Dental radiographic lesions

How are radiographic lesions classified?
They may be cysts, tumors, or tumor-like lesions.
Clinical presentation of this vast spectrum of pathology is nonspecific.
On imaging, they may be classified as radiolucent, mixed, or radioopaque..
How do caries appear on a radiograph?
On radiographs, carious lesions appear as low-density areas under the tooth structure.
This area represents demineralization and dissolving of hard tissue..
What is a lesion in dentistry?
Oral lesions are mouth ulcers or sores, which may be painful.
They can include abnormal cell growth and rare tongue and hard-palate (roof of mouth) disorders.
Types and causes include: Fever blisters – These contagious, often painful blisters on lips, gums or the roof of your mouth can last five to 10 days..
What is the radiographic appearance of oral lesions?
Large size lesions are more common at the angle and ramus of the mandible.
OKC can be presented as a periapical, pericoronal, and interradicular lesion [17], [18].
Radiographically, it is characterized by a well-defined unilocular or multilocular radiolucency with smooth or scalloped and often corticated margins..

Aug 4, 2019This post looks at how to effectively describe dental radiographic lesions - including borders, location, shape/size and internal

The most prevalent radiographic lesion was the widening of the periodontal ligament (PDL) space (34.2%), followed by PA granuloma (17.5%) and PA cyst (10.8%). The most frequently encountered diagnosis was pulpitis (51.7%), followed by irreversible pulpitis with apical periodontitis (25.8%).

How to Describe A Lesion

The best way to imagine describing is to paint a picture with your words. If you were to describe the lesion to someone

Location

There are a few things to consider location wise: 1. Mandible or maxilla– which jaw is the lesion present in

Edge

This is looking at the border of the lesion(s) and includes: 1

Shape/Size

Estimate the size of the lesion – use nearby anatomy as a reference if needed. For example

Internal

This looks at the internal appearance of the lesion and is usually one of 3 things: 1. Radiopaque– the inside of the lesion is likely white or grey

Other Structures

Assess the lesion in relation to surrounding structures and anatomy including: 1

Number

Simply put – is there a single lesions or are there multiplelesions (common in Gorlin-Goltz syndrome)

Summary

1. Effective description of dental radiographic lesions is important to … 2

Are radiolucent lesions associated with the apex of a tooth a result of pulpal degeneration?

A majority of radiolucent lesions associated with the apex of a tooth are a result of the death of the pulp and subsequent involvement of the apical bone

However, many lesions not the result of pulpal degeneration may appear as radiolucent lesions in association with the apex of a tooth

How do you describe a tooth lesion?

There are many ways to describe the shape

Examples include ovoid, round, scalloped between roots of teeth or other structures

This looks at the internal appearance of the lesion and is usually one of 3 things: Radiopaque – the inside of the lesion is likely white or grey

Compare the density to other structures, such as enamel or bone

Why is describing dental radiographic lesions important?

There are many reasons for why describing dental radiographic lesions is important

Help differentials and referrals – A precise description can narrow your differentials significantly

This is important when referring patients

A simple glance at the description can be help triage urgent cases

On an x-ray, dark lesions around the roots of the teeth are known as “periapical radiolucencies”, and they should be investigated to determine if they may pose a threat to your health. Certain lesions, such as cysts, granulomas, and abscesses, are known to appear on an x-ray when the nerve inside of a given tooth is unhealthy.If the radiolucency is associated with the crown of an unerupted tooth, a dentigerous cyst or an odontogenic neoplasm (assuming a secondary relationship to it) should be considered. Lesions that commonly present as well-defined radiolucencies are cysts and neoplasms. Cysts are common and the majority are inflammatory.