Palatal bone defect mimicking a chronic periapical lesion: a case report emphasizing the importance of the use of a three-dimensional radiographic examination

Abstract

Chronic periapical lesion is among the most usual bone pathology observed in human teeth, and it is often first detected by plain radiographs, such as panoramic or periapical radiography. Plain radiographs are widely used in dentistry; however, they have limitations inherent to the technique itself, such as anatomic structures overlapping and lack of information on the extension of the lesion. Therefore, three-dimensional radiographic methods, such as cone beam computed tomography are valuable to accurately assess periapical lesions. Thus, this clinical report describes a case in which the bone radiographic features led to a primary diagnosis of chronic periapical lesion in superior incisors, however, it was a defect in the palatal bone. The resulting radiolucency created by the palatal bone defect overlapped the maxillary bone, mimicking a periapical lesion. Additionally, in the same case, we demonstrate a true chronic periapical lesion in another area that presented as a subtle radiolucency in periapical radiography, however, it was larger than expected when evaluated in Cone Beam Computed Tomography.