Single Tooth Replacement Using Immediately Loaded Basal Implant-Supported Fixed Prosthesis in a Hyperdense Lesion: A Case Report.

Osseous modifications in the periapical areas are related to chronic endodontic infections. Often, teeth with periapical infections and hopeless prognosis are removed and replaced with dental implants. In this clinical report, a patient with a radiopaque lesion on the root apex of the mandibular right first molar root is presented. Bone- and tissue-borne lesions were the differential diagnoses for the radiopaque mass. Based on the clinical and radiological characteristics, condensing osteitis (CO) was the final diagnosis of osseous growth (bone density and trabeculation of the bone). Under local anesthesia, tooth 46 was atraumatically extracted, and the immediate basal implant was placed. This case report investigated the effectiveness and safety of dental implantation in the vicinity of hyperdense lesions.

Idiopathic Osteosclerosis and Condensing Osteitis in a Sample of the Lebanese Population: A Digital Panoramic Based Study.

Background: Idiopathic osteosclerosis (IO) is an area of enlarged bone production in the jaw that usually appears radiopaque and round, elliptical, or irregular in shape. Condensing osteitis (CO) is a focalized osseous reaction leading to periapical sclerotic bone growth. Objective: The aim of this study was to investigate the prevalence, localization, shape, and dental relationship of IO and CO in a group of Lebanese patients and to correlate these findings to age and gender. Methods: 520 digital panoramic radiographs of patients (215 men and 305 women) ranging in age from 18 to 77 (mean age 40.89 years) who visited the Faculty of Dental Medicine, Lebanese University, for dental treatment were included in this study and assessed for IO and CO. The prevalence of the two lesions according to gender and age, as well as their localization, and dental relationship, were recorded and saved in an Excel sheet. Results: Among the 520 radiographs, 47 (9%) showed IO, and 30 (5.8%) showed CO. Both lesions are more frequent among females in their third decade and are essentially found in the mandible, mainly in relation to the root apices. Conclusion: Within the limits of this study, we concluded that in our sample of the Lebanese population, the prevalence of IO and CO is low and supports the theory that IO can be defined as developmental variations of normal bony architecture unrelated to a local stimulant, and CO could be considered reactive bone formations related to pulpitis, deep restoration, or caries.

Efficiency and Safety of Dental Implantation in the Area of Hyperdense Jaw Lesions: A Narrative Review.

BACKGROUND: Mineralized lesions of the jaws are often found incidentally on radiographs and computed tomography. Most of them are benign, and only a few rare cases are associated with malignant transformation. However, there is little clinical data on successful rehabilitation with implants in patients with mineralized lesions. This narrative review aimed to study the efficiency and safety of dental implantation in the area of hyperdense lesions. MATERIALS AND METHODS: A PubMed, Google Scholar, and Science Direct database search was carried out with keywords and manually. RESULTS: The literature exploration identified 323 articles; only 19 of them matched the search criteria and reported cases about dental implantation in the lesion area. It has been shown that in 84.2% of described cases, dental implantation was successful: in the osteoid osteoma, odontoma, cementoblastoma, idiopathic osteosclerosis, and condensing osteitis areas dental implantation was performed without any complications. The possibility of lesion recurrence and implant failure limited the use of dental implants in the area of osteoblastoma and cemento-osseous dysplasia. Although most cases of dental implantation in hyperdense jaw lesions were successful and were not accompanied by complications, further research is needed.

Sclerosis of the clavicle--A challenging diagnosis.

Condensing osteitis of the clavicle is a rare benign disease described as an increase in bone density at the medial end of the clavicle. Its clinical and radiographic presentation can frequently be equivocal and tissue sampling is necessary for diagnostic confirmation. Here we present the case of a 29-year-old female with condensing osteitis of the right medical clavicle, who remained undiagnosed for many years despite obtaining imaging studies and undergoing an initial biopsy. This disease presents oftentimes a challenging diagnosis due to its imaging features overlapping with many benign and malignant bone lesions. A qualified multidisciplinary team with expertise in rare bone conditions becomes oftentimes essential to arrive at an accurate diagnosis.

Prevalence and Pattern of Idiopathic Osteosclerosis and Condensing Osteitis in a Saudi Subpopulation.

