Periapical lucency around the tooth

Radiologic evaluation and differential diagnosis

Margaret N. Chapman, Rohini Narahari Nadgir, Andrew S. Akman, Naoko Saito, Kotaro Sekiya, Takashi Kaneda, Osamu Sakai

Research output: Contribution to journalArticle

Abstract

Periapical lucencies are often seen incidentally at head and neck imaging studies performed for indications not related to the teeth. These lesions are, however, occasionally manifestations of diseases that have a wide range of effects and may at times represent the source of symptoms that prompted the study. The vast majority of periapical lucencies are the result of apical periodontal or pulpal disease. If found in an advanced state or left untreated, disease related to the tooth may spread to adjacent tissues, including the sinuses, orbits, deep fascial spaces of the neck, and intracranial structures, and result in a significant increase in patient morbidity and mortality. Although the majority of periapical lucencies seen on radiographs and computed tomographic images occur secondary to apical periodontal or pulpal disease, not all lucencies near the tooth root are due to infection. Lucency near the tooth root may be seen in the setting of other diseases of odontogenic and non-odontogenic origin, including neoplasms. Although imaging findings for these lesions can include periapical lucent components, awareness of the varied secondary imaging features can aid the radiologist in developing an accurate differential diagnosis. Familiarity with the imaging features and differential diagnoses of diseases or conditions that cause lucency around the tooth root results in appropriate referral and prompt diagnosis, management, and treatment, and can prevent unnecessary additional imaging or intervention. In addition, early recognition and appropriate treatment of infectious processes will result in improved clinical outcomes and a decrease in morbidity and mortality.

Original languageEnglish (US)
JournalRadiographics : a review publication of the Radiological Society of North America, Inc
Volume33
Issue number1
DOIs
StatePublished - Jan 2013
Externally publishedYes

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Tooth
Differential Diagnosis
Tooth Root
Neck
Morbidity
Mortality
Orbit
Referral and Consultation
Head
Therapeutics
Infection
Neoplasms
Recognition (Psychology)

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Periapical lucency around the tooth : Radiologic evaluation and differential diagnosis. / Chapman, Margaret N.; Nadgir, Rohini Narahari; Akman, Andrew S.; Saito, Naoko; Sekiya, Kotaro; Kaneda, Takashi; Sakai, Osamu.

In: Radiographics : a review publication of the Radiological Society of North America, Inc, Vol. 33, No. 1, 01.2013.

Research output: Contribution to journalArticle

Chapman, Margaret N. ; Nadgir, Rohini Narahari ; Akman, Andrew S. ; Saito, Naoko ; Sekiya, Kotaro ; Kaneda, Takashi ; Sakai, Osamu. / Periapical lucency around the tooth : Radiologic evaluation and differential diagnosis. In: Radiographics : a review publication of the Radiological Society of North America, Inc. 2013 ; Vol. 33, No. 1.
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