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Periapical Radiolucency Non-Vital Tooth — NDEB AFK MCQ

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EasyRadiology & ImagingPeriapical Radiolucency Non-Vital ToothNDEB AFK

A periapical radiograph shows a well-defined radiolucency with a thin radiopaque border (sclerotic rim) at the apex of a non-vital mandibular premolar. Which pathology is most likely?

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Correct answer: CPeriapical granuloma or periapical (radicular) cyst

A well-defined periapical radiolucency with a corticated (sclerotic) border at the apex of a non-vital tooth is the classic radiographic presentation of a periapical granuloma or radicular cyst. The sclerotic border indicates a chronic, slowly progressive process that has allowed the surrounding bone to form a reactive cortical rim. These two entities cannot be reliably distinguished radiographically — histopathological examination of the excised tissue is required. Treatment is root canal therapy (for the granuloma) or extraction; cysts may require enucleation if they persist after RCT.

Reference: White & Pharoah – Oral Radiology: Principles and Interpretation, 8th ed., 2019