HomeAnswersOral and Maxillofacial Surgerydental cystA round white shape was seen on my radiograph near my left molar. What could it be?

What is the radiographic appearance of odontogenic cysts?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At March 3, 2023
Reviewed AtMarch 3, 2023

Patient's Query

Hi doctor,

I had an X-ray for my routine checkup today, showing a round white shape near the left molar.

What could that be?

Thank you.

Hi,

Welcome to icliniq.com.

I will be answering your query shortly. Please check your follow-up messages.

Thank you.

Patient's Query

Hi doctor,

Sure.

Hi,

Welcome to icliniq.com.

So the lesion was detected on a routine radiographic examination, given that you do not have a molar in that area nor any other symptoms like pain or swelling in the jaw. So please take an in-clinic examination of the area. It resembles a very mild radiopaque lesion meaning it is quite rounded or circumscribed. But many jaw lesions would often be remnant abscesses that have not healed usually.

Also, I recommend getting a CBCT (cone beam computed tomography) scan for that area. In addition, it would help if you got the CBCT (cone beam computed tomography) for the lower left mandible segment. Then the diagnosis would be very clear about the nature of the round lesion.

A CBCT(cone beam computed tomography) will give the dentist and pathologist a good insight. Nothing to worry about as long as you do not have any clinical symptoms. But in some lesions that are slow growing, it is always unpredictable to determine the nature of the lesion. For example, some would be benign, and others more serious.

You should have a CBCT (cone beam computed tomography) scan to stay on the safer side and get the CBCT report. You can also go for an in-clinic opinion, preferably not just from the general dentist. You have to visit a dentist who is an oral surgeon. So clinically, if they find no problem, it is just a harmless jaw lesion or an unhealed abscess.

So treatment always depends on the nature of the lesion. So I hope you got my point. Please do get a cone beam computed tomography scan and an in-clinic examination. It is important to know what kind of radiopaque lesion is present in the jaw so that suitable treatment or antibiotic therapy can be given for a limited time. For that, CBCT is essential. You will get to know from the differential diagnosis of the report what kind of jaw lesion it is, and then your local dentist can take a call on that.

If you have any doubts after the CBCT report consultation, you can ask for my interpretation if needed.

Thank you.

Patient's Query

Hi doctor,

Thank you for your answer.

I do have a CT scan. So if that would help you to give me the right diagnosis, I can send it to you.

Thank you.

Hi,

Welcome back to icliniq.com.

Not just the scan. You will need a pathologist to interpret the scan. A pathologist can differentiate the cells right in a lesion, whether it is a cyst or a benign lesion. So in a CBCT (cone beam computed tomography) interpretation, they will make the pathologic interpretation. So CT (computed tomography) is different, and CBCT is different (cone beam computed tomography). CBCT is done only for the jaw and tooth, particularly for identifying lesions.

I think the best thing you can do is opt for an in-clinic assessment because you just got to know of this on a routine scan. So nothing to worry about. Just go ahead and see an oral surgeon.

Very rarely, there would be slow-growing tumors, most of them in the jaw that is benign. So there is always a chance of misinterpreting a radiograph unless the pathologist certifies what kind of lesion it is.

From what I can see, this lesion appears more like a cyst to me, you know, rather like a residual cyst. So we need a diagnosis at the moment, and you can get that only from a clinical examination of that area. Visually these are second-opinion platforms only. Hence it would be wiser to get it checked and then consider getting a bit if needed.

Suppose your surgeon does not find any problem in your jaw, the missing tooth region, or no lymphadenopathy. In that case, you can just relax. This lesion, in my opinion, needs a pathologist's interpretation and an in-clinic consultation first. Hope that helped you. There's nothing to worry about. Stay positive. It is fine. Also, if you need second verification once the report comes, I can help with that. But I need to see an oral pathologist specifying what lesion it is.

Thank you.

Patient's Query

Hi doctor,

Thank you for your answer.

Can it be a dense bone island?

Thank you.

Hi,

Welcome back to icliniq.com.

It might be dense bone island but looks more like a cyst. You should check the jaw and the tooth area once in a clinic. The sooner you get it done, the better for confirming the diagnosis. Once you know the report or what your dentist says post-checkup, you can send it or consult me. The in-clinic examination is very important to diagnose cysts and other serious lesions, too, so best not to take a risk based on this X-ray.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Achanta Krishna Swaroop
Dr. Achanta Krishna Swaroop

Dentistry

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