Radiology · single question
Which bone condition involves VITAL teeth, a radiolucent lesion ADJACENT to (but NOT fused to) the root, with NO cortical expansion?
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Correct answer: D. Cemento-osseous dysplasia (early stage)
D) Early-stage cemento-osseous dysplasia — CORRECT.
Early (osteolytic) stage of cemento-osseous dysplasia presents as a periapical RADIOLUCENCY associated with VITAL teeth — mimicking endodontic pathology. Key: teeth test VITAL (negative for pulpal disease), no symptoms, multiple teeth affected, affects middle-aged Black women predominantly. Over time it progresses to mixed then radiopaque (mature). NO cortical expansion differentiates it from cementoblastoma.
A) Cementoblastoma: FUSED to root, has a radiolucent halo, cortical expansion — different presentation.
B) Periapical granuloma: Radiolucency at the apex but associated with NON-VITAL tooth (non-responsive to pulp testing).
C) Idiopathic osteosclerosis: Radiopaque, not radiolucent — opposite presentation.
Early (osteolytic) stage of cemento-osseous dysplasia presents as a periapical RADIOLUCENCY associated with VITAL teeth — mimicking endodontic pathology. Key: teeth test VITAL (negative for pulpal disease), no symptoms, multiple teeth affected, affects middle-aged Black women predominantly. Over time it progresses to mixed then radiopaque (mature). NO cortical expansion differentiates it from cementoblastoma.
A) Cementoblastoma: FUSED to root, has a radiolucent halo, cortical expansion — different presentation.
B) Periapical granuloma: Radiolucency at the apex but associated with NON-VITAL tooth (non-responsive to pulp testing).
C) Idiopathic osteosclerosis: Radiopaque, not radiolucent — opposite presentation.