2004 Volume 44 Issue 1 Pages 16-23
Recently, patients with radiopaque lesions in the jaw bones are sometimes referred to the Hospital of Nihon University School of Dentistry for diagnosis. After examination by rotational panoramic radiography, limited cone beam X-ray CT (dental CT) is usually applied to clarify the internal conditions of radiopaque lesions. This procedure often reveals pearl shell structure (PSS) in the radiopaque lesions. The purpose of this study was to clarify the diagnostic relevance of PSS through the relation between the tooth and the origin of this structure.
We analyzed 100 radiopaque lesions revealed by rotational panoramic radiography and found that PSS most frequently arose in the premolar and molar regions of the mandible. Regarding the site, 60% of lesions were in contact with the root of a tooth, but 24% were localized in the body of the mandible. We found PSS in 34% of all lesions and these were localized at a higher frequency fully enclosed within the roots of teeth than in contact with them.
We show in this study that the PSS in some radiopaque lesions was diagnosed as condensing osteomyelitis histopathologically. Moreover we must follow up PSS to clarify under both conditions, indicating that it is either the starting point of bone sclerosis due to inframmation or the center of increasing bone sclerosis for a long periods.