Background This study aims to investigate the prevalence and pattern of idiopathic osteosclerosis (IO) and condensing osteitis (CO) in the jaws of a Saudi Arabian subpopulation with regards to gender, age, shape, localization, and tooth relationship. Methodology Digital panoramic and periapical radiographs with clinical data of 1,000 patients at King Abdulaziz University Dental Hospital were analyzed to determine the incidence of IO and CO lesions in relation to age, gender, location in the jaws, and dental status of the associated tooth. Descriptive statistics and chi-square tests were used for data analysis. Results Out of the 752 patients (495 females, 257 males), IO was identified in 66 (8.8%) patients, while 44 (5.9%) patients had CO. IO occurred more in females (68.2%) than males (31.8%). CO had a statistically significant higher rate of occurrence in females (81.8%) than males (18.2%) (P ≤ 0.05). IO and CO lesions were observed to be higher in individuals in their third decade, and 100% were in the mandibular molar area. Almost half of the identified IO (48.5%) had a rounded shape radiopacity, while CO mostly appeared irregular (63.6%). Conclusions The prevalence of IO and CO in the studied Saudi subpopulation was low. Both lesions were more frequent in females in their third decade and were primarily found in the mandibular molar region.

Implant Treatment for a Patient With Large Condensing Osteitis: Case Report.

Chronic endodontic infections are associated with osseous changes in the peri-apical regions. Dental implants are often placed after the extraction of hopeless teeth with periapical infections. This clinical report describes a patient with a radiopaque mass attached to the root apex of the mandibular right second premolar tooth (No. 45). The differential diagnoses of the radiopaque mass were bone- and tissue-borne diseases. Based on the clinical and radiologic findings (bone density and trabeculation of the bone), the definitive diagnosis of the osseous mass was condensing osteitis. The osseous tumor associated with tooth 45 was atraumatically extracted under local anesthesia. Guided bone regeneration was performed immediately after extraction of tooth 45, and a dental implant was placed in the site after 6 months of healing.

Tratamiento de la osteítis condensante en molar: informe de caso / Molar condensing osteitis treatment: Case report

En la actualidad, la principal causa por la que acuden los pacientes al odontólogo es el dolor dental, endonde la mayoría presenta un padecimiento pulpar o periapical irreversibles, que pueden estar asociados a factores traumáticos e irritativos. Sin embargo, pocosde ellos son asintomáticos, como la osteítis condensante que es escasamente mencionada en elámbito de la Endodoncia; por lo tanto, el objetivo de este caso clínico es el de proporcionar información acerca de la osteítis condensante siguiendo los lineamientos internacionales de Case Report (CARE). La osteítis condensante tiene una incidencia muy baja en pacientes y se debe diagnosticar correctamente al momento de tratar este tipo de lesiones con las diferentes herramientas de diagnóstico que se conocen. En este caso, se presenta un paciente del sexo femenino de 58 años de edad con un estado prediabético, que refiere un fractura del segundo molar inferior derecho, al cual radiográficamente se le encontróuna lesión periapical radiopaca en la raíz distal. Se muestra la secuencia del tratamiento, el manejo clínico y la rehabilitación.

At present, the main reason for patients to visit adentist is dental pain, where most of them presenta pulp or periapical irreversible condition, whichmay be associated with traumatic and irritative factors. However, few of them are asymptomatic as osteitiscondensing that is barely mentioned in thefield of endodontics. The aim of this case report isto provide information about the condensing osteitisfollowing international Case Report (CARE)guidelines. Condensing osteitis has a very low incidence in patients and should be correctly diagnosed with the different available diagnostic tools. In thiscase a 58-years-old female patient, with prediabeticstate, referred of a right lower second molar fracturewhich radiographically showed a radiopaque periapicallesion in the distal root of the molar. The sequence of treatment, clinical management and rehabilitation is presented.

Frequency and pattern of idiopathic osteosclerosis and condensing osteitis lesions in panoramic radiography of Iranian patients.

BACKGROUND: The purpose of this study was to investigate of radiographic pattern and relative frequency of idiopathic osteosclerosis (IO) and condensing osteitis (CO) in panoramic radiographs. MATERIALS AND METHODS: Totally 411 panoramic radiographies were randomly selected from patients referred to Radiology Department of Faculty of Dentistry, Tabriz University of Medical Sciences. Descriptive characteristics of radiopacities, including shape, border, localization, and dental relationship, were recorded. The Chi-squared test was used. RESULTS: IO was detected in 31 (7.5%) patients and 22 (68.8%) lesions had exact border while their shape was mostly irregular. About 17 (53.1%) lesions were apical, and 13 (40.6%) lesions had no relation to the teeth. The most involved teeth were the second premolar (28.1%) and first molar (25%). Moreover, CO was detected in 32 (7.8%) patients. 17 (53.1%) lesions had an ill-defined border, and their shape was mostly irregular (65.6%) with ill-defined border. Around 18 (56.3%) lesions were apical, and 11 (34.4) lesions were apical and interradicular. The most involved teeth were the second premolar (59.4%) and the first molar (21.9%). CONCLUSION: The results demonstrated that relative frequency of IO in the selected population was 7.5% and for CO, it was 7.8%.

Condensing osteitis of the clavicle in children.

