Radiopaque jaw lesions

Radiopaque lesions of the jaw

Radiopaque lesion or area found on an x-ray? What is it? I’m going to slowly update with more interesting finds. Be aware most of these are bet guesses and not biopsy confirmed, as most do not warrant that. We have a post for radiolucent lesions on panos as well with much of the same information.

An unknown radiopaque area or lesion is a regular find in dentistry.

So what is the calcification that you found on the pano? Typically you can decide by location what the calcification is, but this is not always the case. I have found the following diagram very helpful.

Is there a calcification found on pano?


An antrolith is a calcified mass in the maxillary sinus.

Maxillary antrolith is a calcified mass within the sinus

Idiopathic osteosclerosis or dense bone island DBI

The cause and classification of these is controversial. Biopsy is not necessary unless large changes occur. 25% growth in 6 months or 50% in one year according to Mariani 2009 Oral Implant.

This guy has an amazing website with tons of information on all sorts of pathology.

Idiopathic osteosclerosis defintion table

Idiopathic osteosclerosis around teeth numbers 29 and 30.

Idiopathic osteosclerosis is the working diagnosis of this radiopaque jaw lesion.

Dense bone island DBI CBCT showing the outlines of the bone.

CT of a dense bone island.

Idiopathic osteosclerosis can cause root resorption.

Although rare idiopathic osteosclerosis can cause root resorption over time. Sisman 2010 Eur J Dent

Condensing osteitis

Condensing osteitis from a necrotic tooth.

Condensing osteitis from a tooth that is necrotic.



Ligature clips or staples can be seen in the neck region of panos

Ligature clips from patient with cancer history

Ligature clips from surgery



A radioopaque pano showing tonsils with tonsilloliths.

Pano of many tonsilloliths

Appears to be a lot of diffuse tonsilloliths

Giant tonsillolith with a ghost image seen on the opposite side.

Giant tonsillolith with a ghost image seen on the opposite side.




Sialoliths are present in .1-1% of the population although I think that is a very high number. 94% are in the submandibular gland, 5% in parotid and rest in sublingual and minor glands. Pinheiro 2021 Gen Dent

A very large submanidbular sialolith was removed.

Huge sialolith with ghost image on opposite side.

Huge sialolith with ghost image on opposite side. Brooks AGD Nov 2020



Image of idopathic osteosclerosis

Clinically and radiographically consistent with idiopathic osteosclerosis

Calcified lymph nodes

Calcified lymph nodes on a pano.

Radiopaque foreign body in pano

This one is a gun shot wound patient (GSW). It’s actually just a pellet from a college incident of boys screwing around.

Gun show wound pano

Pellet is still in sinus

This one is the back to an ear ring. She is 12 and there is no memory of doing this. It was not visible in pano so never found until and orthodontic scan was done.


Surgical ligation clips

These pop up on panos. Usually will see a lot of them and they are on only one side in comparison to the next category which is on both sides.

Surgical ligature clips show in a dental pano.

Susuk charm needles

Will be in south east Asian women most likely. Put in place for health or beauty beliefs. Will likely be symmetrical to some degree, unlike surgical ligation clips.

Hundreds of metallic linear susuk charm needles in a south east Asian women's pano.

More landmarks on a pano.


If you are looking for radiolucent lesions check out that blog.

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