Periapical Radiolucencies

Beneath your smile is a tremendous amount of complicated and amazing anatomy. There are bones and soft tissue, muscles and nerves, and the roots of the teeth.  In addition, there are a lot of different openings in the jaw bone.  To be able to properly examine the health of all of these structures, an xray is necessary along with a clinical examination.

Dr. Howard  is trained to interpret head and neck x-rays and analyze any signs of abnormalities or diseases.  It is critical for an oral surgeon to be able to differentiate between the normal landmarks that can be seen on an x-ray from the unhealthy lesions.

It is not uncommon to see dark areas, known as radiolucencies, on a dental x-ray. A radiolucency often is a void or an area of tissue that is less dense. Some radiolucencies are normal and others are abnormal, such as radiolucencies that can be seen around the roots of the teeth.

Dark lesions around the roots of the teeth, shown on an xray, are known as “periapical radiolucencies”, and  should be investigated by an oral surgeon to determine if they may pose a threat to your health.

There are certain lesions, such as cysts, granulomas, and abscesses, that can appear on an x-ray when the nerve inside of a tooth is unhealthy.  In this case, a radiolucency may be present because the unhealthy nerve tissue exits the tooth through a small opening in the tip of the tooth root. In many cases, with early intervention, the dead or dying nerve tissue can be removed, and the tooth can be preserved.

Other known causes of dark lesions located near the roots of the teeth, including bone loss associated with periodontal disease, a traumatic cyst, a benign tumor, or a malignant tumor.  A biopsy must be performed in some cases of  lesions that do not respond to root canal therapy, or for those lesions that require surgical removal.


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