Following extraction of tooth #30, the panoramic radiograph reveals very radiopaque spots on or around the extraction site. What is the most likely explanation?

Correct answer: B. Foreign body

• A. Condensing osteitis is a diffuse, sclerotic bone reaction to low-grade pulpal inflammation. It appears as a diffuse, broad area of increased bone density — not as discrete radiopaque spots.
• B. CORRECT. Very radiopaque spots visible on a panoramic radiograph following extraction most likely represent a foreign body — such as amalgam fragments, a broken instrument tip, or other metallic debris that may have been inadvertently left in the socket or surrounding tissue. Metallic foreign bodies appear highly radiopaque on radiographs.
• C. A bone sequestrum appears as a dense fragment of necrotic bone that is separated from surrounding bone. While radiopaque, it typically presents in the context of osteonecrosis or severe infection, not immediately following a routine extraction.
• D. Residual cementum fragments are typically not visible as discrete radiopaque spots on panoramic radiographs unless very large. They would not typically appear as 'very radiopaque spots' in multiple locations.