Paget Disease Radiographic Features — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRadiology & ImagingPaget Disease Radiographic FeaturesORE Part 1

A patient presents with Paget disease affecting the maxilla. Recent skull radiographs show a 'cotton wool' appearance. Which dental radiographic feature would you expect to observe?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Hypercementosis of the teeth and loss of lamina dura

In Paget disease of the jaws, the characteristic radiographic dental findings are hypercementosis (excessive cementum deposition due to abnormal osteoblastic activity) and loss of lamina dura (due to mixed sclerotic and lytic bone remodeling disrupting the normal radiopaque laminal outline). These changes reflect the fundamental pathophysiology: chaotic bone turnover with areas of excessive formation and resorption. The cotton wool appearance of the skull indicates active disease, which will similarly affect the maxillary alveolus and tooth structures. Option E (normal appearance) contradicts the pathological state. Option B (floating teeth) implies severe uniform bone loss, not characteristic of Paget disease. Option A (periapical lesions with vital teeth) does not fit the bone-remodeling pattern. Option C (generalized root resorption) is not a hallmark feature.

Reference: Paget's Disease: Skeletal Manifestations and Effect of Bisphosphonates. J Korean Orthop Assoc. 2017. https://pubmed.ncbi.nlm.nih.gov/28642853/