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. 2025 Jul;20(3):1982-1984.
doi: 10.1016/j.jds.2025.04.018. Epub 2025 Apr 25.

Novel radiographic pattern of maxillary periostitis induced by endodontic inflammation: A case report

Pai-Chun Huang  1 , I-Hao Su  2 , Meng-Ling Chiang  3   4 , Jyh-Kwei Chen  5   6
Affiliations

Novel radiographic pattern of maxillary periostitis induced by endodontic inflammation: A case report

Pai-Chun Huang et al. J Dent Sci. 2025 Jul.
No abstract available

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Conflict of interest statement

The authors have no conflicts of interest relevant to this article.

Figures

Figure 1
Figure 1
The clinical, histopathological, and radiographical photographs of our case. (A) Clinical photograph displaying an oval mass over the tooth 13 apex with absence of a sinus tract. (B) The periapical radiographs of the tooth 13 at different time points (original, working length measurement, root canal filling, immediate post-surgery, 1-year follow-up). (C) Pre-operative cone-beam computed tomography (CBCT) images exhibiting a blister-like buccal cortical bone lesion at the root apex area of tooth 13 (arrows). (D) Post-operative 1-week follow-up CBCT images revealing the bony remnant at the top of the original cyst. (arrows). (E) Postoperative one-year follow-up CBCT images showed complete resolution of bony remnants at the periapical area (circle) of tooth 13, confirming that the blister-like periostitis was a reactive periosteal response to pulp infection. Once the source of infection was eliminated, the reactive bone lesion resolved. (F1 and F2) Microscopic examination revealed chronic inflammation in the fibrous cystic wall without a true cystic epithelial lining, but with inflammation-induced thin layer of cancellous bone formation at the peripheral area of the cystic wall, confirming the histopathological diagnosis of a periapical cyst with the proliferative periostitis (H&E stain, 40×). (F3) The high-power view showed an infiltrate of lymphocytes and plasma cells with few multinucleated foreign body giant cells (circles) (H&E stain, 100×). (F4) The thin bone specimen showed cancellous bone trabeculae surrounded by osteoblasts (arrows) (H&E stain, 100×).
See this image and copyright information in PMC

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