Review of Normal Anatomy and Common Pathologies in Dental Imaging

Abstract

In imaging of the head and neck regions, the dental space is an area which many radiologists are less familiar with and which often does not receive adequate attention. Dental and periodontal pathologies are hence often overlooked and underreported in daily practice. This article reviews the normal anatomy and imaging findings of the common pathologies in the dental region. Dental infection and inflammation are commonly encountered and have a variety of manifestations with different degrees of severity, ranging from asymptomatic incidental findings, local infection confined within the dental space, and inflammation of the adjacent paranasal sinuses (i.e. odontogenic sinusitis), to severe and extensive deep neck infection. Odontogenic cysts and neoplasms are occasionally seen, most of which are benign. The challenge in the imaging of these lesions is to distinguish them from other mandibular lesions that demonstrate similar radiological appearances. A detailed clinical history and careful imaging interpretation are very helpful in narrowing the differential diagnosis and guiding management. Developmental anomalies (eg, supernumerary teeth, ectopic tooth) of the dentition are usually isolated incidental findings or a manifestation of a syndromal disease such as Gorlin-Goltz syndrome and cleidocranial dysostosis. Finally, dental injury should be carefully evaluated in the context of head and neck trauma, including injury to the tooth itself, the periodontal structures and the associated complications (eg, aspiration of fractured tooth). Learning and becoming familiar with the basic dental anatomy and common pathologies are essential in identifying diseases and making accurate diagnoses.