Download PDF
Semin Musculoskelet Radiol 2020; 24(05): 558-569
DOI: 10.1055/s-0039-3402766
Review Article

Imaging of Mixed and Radiopaque Jaw Lesions

Filip M. Vanhoenacker
1   Department of Radiology, Antwerp University Hospital, Edegem, Belgium
2   Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium
3   Department of Radiology, Ghent University Hospital, Ghent, Belgium
,
Frederik Bosmans
1   Department of Radiology, Antwerp University Hospital, Edegem, Belgium
2   Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium
,
Charlotte Vanhoenacker
4   Department of Radiology, University Hospitals Leuven, Leuven, Belgium
,
Anja Bernaerts
5   Department of Radiology, GZA Hospitals, Antwerp, Belgium
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Radiopaque lesions and lesions of mixed density are less frequent than radiolucent lesions of the jawbones. They comprise a spectrum of odontogenic and non-odontogenic lesions. The latter group includes inherited and developmental disorders, osteomyelitis, and benign and malignant primary bone tumors and metastases. Most odontogenic radiopaque or mixed lesions are either related to the apex or more rarely to the crown of the tooth, although there are exceptions to this rule. Some lesions, such as a torus mandibularis and torus palatinus, have a characteristic location, whereas others show no relationship to the dentition. This article describes the most characteristic and prevalent radiopaque and mixed lesions of the jaws and their imaging characteristics. Paget's disease, fibrous dysplasia, and rare sclerotic bone diseases of the maxillofacial bones are discussed elsewhere in this issue. Careful correlation of clinical presentation, panoramic radiographs, cone beam computed tomography, and histopathology are the cornerstones for appropriate lesion characterization.

Keywords

jaws - tumor and tumor-like lesions - increased bone density - cone beam computed tomography - imaging

Supplementary Material



Publication History

Article published online:
09 October 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

 

