An assessment of the aggressive potential of radiolucencies related to the mandibular molar teeth.
OBJECTIVE
The purpose of this study was to outline the radiographic appearance of radiolucent lesions related to the molar teeth and to determine which features indicate aggressive lesions.


METHODS
Panoramic radiographs were reviewed in 66 patients with radiolucencies related to the molar teeth. The radiographic appearances of the lesions were assessed with regard to location and size, and the relationship to the molar teeth. Radiographic evidence of aggression was assessed and pathology reviewed.


RESULTS
Nineteen patients had aggressive and 47 had non-aggressive radiolucent lesions. The aggressive lesions included keratocysts, unicystic ameloblastoma, adenoid cystic carcinoma, giant cell granuloma, myxofibroma, chondroblastic osteosarcoma, mestastases and squamous cell carcinoma of the tongue invading the mandible.


CONCLUSIONS
The differential diagnosis of radiolucent lesions in the mandible can be difficult using panoramic radiographs alone. Helpful features in determining aggression were older patients, larger lesions, Lodwick type IC tumour border, condition of the mandibular cortex, movement of adjacent teeth and the relationship of the inferior alveolar canal.
O'Reilly
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Departments of Radiology, Kingston Hospital, Galsworthy Road, Kingston on Thames, Surrey, KT2 7QB, U.K.
O'Reilly
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Todd
C E
CE
Altman
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Schafler
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K
D000328:Adult; D000564:Ameloblastoma / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006101:Granuloma, Giant Cell / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000000981:diagnostic imaging; D008339:Mandibular Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D008963:Molar / Q000000981:diagnostic imaging* / Q000473:pathology; D009807:Odontogenic Cysts / Q000000981:diagnostic imaging; D011859:Radiography; D012307:Risk Factors