Idiopathic osteosclerosis

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Idiopathic osteosclerosis
Top: A hyperdense round lesion located under the apex of a non-infected tooth. Bottom: The lesion is separated from the root of the adjacent tooth by a visible periodontal membrane.[1]
SpecialtyDentistry

Idiopathic osteosclerosis, also known as enostosis or dense bone island, is a condition which may be found around the roots of a tooth, usually a premolar or molar.[2] It is usually painless and found during routine radiographs as an amorphous radiopaque (light) area around a tooth. There is no sign of inflammation of the tooth, and if the island is associated with the root the periodontal ligament space is preserved.[2]

Signs and symptoms[edit]

Focal radiodensity of the jaw which is not inflammatory, dysplastic, neoplastic or a manifestation of a systemic disease. This is common and affects 5% of the population, usually seen in teens and those in their 20s. Typically asymptomatic and is an incidental finding on a radiograph, found anywhere in the jaw, most commonly in the mandibular premolar-molar region. The shape ranges from round to linear streaks to occasional angular forms.

Cause[edit]

Mostly unknown (idiopathic),[2] but may be a reaction to past trauma or infection which is difficult to rule out in some cases.

Diagnosis[edit]

Usual diagnosis is via radiograph, patient history, biopsy is rarely needed. Periodic follow ups should included additional radiographs that show minimal growth or regression.

Radiology[edit]

Well defined, rounded or triangular radiodensity, that is uniformly opaque. There is no lucent component. Found near the root apex or in the inter-radicular area. Root resorption and tooth movement are rare. If it blends into bone cortices, it does so with no expansion or thinning.[2]

Differential Diagnosis[edit]

Condensing osteitis, sclerosing osteomyelitis, enostosis cementoblastoma, cemento-osseous dysplasia, hypercementosis,[2] exostoses (tori). Condensing osteitis may resemble idiopathic osteosclerosis, however, associated teeth will have pulpitis or pulpal necrosis with condensing osteitis.[3]

These features help differentiate idiopathic osteosclerosis from similar entities such as condensing osteitis, cemento-osseous dysplasia, hypercementosis, and cementoblastoma.

Treatment[edit]

No treatment is necessary.[2]

References[edit]

  1. ^ Silva, Brunno Santos Freitas; Bueno, Mike Reis; Yamamoto-Silva, Fernanda P.; Gomez, Ricardo Santiago; Peters, Ove Andreas; Estrela, Carlos (2017-07-03). "Differential diagnosis and clinical management of periapical radiopaque/hyperdense jaw lesions". Brazilian Oral Research. 31: e52. doi:10.1590/1807-3107BOR-2017.vol31.0052. PMID 28678971.
  2. ^ a b c d e f Andreasen, Barett (2021-04-28). "Apical Radiopacities". radiodontics.com. Archived from the original on 2022-01-15. Retrieved 2022-01-15.
  3. ^ Eliasson S, Halvarsson C, Ljungheimer C. Periapical condensing osteitis and endodontic treatment. Oral Surg Oral Med Oral Pathol. 1984 Feb;57(2):195-9. doi: 10.1016/0030-4220(84)90211-1. PMID 6583626.

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