalatine duct cyst. Even though the recurrence rate of COC is low, estimated at 3.4% based on our review of the relevant English‐language literature, the current case highlights the possibility of a late recurrence, even several years after the initial diagnosis and treatment, and therefore the need for long‐term follow‐up.

A Comprehensive Clinical Review of Maxillary Sinus Floor Elevation in Patients with Well-Defined Faintly Radiopaque Lesions in the Antrum.

Well-defined, faintly radiopaque lesions are occasionally observed in the antrum of the maxillary sinus in asymptomatic patients during maxillary sinus floor elevation. These lesions are treated as antral pseudocysts (AP) based on the clinical diagnosis in some cases, and maxillary sinus floor elevation is performed without enucleating these lesions. However, further surgery is required after implant placement if the lesion is a mucocele, odontogenic cyst, or tumour. This comprehensive clinical review aimed to identify an appropriate approach for maxillary sinus floor elevation in patients with well-defined, faintly radiopaque lesions in the antrum based on our clinical experience.

Detection of asymptomatic lesions in jaws from patient visiting King Saud University (KSU) College of Dentistry: A retrospective study

The aim of this study was to evaluate the detection of asymptomatic lesions of jaws in retrospective two-year panoramic radiographs from patients’ record visiting for treatment in the College of Dentistry, King Saud University, and accidentally noticed while patients visited for other reasons. Ninety-two (92) cases were selected for the study to detect asymptomatic lesions among 907 patients varying in age of 18 to 72 years (mean 38 years) and who visited the Dentistry College. The information was collected on a designed proforma by two examiners and calculated average. Seventy-six (76) were male and sixteen (16) females, including 79 (85.9%) radiopaque, 11 (12%) radiolucent, and 2 (2.2%) with mixed lesions. These results showed no significant gender differences. The selected cases were divided into three age groups 18-30, 31-50, and 51-72 years to detect different lesions, but the groups did not differ significantly. In this study, location-wise frequency of lesions in the anterior region of jaws were 2 (28.6%) in maxilla and 5 (71.4%) in mandible, whereas in the posterior region 7 (9.7%) were in maxilla and 65 (90.3%) in mandible. However, the study concluded that most of asymptomatic radiopaque lesions were found in the posterior region of mandible and more incidence being in young age group.

Non-endodontic periapical radiopaque jaw lesions: A mini review

Endodontic practice may be affected by periapical radiopaque/ hyperdense lesions. Oral medicine specialists and endodontists may have trouble diagnosing and treating radiopaque lesions. Inflammatory, non-inflammatory, neoplastic, dysplastic, metastatic or metabolic bone changes may occur. With the increased use of cone-beam CT, a detailed review of radiopaque lesions may help clinicians differentiate these lesions. Differentiating inflammatory, non-inflammatory and neoplastic disorders simplifies diagnosis and helps choose the best treatment. Aim: The aim of this review was to investigate the periapical radiopaque/hyperdense lesions. An extensive review of the literature was carried through. The literature search was conducted using MEDLINE (National Library of Medicine)-PubMed, Web of Science and Google scholar without restrictions concerning the date of publication. The inclusion criterion was that the article should be written in English, whereas the exclusion criterion was the opposite. This literature review covers radiopaque/hyperdense lesion differential diagnoses, clinical, radiographic, histological, and management issues. The effectiveness of root canal therapy is measured by the absence of pain, the absence or reduction of periapical lesions, and the restoration of tooth function. In endodontic practice, the diagnosis of periapical lesions is difficult because many of these lesions can mimic endodontic lesions, even when derived from different sources. For the diagnosis of periapical lesions in this scenario, a comprehensive clinical examination, in conjunction with clinical and radiographic aspects of the disease, is essential. The oral medicine specialist and endodontist must know how to diagnose radiopaque periapical lesions. Knowing how to differentiate between inflammatory, non-inflammatory, neoplastic and metabolic lesions expedites diagnosis and ensures the selection of the appropriate treatment.

Solitary Radiopacity Associated with Root of Unerupted Supernumerary Tooth - A Case Report and Differential Diagnosis

Radiopaque lesions of jaws are innumerable and variable in appearance. There are several radiopaque lesions seen in the periapical region of tooth root which are indistinguishable from other lesions. The diagnosis and management of these lesions from clinical and radiographic features could be challenging to the dentist. Alterations in the bone could be inflammatory cystic odontogenic and non-odontogenic neoplastic reactive vascular traumatic dysplastic or metabolic in origin. As intraoral periapical radiographs IOPA provide the best image resolution they can aid in identifying the subtle changes in the bone architecture periodontal ligament Pdl space and lamina dura. Radiographic analysis of the involvement of adjacent structures using panoramic imaging is not sufficient for diagnosis as it provides 2D imaging of a 3D object. Cone Beam Computed Tomography CBCT provides an accurate 3D image of the involvement of bone and adjacent structures. Systematic radiologic analysis of lesions based on their location size shape borders internal structure effect on surrounding structures and consideration of clinical signs and symptoms enable clinicians to arrive at a reliable diagnosis. Here we present a case report of an asymptomatic radiopaque lesion associated with the root of an unerupted supernumerary tooth which was accidentally detected on an IOPA taken for treating the adjacent tooth.

