A periapical lesion, not always an inflammation. Overprojection of non-neoplastic pathology
A radiolucency, radiopacity or mixed lesion, identified on a radiograph is usually the result of an inflammation of endodontic origin. However, a periapical lesion is sometimes caused by primary bone pathology, predominantly manifesting at the apices of the teeth. Various intraosseous lesions can be projected across the apices, creating the impression of a causal relation with these teeth. An incorrect diagnosis can lead to 1 or more endodontic treatments being carried out unjustifiably. A thorough and detailed anamnesis, a complete extra- and intraoral examination, and a careful examination of the radiological imaging will result in a correct diagnosis in most cases. Knowledge of the differential diagnosis of periapical lesions is essential. This article focuses on apparent periapical radiolucencies caused by overprojection of non-neoplastic pathology.