No abstract

Osteopathia striata with cranial sclerosis (OS-CS) is a bone dysplasia characterized by a linear striated pattern of sclerosis, especially in the long bones, and cranial sclerosis. It has variable clinical findings but distinctive radiological findings. Multiple oral and dental findings have been associated with this disease and can be seen during dental and/or medical imaging of the head and neck. Dentists and clinicians must be familiar with these signs to differentiate them from pathosis or erroneous radiographs. In the following case, we present a patient with OS-CS that presented at The University of Florida College of Dentistry with multiple craniofacial manifestations of this syndrome that were seen on a panoramic radiograph, which is one of the most commonly requested radiographs by dentists.

The radicular cyst is the most common inflammatory odontogenic cyst in the jaws. It is a periapical lesion associated with non-vital teeth in the tooth-bearing regions of the jaws with a slight male predilection. A radicular cyst is typically asymptomatic, but if large or secondarily infected may cause swelling. The usual radiographic appearance of a radicular cyst is that of a periapical radiolucent lesion. This case report documents a rare case of 61-year-old male with a mixed-density periapical lesion diagnosed as a radicular cyst. The lesion presented as a well-defined, expansile, space occupying, corticated, sclerotic, hydraulic, unilocular, mixed density lesion, associated with the right mandibular second premolar that was predominantly radiolucent with scattered foci of radiopacities. Microscopic examination revealed fragments of lining epithelium along with small fragments of inflamed fibrous connective tissue, aggregates of necrotic cellular debris, and bacterial colonies intermixed with foci of dystrophic calcifications. The histopathological diagnosis was a radicular cyst with dystrophic calcification. Although rare, this entity should be considered in the differential diagnosis of mixed-density periapical lesions. Complete history and proper diagnosis is important in this type of rare cases as treatment varies between a radicular cyst and other odontogenic neoplasms.