Radiology · patient case question
The dense, well-circumscribed radiopacity in the #16 region on both the film and the 3D reconstruction is most consistent with:
Patient case: Radiopaque Lesions
demo: 22-year-old female
chief: Routine radiographic survey.
history: Non-contributory. Asymptomatic.
meds: None
findings: Finding A: a well-defined radiopacity in the region of the missing #16, also visible on 3D reconstruction. Finding B: a cluster of small tooth-like radiopacities surrounded by a thin radiolucent halo, located between the mandibular premolars, blocking eruption.
Show answer and explanation
Correct answer: A. Osteoma
- A. Correct. An osteoma is a benign proliferation of mature compact or cancellous bone, appearing as a homogeneous, well-circumscribed radiopacity. Its presence on the 3D reconstruction confirms it is a real anatomic structure, not an artifact.
- B. Condensing osteitis is a localized sclerotic reaction at the apex of a tooth with long-standing low-grade pulpal inflammation — it requires a tooth.
- C. A compound odontoma consists of multiple small tooth-like denticles with a surrounding radiolucent rim, not a homogeneous mass.
- D. An artifact would not reproduce on an independent 3D reconstruction.
Note: Multiple osteomas should prompt a search for Gardner syndrome: supernumerary teeth, epidermoid cysts, and colonic polyps with near-certain malignant transformation.