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Abstract
Radiographic findings of enostosis often resemble those of focal condensing osteomyelitis of inflammatory origin, and the location and state of these lesions cannot be precisely diagnosed using rotational panoramic radiography. Consequently, a differential diagnosis approach is required. This study examined the situation and characteristics of mandibular enostosis using limited cone-beam computed tomography (CBCT) in comparison with rotational panoramic radiography.
Forty-four radiopaque lesions were examined on rotational panoramic radiography and CBCT. The lesions were diagnosed as enostosis from radiographic features on CBCT that had been performed for other clinical diagnoses or dental treatments. For each lesion, the site, margin, density, and relationship to tooth roots were determined on rotational panoramic radiography, and the shape of the cortical bone was determined on CBCT.
Enostosis occurred in the premolar region of the mandible in 25 cases (57%) and displayed numerous patterns of relationships to adjacent teeth on rotational panoramic radiography. All lesions displayed an ovoid external form on rotational panoramic radiography. On CBCT, enostosis arose from buccal cortical bone in 13 cases and from lingual cortical bone in 25 cases; a lingual origin was suspected in the remaining six cases. The periodontal ligament space of adjacent teeth near the lesion was clearly apparent on both rotational panoramic radiography and CBCT.
Rotational panoramic radiography and occlusal radiography cannot diagnose exactly the location and state of enostosis. The diagnosis of enostosis can be difficult for lesions influenced by secondary infection in the roots of surrounding teeth; diagnosis in these cases may be facilitated by clarifying the manifestation involving the periodontal ligament space of adjacent teeth and confirming bone thickening arising from the inner surface of cortical bone.[PUBLICATION ABSTRACT]