Diagnosing periapical lesions - disagreement and borderline cases

• Published in: International endodontic journal Vol. 35; no. 8; pp. 703 - 709
• Main Authors: Halse, A., Molven, O., Fristad, I.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.08.2002
• Subjects: Alveolar Bone Loss - diagnostic imaging; Alveolar Process - diagnostic imaging; borderline cases; Consensus; Dentistry; Diagnosis, Differential; Furcation Defects - diagnostic imaging; Humans; Observer Variation; oral radiology; Osteitis - diagnostic imaging; periapical disease; Periapical Periodontitis - diagnostic imaging; Periodontal Ligament - diagnostic imaging; Radiography
• ISSN: 0143-2885; 1365-2591
• DOI: 10.1046/j.1365-2591.2002.00552.x

The aim of this paper is to present a selection of disagreement and borderline cases from a methodological study on the radiographic diagnosis of periapical disease. Thirty-two roots, 12% of the material in an earlier study, were subjected to joint discussion because of diagnostic problems. The aim was consensus. Six cases representing different teeth/roots illustrating typical problems are presented. The varying morphology of apical areas and varying density of surrounding bone present a number of challenges. Even so, the joint discussion resulted in an agreement for all the cases. Twenty-five diagnoses were established and seven cases were not diagnosed owing to substandard radiographs. A detailed analysis of the periodontal ligament space, the lamina dura, trabecular pattern and bone marrow spaces is mandatory for the radiographic diagnosis of periapical disease