Radiolucency on pano

What is that radiolucency on your pano?

Radiolucency on pano? What is it? I’m going to slowly update with more interesting finds. We also have a post with radio-opaque lesions on a pano with much of the same information.

A radiolucency found on pano is a regular finding in dentistry.

So what is the radiolucency that you found on the pano? Typically you can decide by location what the lesion is, but this is not always the case. Many need a biopsy

 

Radiolucency on pano – Dentigerous cysts

Dentigerous cysts, while being benign, can be very damaging because they continue to quietly grow and destroy bone. The surgery can be tricky as well as the tooth can be displaced to areas far from where it began, as seen below with tooth number 1.

Dentigerous cyst displacing a wisdom tooth.

 

Radiolucent lesion consistent with a dentigerous cyst
Radiolucent lesion consistent with a dentigerous cyst on a CBCT

Stafne bone cyst

Pano showing a stafne bone cyst

Radiolucency on pano – Benign simple bone cyst

Pano of radiolucent simple bone cyst
Pano of radiolucent lesion and biopsy shows lesion is a benign simple bone cyst.

Radiolucency on pano – Pneumatized articular eminence

A pneumatized articular eminence presents as a multilocular radiolucency above the condyle. The red arrow with a #2 under it points to the pneumatized articular eminence. In this particular pano you can see a large section of the mastoid cells of the temporal bone as well, which have a red arrow and a number one under them.

An interesting study on the pneumatization of several skeletal bones and a better example of the pneumatized articular eminence are a few interesting things I was able to locate online. Prevalence is found to be 1-3% according to pano studies but up to 8% in a CT study.

Periapical lesion

These are commonly seen by dentists. This is the largest we have seen in our practice.

CBCT of a large periapical lesion.

Gubernaculum dentis

The gubernaculum dentis is a channel of connective tissue connecting the dental lamina of an unerupted tooth to the lamina propria of the overlying gingivae at the site of normal eruption of the tooth.

CBCT of a gubernaculum dentis.

Dentigerous cyst impacting the IAN or a gubernaculum dentis
Gubernaculum dentis or dentigerous cyst?

Nutrient canal

PA of nutrient canals in the lower anterior.

Widened pdl can mean several things.

It can just be periodontal disease. It can be from scleroderma. It can also be oral leukemic infiltration as seen in Al-Sabbagh JADA 2023. All of these are systemic conditions that may or may not need local treatment.

Oral leukemic infiltration in the periodontal ligament.
Oral leukemic infiltration in the periodontal ligament can look like normal periodontal disease and/or apical radiolucencies.

Multilocular lesions of the jaw bone

 

Myospherulosis

Rare lesion when someone packs petroleum product into socket.

Floss abrasion

Floss abrasion occurs on teeth from overly aggressive and improper flossing technique. Similar damage can be done by an aggressive hygienist as seen in the SRP blog that links to a DT case.

Floss abrasion from overly aggressive flossing.

Some pano labels and a great blog with lots of labels.