title: Differential Diagnosis of a Periapical Radiolucent Lesion. A Case Report and Review of the Literature.
abstract: This article demonstrates a methodological approach to diagnosing a periapical radiolucency that could not be diagnosed using only basic clinical and radiographic findings. The patient was a 59-year-old Hispanic female with a small tender mass on the lower gingiva associated with tooth #25. Radiographic appearance demonstrated a well-defined radiolucent lesion at the apices of the mandibular incisors. The patient had no significant medical history. Cone-beam computed tomography (CBCT) showed bony expansion of the buccal plate. Differential diagnosis included non-endodontic unilocular radiolucent lesions in the anterior mandibular region. Biopsy findings were consistent with periapical cemento-osseous dysplasia (PCOD). In conclusion, clinical appearance of PCOD varies from non-expansile and asymptomatic to being expansile and sometimes symptomatic. In the latter cases, it may be necessary to use additional diagnostic tools to confirm the diagnosis.
authors.forename: Matthew
authors.initials: M
authors.lastname: Malek
authors.forename: Lina M
authors.initials: LM
authors.lastname: Cortes
authors.forename: Asgeir
authors.initials: A
authors.lastname: Sigurdsson
authors.forename: Paul A
authors.initials: PA
authors.lastname: Rosenberg
mesh_terms: D001706:Biopsy / Q000379:methods; D002485:Cementoma / Q000000981:diagnostic imaging*; D054893:Cone-Beam Computed Tomography / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007180:Incisor / Q000000981:diagnostic imaging*; D008339:Mandibular Neoplasms / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010483:Periapical Diseases / Q000000981:diagnostic imaging*; D011842:Radicular Cyst / Q000000981:diagnostic imaging; D019227:Tooth Apex / Q000000981:diagnostic imaging