Diagnosing periapical lesions--disagreement and borderline cases.
OBJECTIVE
The aim of this paper is to present a selection of disagreement and borderline cases from a methodological study on the radiographic diagnosis of periapical disease.


METHODS
Thirty-two roots, 12% of the material in an earlier study, were subjected to joint discussion because of diagnostic problems. The aim was consensus. Six cases representing different teeth/roots illustrating typical problems are presented.


RESULTS
The varying morphology of apical areas and varying density of surrounding bone present a number of challenges. Even so, the joint discussion resulted in an agreement for all the cases. Twenty-five diagnoses were established and seven cases were not diagnosed owing to substandard radiographs.


CONCLUSIONS
A detailed analysis of the periodontal ligament space, the lamina dura, trabecular pattern and bone marrow spaces is mandatory for the radiographic diagnosis of periapical disease
Section of Oral Radiology, School of Dentistry, University of Bergen, Norway. agnar.halse@odont.uib.no
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Halse
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Molven
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Fristad
D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging*; D000539:Alveolar Process / Q000000981:diagnostic imaging; D032921:Consensus; D003937:Diagnosis, Differential; D017823:Furcation Defects / Q000000981:diagnostic imaging*; D006801:Humans; D015588:Observer Variation; D010000:Osteitis / Q000000981:diagnostic imaging; D010485:Periapical Periodontitis / Q000000981:diagnostic imaging*; D010513:Periodontal Ligament / Q000000981:diagnostic imaging; D011859:Radiography