Idiopathic osteosclerosis, also known as enostosis or dense bone island, is a condition which may be found around the roots of a
tooth
A tooth ( : teeth) is a hard, calcified structure found in the jaws (or mouths) of many vertebrates and used to break down food. Some animals, particularly carnivores and omnivores, also use teeth to help with capturing or wounding prey, tear ...
, usually a
premolar
The premolars, also called premolar teeth, or bicuspids, are transitional teeth located between the canine and molar teeth. In humans, there are two premolars per quadrant in the permanent set of teeth, making eight premolars total in the mouth ...
or
molar.
It is usually painless and found during routine
radiograph
Radiography is an imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical radiography ("diagnostic" and "therapeut ...
s as an amorphous
radiopaque
Radiodensity (or radiopacity) is opacity to the radio wave and X-ray portion of the electromagnetic spectrum: that is, the relative inability of those kinds of electromagnetic radiation to pass through a particular material. Radiolucency or hypod ...
(light) area around a tooth. There is no sign of
inflammation
Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a protective response involving im ...
of the tooth, and if the island is associated with the root the periodontal ligament space is preserved.
Signs and symptoms
Focal radiodensity of the jaw which is not inflammatory, dysplastic, neoplastic or a manifestation of a systemic disease. This is common and affects 5% of the population, usually seen in teens and those in their 20s. Typically asymptomatic and is an incidental finding on a radiograph, found anywhere in the jaw, most commonly in the mandibular premolar-molar region. The shape ranges from round to linear streaks to occasional angular forms.
Cause
Mostly unknown (idiopathic),
but may be a reaction to past trauma or infection which is difficult to rule out in some cases.
Diagnosis
Usual diagnosis is via radiograph, patient history,
biopsy
A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a diseas ...
is rarely needed. Periodic follow ups should included additional radiographs that show minimal growth or regression.
Radiology
Well defined, rounded or triangular radiodensity, that is uniformly opaque. There is no lucent component. Found near the root apex or in the inter-radicular area. Root resorption and tooth movement are rare. If it blends into bone cortices, it does so with no expansion or thinning.
Differential Diagnosis
Condensing osteitis
Condensing osteitis is a periapical inflammatory disease that results from a reaction to a dental related infection. This causes more bone production rather than bone destruction in the area (most common site is near the root apices of premolars ...
,
sclerosing osteomyelitis, enostosis
cementoblastoma
Cementoblastoma, or benign cementoblastoma, is a relatively rare benign neoplasm of the cementum of the teeth. It is derived from ectomesenchyme of odontogenic origin. Cementoblastomas represent less than 0.69–8% of all odontogemic tumors.
Signs ...
, cemento-osseous dysplasia,
hypercementosis
Hypercementosis is an idiopathic, non-neoplastic condition characterized by the excessive buildup of normal cementum (calcified tissue) on the roots of one or more teeth. A thicker layer of cementum can give the tooth an enlarged appearance, which ...
,
exostoses (tori).
Condensing osteitis may resemble idiopathic osteosclerosis, however, associated teeth are always nonvital in condensing osteitis.
These features help differentiate idiopathic osteosclerosis from similar entities such as condensing osteitis, cemento-osseous dysplasia, hypercementosis, and cementoblastoma.
Treatment
No treatment is necessary.
References
External links
Pathology of the maxilla and mandible
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