Abstract
Objectives
Practitioners should be aware of the occurrence rate and usual location of radiolucent
jaw lesions. The aims of this study were to examine the frequency and location of
radiolucent jaw lesions, including apical granulomas, apical cysts, keratocystic odontogenic
tumors (KOTs), central giant cell lesions (CGCLs), ameloblastomas, and metastatic
lesions, that were submitted for biopsy along with associated demographics.
Methods
Biopsy diagnoses from 9,723 lesions (submitted between 1992 and 2006) were included
in this study. Data on lesion location as well as patient demographics were evaluated.
Results
Thirty types of radiolucent jaw lesions were classified. Nonhealing apical granulomas
(40.4%) and cysts (33.1%) occurred at similar rates and together totaled 73% of all
biopsied lesions. The majority of reported granulomas and cysts occurred in the anterior
maxilla (>36% in each category). The frequency of KOTs (8.8%), CGCLs (1.3%), ameloblastomas
(1.2%), and metastatic lesions (<1%) are to be noted along with their location, which
was predominately in the posterior mandible. The occurrence of apical cysts, ameloblastomas,
KOTs, and metastatic lesions were seen slightly more in men, at 56%, 54%, 55%, and
68%, respectively. The occurrence of CGCLs was seen slightly more in women at 56%,
whereas apical granulomas were equally present in men and women.
Conclusions
Most nonhealing lesions submitted for biopsy were classified as granulomas or cysts
(73%) often from the anterior maxillary jaw. Nonhealing radiolucent jaw lesions other
than granulomas or cysts were reported over 20% of the time and may have more severe
pathological implications, suggesting the value of differential diagnoses.
Key Words
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References
- Oral surgery-oral pathology conference No. 17, Walter Reed Army Medical Center. Periapical lesions–types, incidence, and clinical features.Oral Surg Oral Med Oral Pathol. 1966; 21: 657-671
- The odontogenic keratocyst. A clinicopathologic study of 312 cses. Part1.Oral Surg Oral Med Oral Pathol. 1976; 42: 54-72
- Clinical and radiological features of central giant-cell lesions of the jaw.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 99: 464-470
- Central giant cell lesions of the jaws. A clinical, radiologic, and histopathologic study.Oral Surg Oral Med Oral Pathol. 1993; 75: 199-208
- Radiologic features, including those seen with computed tomography, of central giant cell granuloma of the jaws.Oral Surg Oral Med Oral Pathol. 1988; 65: 255-261
- Central giant cell granuloma of the jaws: experiences in the management of thirty-seven cases.J Oral Maxillofac Surg. 1988; 46: 376-384
- Ameloblastoma: a clinical, radiographic, and histopathologic analysis of 71 cases.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 91: 649-653
- Proceedings: ameloblastoma of maxilla and mandible.Cancer. 1974; 33: 324-333
- Oral metastases: report of 24 cases.Br J Oral Maxillofac Surg. 2003; 41: 3-6
- Metastatic tumors of the jawbones: analysis of 390 cases.J Oral Pathol Med. 1994; 23: 337-341
- Metastatic tumors in the jaws: a retrospective study of 114 cases.J Am Dent Assoc. 2006; 137: 1667-1672
- The relationship of lesion size to diagnosis, incidence, and treatment of periapical cysts and granulomas.Oral Surg Oral Med Oral Pathol. 1984; 57: 82-94
- Differentiation of periapical granulomas and radicular cysts by digital radiometric analysis.Oral Surg Oral Med Oral Pathol. 1993; 76: 356-361
- Nonsurgical root canal therapy of large cyst-like inflammatory perapical lesions and inflammatory apical cysts.J Endod. 2009; 35: 607-615
- Use of computed tomography scans and ultrasound in differential diagnosis and evaluation of nonsurgical management of periapical lesions.Oral Surg Oral Med Oral Pathol Radiol Endod. 2010; 109: 917-923
- Electrophoretic differentiation of radicular cysts and granulomas.Oral Surg Oral Med Oral Pathol. 1973; 35: 249-264
- Evaluation of pathologists (histopathology) and radiologists (cone beam computed tomography) differentiating radicular cysts from granulomas.J Endod. 2010; 36: 423-428
- Differential diagnosis of large periapical lesions using cone-beam tomography measurements and biopsy.J Endod. 2006; 32: 833-837
- Clinicopathological study of 252 jaw bone periapical lesions from a private pathology laboratory.J Formos Med Assoc. 2010; 109: 810-818
- Endodontic treatment of a large cyst-like periradicular lesion using a combination of antibiotic drugs: a case report.J Endod. 2005; 31: 898-900
- Keratocystic odontogenic tumour: reclassification of the odontogenic keratocyst from cyst to tumor.J Can Dent Assoc. 2008; 74 (165–165h)
- Central giant cell lesions of the jaws. A clinical, radiologic, and histopathologic study.Oral Surg Oral Med Oral Pathol. 1993; 75: 199-208
- Clinical Endodontics: A Manual of Scientific Endodontics.Saunders, Philadelphia1956
- The frequency and distribution of periapical cysts and granulomas. An evaluation of 800 specimens.Oral Surg Oral Med Oral Pathol. 1965; 25: 861-868
- Radiolucent inflammatory jaw lesions: a twenty-year analysis.Int Endod J. 2010; 43: 859-865
- Oral and Maxillofacial Pathology.3rd ed. Elsevier, St Louis, MO2009
- Endodontic radiography: who is reading the digital radiograph?.J Endod. 2011; 37: 919-921
- Lymphangioma mimicking apical periodontitis.J Endod. 2011; 37: 91-96
- Differential diagnosis of apical periodontitis and nasopalatine duct cyst.J Endod. 2011; 37: 403-410
- Ossifying fibroma misdiagnosed as chronic apical periodontitis.J Endod. 2010; 36: 546-548
- Lateral periodontal cysts arising in periapical sites: a report of two cases.J Endod. 2010; 36: 1707-1711
Article info
Publication history
Published online: April 16, 2012
Footnotes
Supported by Minnesota Association of Endodontists through the University of Minnesota Dental Student Summer Research program.
Identification
Copyright
© 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
