Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 8;48(3):e23.
doi: 10.5395/rde.2023.48.e23. eCollection 2023 Aug.

Radiographic patterns of periosteal bone reactions associated with endodontic lesions

Poorya Jalali  1 , Jessica Riccobono  1 , Robert A Augsburger  1 , Mehrnaz Tahmasbi-Arashlow  2
Affiliations

Radiographic patterns of periosteal bone reactions associated with endodontic lesions

Poorya Jalali et al. Restor Dent Endod. .

Abstract

Objectives: The formation of new bone by periosteum due to an insult is called periosteal bone reaction (PBR). This study assessed the cone beam computed tomography (CBCT) patterns of periosteal bone reactions associated with periapical inflammatory lesion (apical periodontitis/periapical rarefying osteitis).

Materials and methods: Twenty-two small field of view CBCT images of patients with PBR were selected from a database of a private practice limited to endodontics. The volume of the periapical inflammatory lesion, the presence of cortical fenestration, the distance of the root apices to the affected cortex, and the location, pattern, and longest diameter of the periosteal reaction were recorded. Statistical analysis was performed using Wilcoxon Ranksum, Fischer's exact, Spearman Correlation Coefficient, and paired t-test.

Results: In all cases, periosteal bone reaction manifested as either parallel (90.9%) or irregular (9.1%). No correlation was found between periapical inflammatory lesion volume and the periosteal reaction's longest diameter (p > 0.05). Cortical fenestration was noted in 72.7% of the cases. In addition, the findings showed that periosteal reactions were located mostly on the buccal and were present 53.8% and 100% of the time in the mandible and maxilla, respectively.

Conclusions: The periosteal reactions of endodontic origin had a nonaggressive form (i.e., parallel or irregular), and none of the lesions resulted in a periosteal reaction with an ominous Codman's triangle or spicule pattern.

Keywords: Cone beam computed tomography; Differential diagnosis; Imaging, jaw; Periapical periodontitis; Periosteal bone reaction.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1. The volume of the apical periodontitis/periapical rarefying osteitis was calculated using Mimics Innovation Suite.
Figure 2
Figure 2. Cone beam computed tomography images of 7 cases with periosteal reactions (red arrow) and periapical inflammatory lesion (yellow arrow). (A-C), (E-G) manifesting parallel periosteal reactions, and (D) showing irregular periosteal reaction.
See this image and copyright information in PMC

References

    1. Chen EM, Masih S, Chow K, Matcuk G, Patel D. Periosteal reaction: review of various patterns associated with specific pathology. Contemp Diagn Radiol. 2012;35:1–5.
    1. Rana RS, Wu JS, Eisenberg RL. Periosteal reaction. AJR Am J Roentgenol. 2009;193:W259-72. - PubMed
    1. Seok H, Kim SG, Song JY. Proliferative periostitis of the mandibular ramus and condyle: a case report. J Korean Assoc Oral Maxillofac Surg. 2015;41:198–202. - PMC - PubMed
    1. Koorbusch GF, Deatherage JR, Curé JK. How can we diagnose and treat osteomyelitis of the jaws as early as possible? Oral Maxillofac Surg Clin North Am. 2011;23:557–567. - PubMed
    1. Ida M, Tetsumura A, Kurabayashi T, Sasaki T. Periosteal new bone formation in the jaws. A computed tomographic study. Dentomaxillofac Radiol. 1997;26:169–176. - PubMed

LinkOut - more resources