Idiopathic osteosclerosis

Idiopathic osteosclerosis

Idiopathic osteosclerosis is a condition which may be found around the roots of a tooth. It is usually painless and found during routine radiographs. It appears as a radiopaque (light area) around a tooth, usually a premolar or molar. There is no sign of inflammation of the tooth.

Presentation

Focal radiodensity of the jaw which is NOT inflammatory, dysplastic, neoplastic or a manifestation of a systemic disease. This is common and affects 5% of the population, usually seen in teens and those in their 20s. Typically asymptomatic and is an incidental finding on a radiograph. found anywhere in the jaw, most commonly in the mandibular premolar-molar region. The shape ranges from round to linear streaks to occasional angular forms.

Cause

A reaction to past trauma or infection but it's difficult to rule out in some cases.

Diagnosis

Usual diagnosis is via radiograph, patient history, biopsy is rarely needed. Periodic follow ups should included additional radiographs that show minimal growth or regression.

Radiology

Well defined, rounded or triangular radiodensity, that is uniformly opaque. There is no lucent component. Found near the root apex or in the inter-radicular area. Root resorption and tooth movement are rare.

Differential Diagnosis

Condensing osteitis, sclerosing osteomyelitis, cementoblastoma, hypercementosis, Exostoses (tori). Condensing osteitis may resemble idiopathic osteosclerosis, however, associated teeth are always nonvital in condensing osteitis.

Treatment

No treatment is necessary.

References

• Kahn, Michael A. Basic Oral and Maxillofacial Pathology. Volume 1. 2001.