AIM: To confirm the rarity of this disorder and then to evaluate the effects of antibiotic treatment alone and assess whether this could produce a complete remission of symptoms in children and adolescents. METHODS: We made a retrospective review of all cases of condensing osteitis of the clavicle in children and adolescents between January 2007 and January 2016. Outpatient and inpatient medical records, with radiographs, magnetic resonance imaging, triphasic bone scan and computed tomography scans were retrospectively reviewed. All the patients underwent biopsy of the affected clavicle and were treated with intra venous (IV) antibiotics followed by oral antibiotics. RESULTS: Seven cases of condensing osteitis of the clavicle were identified. All the patients presented with swelling of the medial end of the clavicle, and 5 out of 7 reported persisting pain. The patients' mean age at presentation was 11.5 years (range 10.5-13). Biopsy confirmed the diagnosis in all cases. All the patients completed the treatment with IV and oral antibiotics. At last follow-up visit none of the patients complained of residual pain; all had a clinically evident reduction in the swelling of the medial end of the affected clavicle. The mean follow-up was 4 years (range 2-7). CONCLUSION: Our findings show that condensing osteitis of the clavicle is a rare condition. Biopsy is needed to confirm diagnosis. The condition should be managed with IV and oral antibiotics. Aggressive surgery should be avoided.

Asymptomatic, nonexpansile radiopacity of the jaw associated with external root resorption: a diagnostic dilemma.

Incidental radiopacities of the jaws are commonly identified on routine intraoral and extraoral radiographs. Dentists should be able to develop a differential diagnosis of these lesions. This article presents 2 cases in which mandibular radiopacities associated with external root resorption were identified incidentally and discusses the differential diagnosis of these lesions. Both patients were referred by their general practitioners to dental specialists for further evaluation of homogenous osteosclerotic foci surrounding and resorbing the roots of the permanent mandibular right first molar. The lesions were asymptomatic, caused no cortical expansion, and were static over time. The clinical and radiographic features were consistent with a diagnosis of idiopathic osteosclerosis (IO). External root resorption is present in 10%-12% of cases of IO and often involves the permanent mandibular first molars.

Histologic examination of condensing osteitis in cadaver specimens.

OBJECTIVES: Condensing osteitis is a radiographic finding, but with no reported histologic investigations in humans. The objectives of this study were to evaluate and describe histologically condensing osteitis in human cadaver jaws. Patterns of bone formation and presence/absence and nature of inflammation were examined. METHODS: Specimens of mandibles and maxillas were obtained from cadavers and examined radiographically. Those periapical areas with characteristics of condensing osteitis were removed en bloc, decalcified, and processed for light microscopy. For comparison, specimens that showed normal apical radiographic anatomy were also removed for examination. RESULTS: Normal apical regions showed an intact periodontal ligament and a thin layer of alveolar bone proper surrounded by cancellous bone with fatty marrow. In contrast, areas of condensing osteitis exhibited areas of inflammation or no inflammation, occupied by connective tissue. This area was bordered by a rim of varying widths of dense lamellar-type bone replacing the cancellous bone and marrow. CONCLUSIONS: The histologic changes of condensing osteitis consisted of the replacement of cancellous bone with compact bone. Areas of fibrosis and an inflammatory infiltrate were seen in some but not all specimens. All teeth exhibiting condensing osteitis had an identifiable etiology that likely resulted in degenerative pulp disease.

Conservative Management of Condensing Osteitis of the Medial End of the Clavicle / 대한정형외과학회잡지

PURPOSE: To assess the clinical features and the outcomes of conservative treatment of condensing osteitis of the medial end of the clavicle. MATERIALS AND METHODS: We reviewed 24 patients among 44 patients with pain and protrusion on the medial clavicle, who were diagnosed as condensing osteitis and followed over one year between April 2003 and August 2008. Plain radiograph and laboratory examination (24 cases), bone scan (12 cases), computed tomography (3 cases), MRI (1 case) and biopsy (1 case) were performed. Patients were followed with UCLA score, VAS (Visual Analogue Scale) and change of protrusion. RESULTS: In all cases, mild sclerosis and expansion were seen at the medial clavicle and sternoclavicular joint was preserved. Laboratory examination showed nonspecific results but various abnormal findings. Protrusion was not changed in 20 cases (83%) and decreased in 4 cases (17%). VAS for pain was improved from 3.4 to 1.2 and VAS for function was improved from 25.5 to 29.1. UCLA score was improved from 28.8 points to 33.7 points. CONCLUSION: Physical and radiologic examination was important for diagnosis of condensing osteitis and laboratory exmination was useful to differentiate it from other diseases. Conservative treatment with rest and nonsteroidal anti-inflammatory drugs showed satisfactory result.