Radiology Case Reports (Dec 2021)

Multiple periapical dysplasias analyzed by cone-beam-computer tomography and 99Tcm-Scintigraphy.

  • Manfred Nilius, MD DDS,
  • Minou Nilius, MD,
  • Charlotte Müller, DMD,
  • Henry Leonhardt, MD DMD,
  • Dominik Haim, MD DMD,
  • Patrick Novak, DMD,
  • Adrian Franke,
  • Bernhard Weiland, MD,
  • Guenter Lauer, PhD

Journal volume & issue
Vol. 16, no. 12
pp. 3757 – 3765

Abstract

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Periapical cemental dysplasia (PCD) is considered a non-neoplastic proliferation of fibrous tissues and cementum-like hard tissues, usually occurring in the periapical regions of teeth. PCD is characterized by the presence of vital pulp and is often accidentally discovered during a general radiographic survey. PCD may arise from the tissue of odontogenic origin or occur as a reactive process in the periapical tissue. Multilocular occurrences in both jaws are rare. However, we encountered a case of multiple PCDs by orthopantomography, which showed different degrees of maturation in the mandible and maxilla by osteodensitometric detection via cone-beam computed tomography (CB-CT) validated by Tc-99m bone-scintigraphy (BS). Biopsies confirmed the radiological results. CB-CT osteodensitometry allows for the categorization and assessment of different stages of PCD maturation from beginning to florid, detection of remittent osseous changes, and evaluation in the clinical follow-up. When using the local cortical bone as a reference value of 100%, periapical dysplasias show density values of 75% in the mandible and 80% in the maxilla. Early classification of PCD is possible with CB-CT osteodensitometry.

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