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Radiology · patient case question

The same patient reports tenderness between #8 and #9. The radiograph shows a balloon-like radiolucency arising from the root canal space with loss of the canal outline. What is the diagnosis and treatment?

Patient case: Ossifying Fibroma and Anterior Maxillary Radiolucency

demo: 31-year-old female

chief: Asymptomatic lesion noted on routine imaging.

history: Non-contributory.

meds: None

findings: A well-circumscribed lesion of mixed density is present in the posterior mandible (images below). On a separate periapical film of the maxillary central incisors, a well-defined radiolucency is seen between the roots of #8 and #9.

  1. Lateral periodontal cyst — treat with enucleation
  2. Internal resorption — treat with root canal therapy
  3. External cervical resorption — treat with surgical repair and restoration
  4. Condensing osteitis — no treatment required
Show answer and explanation

Correct answer: B. Internal resorption — treat with root canal therapy

  • A. A lateral periodontal cyst sits in the bone lateral to a vital root, not within the canal space.
  • B. Correct. Internal resorption is odontoclastic activity within the canal, driven by inflamed vital pulp tissue. The canal outline is lost within the lesion and the defect moves with the tooth on parallax. Removing the pulp arrests it — root canal therapy is the treatment.
  • C. External resorption preserves the canal outline through the defect and the lesion shifts relative to the canal when the beam angle changes.
  • D. Condensing osteitis is a sclerotic radiopacity, not a radiolucent balloon.

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