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Steven Koos MD DDS
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Oral Maxillofacial Surgeon Chicago Wisdom Teeth and Dental Implant Expert
Oral Maxillofacial Surgeon Chicago Wisdom Teeth and Dental Implant Expert

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Bony Lesions: Periapical Radiolucencies

Beneath a perfect smile lies a tremendous amount of complicated and interesting anatomy. There are bones and soft tissue, muscles and nerves, as well as the roots of the teeth, and various openings in the jaw bone. From the outside, looking in, it is virtually impossible to assess the health of these structures. That’s why x-rays are so important during clinical examinations and procedures.

Your oral surgeon is trained to interpret head and neck x-rays for signs of abnormalities and diseases. It is also a surgeon’s job to identify the normal or common landmarks that can be seen on an x-ray in order to differentiate between healthy structures and unhealthy lesions.

It is common to see dark areas, known as radiolucencies, on a dental x-ray. A radiolucency often represents a void or an area of tissue that is less dense. Some of these radiolucencies are normal, such as those that represent openings in the jaw bone that allow certain nerves to enter and exit the jaw. Others are abnormal, such as certain radiolucencies that can be seen around the roots of the teeth.

On an x-ray, dark lesions around the roots of the teeth are known as “periapical radiolucencies”, and they should be investigated to determine if they may pose a threat to your health.

Certain lesions, such as cysts, granulomas, and abscesses, are known to appear on an x-ray when the nerve inside of a given tooth is unhealthy. The unhealthy nerve tissue may exit the tooth via a small opening in the tip of the tooth root, resulting in a radiolucency. In many cases, with early intervention, the dead or dying nerve tissue and scar tissue can be removed, and the tooth can be preserved.
There are 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. For lesions that do not respond to root canal therapy, or for those lesions that require surgical removal, a biopsy must be performed to determine the exact nature of the bony lesion and most importantly, if it is cancerous tissue present.

For a detailed explanation regarding radiolucencies that may be located near the roots of your teeth, contact ORA® Oral Surgery & Implant Studio at 312-328-9000 today.

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