  • References

  • 1 Dunfee BL, Sakai O, Pistey R, Gohel A. Radiologic and pathologic characteristics of benign and malignant lesions of the mandible. Radiographics 2006; 26 (06) 1751-1768
    CrossrefPubMedGoogle Scholar
  • 2 Bernaerts A, Vanhoenacker FM, Hintjens J. et al. Tumors and tumor-like lesions of the jaw mixed and radiopaque lesions. JBR-BTR 2006; 89 (02) 91-99
    PubMedGoogle Scholar
  • 3 Harmon M, Arrigan M, Toner M, O'Keeffe SA. A radiological approach to benign and malignant lesions of the mandible. Clin Radiol 2015; 70 (04) 335-350
    CrossrefPubMedGoogle Scholar
  • 4 Curé JK, Vattoth S, Shah R. Radiopaque jaw lesions: an approach to the differential diagnosis. Radiographics 2012; 32 (07) 1909-1925
    CrossrefPubMedGoogle Scholar
  • 5 More C, Thakkar K, Asrani M. Cemento-ossifying fibroma. Indian J Dent Res 2011; 22 (02) 352-355
    CrossrefPubMedGoogle Scholar
  • 6 Trijolet J-P, Parmentier J, Sury F, Goga D, Mejean N, Laure B. Cemento-ossifying fibroma of the mandible. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 128 (01) 30-33
    CrossrefPubMedGoogle Scholar
  • 7 Liu Y, Wang H, You M. et al. Ossifying fibromas of the jaw bone: 20 cases. Dentomaxillofac Radiol 2010; 39 (01) 57-63
    CrossrefPubMedGoogle Scholar
  • 8 MacDonald-Jankowski DS. Ossifying fibroma: a systematic review. Dentomaxillofac Radiol 2009; 38 (08) 495-513
    CrossrefPubMedGoogle Scholar
  • 9 Sontakke SA, Karjodkar FR, Umarji HR. Computed tomographic features of fibrous dysplasia of maxillofacial region. Imaging Sci Dent 2011; 41 (01) 23-28
    CrossrefPubMedGoogle Scholar
  • 10 Weber AL. Imaging of cysts and odontogenic tumors of the jaw. Definition and classification. Radiol Clin North Am 1993; 31 (01) 101-120
    CrossrefPubMedGoogle Scholar
  • 11 Fenerty S, Shaw W, Verma R. et al. Florid cemento-osseous dysplasia: review of an uncommon fibro-osseous lesion of the jaw with important clinical implications. Skeletal Radiol 2017; 46 (05) 581-590
    CrossrefPubMedGoogle Scholar
  • 12 Gonçalves M, Píspico R, Alves Fde A, Lugão CEB, Gonçalves A. Clinical, radiographic, biochemical and histological findings of florid cemento-osseous dysplasia and report of a case. Braz Dent J 2005; 16 (03) 247-250
    CrossrefPubMedGoogle Scholar
  • 13 Eldaya R, Eissa O, Herrmann S, Pham J, Calle S, Ribe T. Mandibular lesions: a practical approach for diagnosis based on multimodality imaging findings. Contemp Diagnost Radiol 2017; 40 (06) 1-8
    CrossrefPubMedGoogle Scholar
  • 14 Singer SR, Mupparapu M, Rinaggio J. Clinical and radiographic features of chronic monostotic fibrous dysplasia of the mandible. J Can Dent Assoc 2004; 70 (08) 548-552
    PubMedGoogle Scholar
  • 15 Neyaz Z, Gadodia A, Gamanagatti S, Mukhopadhyay S. Radiographical approach to jaw lesions. Singapore Med J 2008; 49 (02) 165-176 ; quiz 177
    PubMedGoogle Scholar
  • 16 de Oliveira BH, Campos V, Marçal S. Compound odontoma—diagnosis and treatment: three case reports. Pediatr Dent 2001; 23 (02) 151-157
    PubMedGoogle Scholar
  • 17 Chapman MN, Nadgir RN, Akman AS. et al. Periapical lucency around the tooth: radiologic evaluation and differential diagnosis. Radiographics 2013; 33 (01) E15-E32
    CrossrefPubMedGoogle Scholar
  • 18 Eversole R, Su L, ElMofty S. Benign fibro-osseous lesions of the craniofacial complex. A review. Head Neck Pathol 2008; 2 (03) 177-202
    CrossrefPubMedGoogle Scholar
  • 19 Scholl RJ, Kellett HM, Neumann DP, Lurie AG. Cysts and cystic lesions of the mandible: clinical and radiologic-histopathologic review. Radiographics 1999; 19 (05) 1107-1124
    CrossrefPubMedGoogle Scholar
  • 20 Gupta M, Kaste SC, Hopkins KP. Radiologic appearance of primary jaw lesions in children. Pediatr Radiol 2002; 32 (03) 153-168
    CrossrefPubMedGoogle Scholar
  • 21 Wright JM, Soluk Tekkeşin M. Odontogenic tumors: where are we in 2017?. J Istanb Univ Fac Dent 2017; 51 (03) (Suppl. 01) S10-S30
    PubMedGoogle Scholar
  • 22 Kaneda T, Minami M, Kurabayashi T. Benign odontogenic tumors of the mandible and maxilla. Neuroimaging Clin N Am 2003; 13 (03) 495-507
    CrossrefPubMedGoogle Scholar
  • 23 Kaplan I, Buchner A, Calderon S, Kaffe I. Radiological and clinical features of calcifying epithelial odontogenic tumour. Dentomaxillofac Radiol 2001; 30 (01) 22-28
