MenuPeriapical Radiolucencies – pulpal origin Periapical granuloma Radicular cyst Periapical Abscess Surgical defect Osteomyelitis, periapical Periapical Radiolucencies – non pulpal origin Periapical Cemento-Osseous Dysplasia 1st stage Simple bone cyst (traumatic cyst) Nasopalatine duct cyst Eosinophilic granuloma (Langerhans cell histiocytosis) Periodontitis Pericoronal Radiolucencies Dental follicle Pericoronitis Dentigerous (follicular) cyst Buccal biffurcation cyst Unicystic Ameloblastoma (Mural) Adenomatoid odontogenic tumor (AOT) Interradicular Lateral periodontal cyst Lateral radicular cyst Nasopalatine duct cyst Simple bone cyst (traumatic cyst) Solitary (Cyst-like) Radiolucencies Tooth germ (early stage) Bone marrow cavity Residual Radicular cyst Odontogenic keratocyst (circumscribed) Ameloblastoma (circumscribed) Stafne’s bone cavity (Lingual salivary gland depression) Central giant cell granuloma (circumscribed) Cemento-Ossifying fibroma (1st stage) Benign tumors of neural origin Multiple Radiolucencies Multiple cysts of the jaws Langerhans cell histiocytosis (eosinophilic granuloma) Multiple myeloma Metastatic tumors (multiple) Multilocular Radiolucencies Odontogenic keratocyst (multilocular) Ameloblastoma (multilocular) Odontogenic myxoma Central giant cell granuloma (Multilocular) Aneurysmal bone cyst Hemangioma, central Cherubism Odontogenic fibroma, central Malignant lymphoma (multilocular) Ill-defined Radiolucencies Osteomyelitis (ill defined) Squamous cell carcinoma Eosinophilic granuloma (Langerhans cell histiocytosis) Malignant lymphoma (ill defined) Metastatic tumors (ill defined) Osteogenic sarcoma (osteosarcoma) Ewing sarcoma Malignant salivary gland tumors Melanoma Generalized rarefactions Hyperparathyroidism Osteoporosis Thalassemia Sickle cell anemia Leukemia Osteomalacia – Rickets Periodontitis . In severe periodontal cases, significant bone destruction can occur, sometimes extending around the apices of the teeth roots. When this happens, it may manifest as periapical radiolucency on a radiograph. Differential Diagnosis Eosinophilic granuloma Periapical Granuloma Radicular cyst Simple bone cyst (traumatic cyst) Case 1 Several cases of periodontitis Case 2 Periodontitis: bone loss with furcation involvement