Osteocondroma maxilar benigno: um relato de caso clínico

ABSTRACT Osteochondroma is a benign tumor that arises from bone tissue with the presence of cartilage, slow growing, commonly asymptomatic, and can impact structures as the lesion grows. The objective of this study was to report a clinical case of benign maxillary osteochondroma that occurred in a 55-year-old female patient. In the initial clinical examination, no signs and symptoms were found. In imaging studies, a radiopaque lesion was found associated with the buccal bone cortex of the maxilla, above dental element 21, with pedicled insertion and lobulated surface. Due to the particularities of the lesion, surgical excision was proposed. The histopathological examination indicated mature cartilaginous and bone tissue, confirming the suspicion of osteochondroma.

CBCT In Imaging Radiopaque and Mixed Lesions of The Jaw

Radiolucent lesion in jawbone more than radiopaque and mixed lesion, this appears in any lesion (odontogenic, non-odontogenic). However, this group include benign and malignant bone tumor. this lesion appears rarely in crown of tooth and more than in apex tooth.

Occurrence of radiopaque and mixed lesions at periapical region in patients with rheumatoid arthritis and ankylosing spondylitis: a retrospective study

BackgroundRheumatoid arthritis (RA) and ankylosing spondylitis (AS) have different effects on bones, cartilage and joints, sometimes destroying the spine and joints, and other times causing new bone formation. This study aimed to evaluate the effects of RA and AS on the types (radiolucent, radiopaque and mixed) of periapical lesions in jaw bones.MethodsThis study included 708 individuals (97 with AS, 327 with RA and 284 healthy controls (C)) and a total of 17,118 teeth (AS: 2,442; RA: 7,638; C: 7,038). The number of teeth, extracted teeth and teeth with root canal treatment and the presence of radiopaque, radiolucent and mixed periapical lesions were recorded from dental panoramic radiographs. Kruskal–Wallis and chi-square tests were used for statistical analysis.ResultsThe frequency of radiopaque lesions in the AS and RA groups was similar (p > 0.05) and significantly higher than in the C group (p < 0.05) (AS: 13.4%; RA: 6.1%; C: 2%). Mixed lesions (AS: 3.1%; RA: 4.0%; C: 0.4%) were statistically significantly higher for the RA group compared to the C group (p < 0.05), while the AS–C and AS–RA groups were similar (p > 0.05). There was no significant difference in terms of radiolucent lesions among groups (p > 0.05).ConclusionRadiopaque apical lesions were frequent in RA and AS patients, while mixed lesions were significantly higher in RA patients.

Radiographic appearance of ossifying fibroma in the left mandible: a case report

This article reports on ossifying fibroma (OF) which was established based on panoramic radiographic, CBCT and histopathological examination and treatment performed on a 31 years old male patient. The diagnosis is made by comparing with existing theories in the literature.&#x0D; Case Report: A 31 years old man was referred to the Oral Surgery Department of Al Ihsan Hospital. The patient complained of swelling in the lower left jaw. On palpation it feels hard and cannot be moved. Panoramic radiograph examination showed loss of teeth 34-35 and a radiolucent lesion mixed with radiopaque in the left mandible which resulted in a shift in the position of teeth 36 and 37 more superiorly. The CBCT examination performed revealed a mixed radiolucent and radiopaque lesion of teeth 33-38. Histopathological examination also showed the presence of cellular fibrous with a mineralized component. The patient has been treated in the form of excision of the lesion.&#x0D; Conclusion: CBCT can be used as a reliable supporting examination in helping to diagnose cases of benign neoplasms involving hard bone tissue such as ossifying fibroma. OF has distinctive features on radiographs, one of which is the presence of mixed radiolucent and radiopaque lesions with wispy septa which result in resorption and displacement of the teeth involved. The accuracy of the diagnosis of OF can be enforced by a combination of clinical, radiographic and HPA examinations, so that the treatment given to patients is according to the procedure.

Incidentally Detected Radiopaque Lesions in The Jaw: Report of Three Cases

Çeşitli sistemik hastalıklarda, inflamatuar durumlarda, kemik displazilerinde, heterotropik kalsifikasyonlarda, ossifikasyonlarda, kistlerde ve tümörlerde lezyonun ihtiva ettiği kalsifiye yapıya bağlı olarak radyoopasite görülebilmektedir. Bu makalede klinikte tesadüfen tespit edilen üç farklı tip radyoopak lezyonun klinik ve radyolojik bulguları sunulmuştur.Çenede tesadüfen fark edilen radyoopasitelerin anlaşılması için bilgisayarlı tomografi, konik ışınlı bilgisayarlı tomografi, manyetik rezonans görüntüleme ve ultrasonografi gibi ileri görüntülemeye gerek duyulabilir. Muayene sırasında çenede görülen radyoopak lezyonların özelliklerinin iyi bilinmesi ve radyografik olarak doğru yorumlanması, ayrıcı tanılarının yapılması ve uygun tedavi yönteminin seçilmesi açısından önemlidir. Lezyonların doğru değerlendirilmesi, tanının doğru konulmasını sağlayarak hastayı potansiyel yan etkilerden koruyacaktır.

Condensing Osteitis – A Review and Case Report

Condensing osteitis is pathological lesions of the maxillomandibular region which is seen in root apex of long standing untreated carious lesions or tooth having inappropriate endodontic treatment and generally occurs as a result of body’s defence mechanism against the infection. Dense trabeculae formation is seen within the bone marrow which appears as a radiopaque lesion near the apex of the affected tooth. Diagnosis of condensing osteitis depends on proper clinical and radiographic evaluation. In the present case report, condensing osteitis in a 12-year female is reported and with adequate endodontic procedure, healing and regression were seen after 6 months of follow-up.