    CrossrefPubMedGoogle Scholar
  • 24 More CB, Vijayvargiya R. Intraosseous calcifying epithelial odontogenic (Pindborg) tumor: A rare entity. J Oral Maxillofac Pathol 2015; 19 (02) 269
    CrossrefPubMedGoogle Scholar
  • 25 Garcia Garcia B, Ruiz Masera JJ, Zafra Camacho FM, Centella Gutierrez C. Intraosseous dentinogenic ghost cell tumor: Case report and treatment review. Rev Esp Cir Oral Maxilofac 2015; 37 (04) 243-246
    CrossrefPubMedGoogle Scholar
  • 26 Li BB, Gao Y. Ghost cell odontogenic carcinoma transformed from a dentinogenic ghost cell tumor of maxilla after multiple recurrences. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107 (05) 691-695
    CrossrefPubMedGoogle Scholar
  • 27 Agrawal Y, Naidu GS, Makkad RS. et al. Dentinogenic ghost cell tumor—a rare case report with review of literature. Quant Imaging Med Surg 2017; 7 (05) 598-604
    CrossrefPubMedGoogle Scholar
  • 28 Hoff AO, Toth B, Hu M, Hortobagyi GN, Gagel RF. Epidemiology and risk factors for osteonecrosis of the jaw in cancer patients. Ann N Y Acad Sci 2011; 1218 (01) 47-54
    CrossrefPubMedGoogle Scholar
  • 29 Özgür A, Kara E, Arpacı R. et al. Nonodontogenic mandibular lesions: differentiation based on CT attenuation. Diagn Interv Radiol 2014; 20 (06) 475-480
    CrossrefPubMedGoogle Scholar
  • 30 Deshpande SS, Thakur MH, Dholam K, Mahajan A, Arya S, Juvekar S. Osteoradionecrosis of the mandible: through a radiologist's eyes. Clin Radiol 2015; 70 (02) 197-205
    CrossrefPubMedGoogle Scholar
  • 31 Hermans R, Fossion E, Ioannides C, Van den Bogaert W, Ghekiere J, Baert AL. CT findings in osteoradionecrosis of the mandible. Skeletal Radiol 1996; 25 (01) 31-36
    CrossrefPubMedGoogle Scholar
  • 32 Hermans R. Imaging of mandibular osteoradionecrosis. Neuroimaging Clin N Am 2003; 13 (03) 597-604
    CrossrefPubMedGoogle Scholar
  • 33 Avril L, Lombardi T, Ailianou A. et al. Radiolucent lesions of the mandible: a pattern-based approach to diagnosis. Insights Imaging 2014; 5 (01) 85-101
    CrossrefPubMedGoogle Scholar
  • 34 Tsuchimochi M, Kurabayashi T. Symposium: Imaging modalities for drug-related osteonecrosis of the jaw (1), role of imaging in drug-related osteonecrosis of the jaw: an up-to-date review (secondary publication). Jpn Dent Sci Rev 2019; 55 (01) 1-4
    CrossrefPubMedGoogle Scholar
  • 35 Mohan Choontharu M, Ahmad Buch S, Subhas Babu G. et al. A rare clinical presentation of an osteochondroma of coronoid process of mandible. J Dent (Shiraz) 2018; 19 (04) 325-330
    PubMedGoogle Scholar
  • 36 Navaneetham A, Rao KA, Kumaran S, Baweja HH. A unique case of multiple osteochondroma: mandibular symphysis and femur. Ann Maxillofac Surg 2012; 2 (02) 182-184
    CrossrefPubMedGoogle Scholar
  • 37 Vanhoenacker FM, Van Hul W, Wuyts W, Willems PJ, De Schepper AM. Hereditary multiple exostoses: from genetics to clinical syndrome and complications. Eur J Radiol 2001; 40 (03) 208-217
    CrossrefPubMedGoogle Scholar
  • 38 Kumar G, Manjunatha B. Metastatic tumors to the jaws and oral cavity. J Oral Maxillofac Pathol 2013; 17 (01) 71-75
    CrossrefPubMedGoogle Scholar
  • 39 Muttagi SS, Chaturvedi P, D'Cruz A. et al. Metastatic tumors to the jaw bones: retrospective analysis from an Indian tertiary referral center. Indian J Cancer 2011; 48 (02) 234-239
    CrossrefPubMedGoogle Scholar
  • 40 Theodorou DJ, Theodorou SJ, Sartoris DJ. Primary non-odontogenic tumors of the jawbones: an overview of essential radiographic findings. Clin Imaging 2003; 27 (01) 59-70
    CrossrefPubMedGoogle Scholar
  • 41 Vanhoenacker FM, Camerlinck M, De Vuyst D, Chapelle K. Osteosarcoma of the maxilla. JBR-BTR 2012; 95 (03) 168-169
    PubMedGoogle Scholar
  • 42 Singh A, Solomon MC. Osteoid osteoma of the mandible: a case report with review of the literature. J Dent Sci 2017; 12 (02) 185-189
    CrossrefPubMedGoogle Scholar
  • 43 Uchiyama Y, Akiyama H, Murakami S. et al. Calcifying cystic odontogenic tumour: CT imaging. Br J Radiol 2012; 85 (1013): 548-554
    CrossrefPubMedGoogle Scholar
  • 44 Sonone A, Sabane VS, Desai R. Calcifying ghost cell odontogenic cyst: report of a case and review of literature. Case Rep Dent 2011; 2011: 328743
    PubMedGoogle Scholar