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The effect of periapical rarefying osteitis on cortical and cancellous bone. A study comparing conventional
1Department of Oral Medicine and Radiology, Hebrew University - Hadassah Faculty of Dental Medicine, Jerusalem, Israel.
Objective:
To determine whether erosion of the cortical plate is necessary for successful radiographic identification of periapical rarefying osteitis.
Methods:
Forty-two periapical osteitic lesions were diagnosed from periapical radiographs of 26 patients who were subsequently examined by cross-sectional computed tomography (CT). The relation of the lesions to the buccal and lingual cortical plates was determined and their size measured.
Results:
The 42 lesions varied in size from 2 - 10 mm. Thirty one (74%) lesions diagnosed on the periapical radiographs were limited on CT to the cancellous bone with no erosion of the cortical plates. The 11 lesions with cortical erosion were randomly located throughout the jaws. Erosion was due to either the eccentric buccal or lingual location of the tooth apex, large size (>6 mm) of the lesion or narrowness of the jaw.
Conclusions:
Periapical lesions can be diagnosed from periapical radiographs while they are limited to the cancellous bone and before they have eroded the cortices.