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The presence of buccal exostosis can be diagnosed by both clinical examination and radiological interpretation of the oral cavity. Clinically, buccal exostoses appear as single, broad-based masses, usually situated bilaterally in the premolar and molar region on the facial surface of the maxillary alveolar bone. [11]
Larger cysts may cause bone expansion or displace roots. Discoloration of the affected tooth may also occur. Patient will present negative results to electric and ice test of the affected tooth but will be sensitive to percussion. Surrounding gingival tissue may experience lymphadenopathy. The alveolar plate may exhibit crepitus when palpated.
Idiopathic osteosclerosis, also known as enostosis or dense bone island, is a condition which may be found around the roots of a tooth, usually a premolar or molar. [2] It is usually painless and found during routine radiographs as an amorphous radiopaque (light) area around a tooth.
A lump may be felt, which may feel hard if there is still bone covering the cyst, or fluctuant if the cyst has eroded through the bone surrounding it. [5] A cyst may become acutely infected, and discharge into the oral cavity via a sinus. Adjacent teeth may be loosened, tilted or even moved bodily. [6]
Typically the tooth is lifted using an elevator, and using dental forceps, specific tooth movements are performed (e.g. rocking the tooth back and forth) expanding the tooth socket. Once the periodontal ligament is broken and the supporting alveolar bone has been adequately widened the tooth can be removed.
Tooth #5, the upper right second premolar, after extraction. The two single-headed arrows point to the CEJ, which is the line separating the crown (in this case, heavily decayed) and the roots. The double headed arrow (bottom right) shows the extent of the abscess that surrounds the apex of the palatal root.
Alveolar osteitis usually occurs where the blood clot fails to form or is lost from the socket (i.e., the defect left in the gum when a tooth is taken out). This leaves an empty socket where bone is exposed to the oral cavity , causing a localized alveolar osteitis limited to the lamina dura (i.e., the bone which lines the socket).
Periapical granuloma, [1] also sometimes referred to as a radicular granuloma or apical granuloma, is an inflammation at the tip of a dead (nonvital) tooth. It is a lesion or mass that typically starts out as an epithelial lined cyst, and undergoes an inward curvature that results in inflammation of granulation tissue at the root tips of a dead tooth.