Limitation of panoramic radiography in diagnosing adenomatoid odontogenic tumors

Adenomatoid odontogenic tumor is frequently not diagnosed preoperatively even when radiographs are available. This study evaluates radiographic findings with special emphasis on the characteristic radiopacities of adenomatoid odontogenic tumor. In correlating radiologic findings with pathologic findings, differences in diagnostic accuracy between intraoral periapical and panoramic radiographs were found. The intraoral periapical radiograph allows perception of the radiopacities in adenomatoid odontogenic tumor as discrete foci having a flocculent pattern within radiolucency even with minimal calcified deposits. Panoramic radiography was often unable to demonstrate radiopacities in adenomatoid odontogenic tumor when the calcification was minimal. The result indicates that intraoral radiographs may be essential for correct radiographic interpretation of an adenomatoid odontogenic tumor in the presence of minimal quantities of calcified deposits.