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J Oral Maxillofac Surg. 2008 Aug;66(8):1600-5. doi: 10.1016/j.joms.2007.11.024.

Correlation of radiographic size and the presence of radiopaque lamina with histological findings in 70 periapical lesions.

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Valencia University Medical and Dental School, Valencia, Spain.



This study was conducted to relate the histological diagnosis of chronic inflammatory periapical lesions with the radiographic images of these lesions.


A total of 70 biopsy specimens obtained during periapical surgery were stained with hematoxylin and eosin and examined under a microscope. Histological analysis established the diagnosis as granuloma, cyst, or scar tissue. The location of the lesion was recorded, as were the radiographic size (maximum and minimum diameter in mm and area in mm(2)) and the presence of radiopaque lamina around the lesion, using an image analyzing system.


The distribution of the biopsy specimens was 65.7% granulomas, 25.7% scar tissue, and 8.6% cysts, 1 of which was a keratocyst. The largest lesions were cysts and epithelialized granulomas, with statistically significant differences. Radiopaque lamina was observed around 9 lesions; of these, only 2 were histologically diagnosed as cysts, with the rest as granulomas.


Most of the apical lesions were granulomas. Cysts had the largest radiotransparent images; however, in the 70 cases studied, neither the radiographic size nor the presence of associated radiopaque lamina alone was sufficient to determine the type of lesion. Histological analysis is required.

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