Idiopathic osteosclerosis
| 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] | |
| Specialty | Dentistry |
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]- ^ 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.
- ^ 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.
- ^ 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.
External links
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