Condensing osteitis

Last updated
Condensing osteitis
Other namesfocal sclerosing osteomyelitis
Jaw lesions - Condensing osteitis - Cone beam CT.jpg
Cone beam CT scan presenting a diffuse hyperdense lesion in the apex of a mandibular molar (arrowhead, top) adjacent to an inflammatory periapical lesion (arrow, bottom). [1]
Specialty Dentistry

Condensing osteitis is a periapical inflammatory disease that results from a reaction to a dental related infection. This causes more bone production rather than bone destruction in the area (most common site is near the root apices of premolars and molars). The lesion appears as a radiopacity in the periapical area hence the sclerotic reaction. The sclerotic reaction results from good patient immunity and a low degree of virulence of the offending bacteria. The associated tooth may be carious or contains a large restoration, and is usually associated with a non-vital tooth. It was described by Dr. Carl Garré in 1893.

Contents

Cause

Infection of periapical tissues of a high immunity host by organisms of low virulence which leads to a localized bony reaction to a low grade inflammatory stimulus.

Diagnosis

Differential diagnosis

Treatment

The process is usually asymptomatic and benign, in most cases the tooth will require root canal treatment. endodontic treatment.

The offending tooth should be tested for vitality of the pulp, if inflamed or necrotic, then endodontic treatment is required as soon as possible, while hopeless teeth should be extracted.

Prognosis

The prognosis is excellent, once root canal treatment is completed. If the offending tooth is extracted, the area of condensing osteitis may remain in the jaws indefinitely, which is termed osteosclerosis or bone scar.

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Periapical granuloma, also sometimes referred to as a radicular granuloma or apical granuloma, is an inflammation at the tip of a dead (nonvital) tooth. It is a lesion or mass that typically starts out as an epithelial lined cyst, and undergoes an inward curvature that results in inflammation of granulation tissue at the root tips of a dead tooth. This is usually due to dental caries or a bacterial infection of the dental pulp. Periapical granuloma is an infrequent disorder that has an occurrence rate between 9.3 to 87.1 percent. Periapical granuloma is not a true granuloma due to the fact that it does not contain granulomatous inflammation; however, periapical granuloma is a common term used.

References

  1. Silva, Brunno Santos Freitas; Bueno, Mike Reis; Yamamoto-Silva, Fernanda P.; Gomez, Ricardo Santiago; Peters, Ove Andreas; Estrela, Carlos (2017-07-03). "Differential diagnosis and clinical management of periapical radiopaque/hyperdense jaw lesions". Brazilian Oral Research. 31: e52. doi: 10.1590/1807-3107BOR-2017.vol31.0052 . PMID   28678971.