What distinguishes condensing osteitis from idiopathic osteosclerosis radiographically and clinically?

Correct answer: B. Pulpal status of the associated tooth

• A. Neither lesion characteristically has a radiolucent rim — that would suggest a different entity.
• B. Correct. Condensing osteitis is a reactive sclerosis to a pulpal inflammatory stimulus — the tooth is non-vital or has a large restoration/caries. Idiopathic osteosclerosis occurs adjacent to a completely vital, sound tooth.
• C. Both can be small or large; size does not distinguish them.
• D. Both are seen in young adults; age does not separate them.