Nonendodontic periapical lesions: a retrospective study in Chile

Abstract

The histopathological study of periapical pathosis can occasionally reveal nonendodontic lesions. Odontogenic tumours made up the largest group.

Periapical Lesions: a Review of Clinical, Radiographic, and Histopathologic Features

“…In addition, unlike the lesion in the condensing osteitis, the radiolucent margin is not detected (53). Some case report studies have been shown other rare benign lesions in periapical area containing myxoma, Pindborg tumor, squamous odontogenic tumor, intrabony hemangioma, lipoma, and amalgam tattoo (3,5,54,55).…”

“…Furthermore, vitality testing in some cases such as teeth under orthodontic treatment, calcified root canal, traumatized teeth, teeth with open apexes, large amalgam restoration, and metal crown does not provide definitive responds. In these cases, more clinical and radiologic evaluation and history of dental treatment are required (2,3). If the vitality tests results are positive, the nonendodontic origin is confirmed.…”

“…Careful evaluation of every abnormal radiolucency or radiodensity observed in radiographic images of the jaws, with regard to all clinical and radiographic signs, can guide the practitioner to reach the correct diagnosis and accordingly, prevent mistreatment and patient dissatisfaction. Periapical lesions may have odontogenic or nonodontogenic origins (Table 1) (1)(2)(3). Many periapical lesions with nonodontogenic origins such as benign and malignant tumors, nonodontogenic cysts, and infections can imitate radiographic view of inflammatory odontogenic lesions (1,2,4).…”

“…Several malignant lesions are observed in periapical area such as lymphoma, leukemia, multiple myeloma, squamous cell carcinoma, adenocarcinoma, chondrosarcoma, osteosarcoma, and metastatic lesions (1,3,5,(56)(57)(58)(59). Lymphoma is a malignant neoplasm of lymphoid system, and very rarely occurs in jaws.…”

Nasopalatine duct cyst: A diagnostic dilemma

“…The burning sensation can develop due to the pressure on the nasopalatine nerve [9]. Intraoral periapical radiograph can reveal a heart-shaped radiolucency due to the superimposition of the anterior nasal spine, superimposition of the cystic lesion and the anterior teeth can cloud the judgment leading to misdiagnosis of nasopalatine cyst if endodontic examination haven't done properly or not at all, moreover most of the reported cases of misdiagnosis were initially treated by general dentists [10][11][12][13][14][15]. A positive response to vitality tests in the involved teeth should indicate a lesion of nonodontogenic origin, yet if the vitality test gave a negative response or endodontic therapy has been initiated or completed, establishing the differential diagnosis becomes clouded.…”