Radiopaque jaw lesions observed at Egas Moniz Dental University Clinic

Abstract

Introduction: Radiopaque jaw lesions are commonly found on radiography but they are usually insufficiently described or completely missed by radiology reports [1]. Most radiopaque lesions are asymptomatic and discovered accidentally in common dental exams such as orthopantomography [2]. A variety of conditions such as chronic inflammation, odontogenic tumors and bone neoplasms can manifest as radiopaque lesions of the jawbones. These lesions are often difficult to radiologically distinguish them from each other, hence rendering difficult the process of differential diagnosis. These lesions can be considered complex in terms of etiology, clinical behavior, aggressiveness and recurrence. Physiopathologically, these lesions present variable malignant potential. The objective of this study was to statistically analyze mandibular radiopaque lesions observed during diagnosis consultation at Egas Moniz Dental University Clinic.

Materials and methods: This observacional study follows the principles of the Declaration of Helsinki. From January to June of 2018, 1460 random orthopantomography of patients who attended the Diagnostic Department at Egas Moniz Dental Clinic – IUEM were observed. Frequency tables were organized according to the diagnosis and clinical/radiological aspects of each case. The results were gathered in classes, according to radiological diagnosis: 1) Remaining Intrabony Root Fragments, 2) Focal Sclerosing Osteomyelitis, 3) Supernumerary Teeth, 4) Cementoblastoma/ Hypercementosis and 5) Remaining Dental Amalgam Fragments.

Results: Radiopaque Jaw lesions were found in 112 cases: 7.67%. Remaining Intrabony Root fragments were found in 41,08% of the cases. Most frequent in the region of tooth 38: 26.09%. Not observed in the anterior region. Molar root fragments: 91.31%. Inferior Left Mandible: 65.21%. 3rd Molar root fragments: 36.96%. Focal Sclerosing Osteomyelitis were observed in 36.60% of the cases. Most commonly observed in tooth 46 and 45: 24.3%. No significant differences between molars and premolars. Repeatedly observed in female patients. Most frequently observed in the lower right side of the mandible: 23 cases; 56.09%. Supernumerary Teeth were found in 7.14% of the cases. Lower left parapremolars were the most frequently observed: 50%. Mandible premolars were the most commonly observed: 62.5%. No sex predominance was found. Cementoblastoma/ hypercementosis were found at 8.04% of the cases. Most frequently found in the lower right jaw: 77.78%, Most frequent in female patients: 77.78%. Remaining Dental Amalgam Fragments were observed at 7.14% of the cases. Location of teeth 36 and 46 more frequently observed: 37.5%. Mostly in molar teeth: 75%.

Discussion and conclusions: The diversity of radiographic findings documented in this study shows the importance of performing a good clinical, radiological and histological diagnosis. Awareness of the demographic distribution of these lesions and their associated clinical features, as well as the radiologic aspect, are also important to explore [1]. Early diagnostic is fundamental and the therapeutically approach vary according to the diagnosis. The clinical management of these lesions depends on several factors such as radiological and or histological diagnosis, growth rate, size and anatomical location [3].