(TC62) Lesions that Mimic Endodontic Pathosis: A Comprehensive Guide to Recognition and Diagnosis

Abstract: Diagnosis is arguably one of the most important yet most challenging aspects in the field of endodontics. Though there have been technological advancements to help suggest the best possible treatment for our patients based on clinical and radiographic findings, being aware of the limitations of endodontic lesions can help improve our diagnosing process. The purpose of our table clinic is to explore four primary pathological entities that mimic endodontic lesions, delving into their distinct characteristics and potential diagnostic challenges. The mimicking lesions discussed include benign fibro-osseous lesions, odontogenic cysts and tumors, other jaw cysts, and metastatic or lymphoproliferative diseases affecting the bone. Within the benign fibro-osseous lesions, there are three forms of cemento-osseous dysplasia: periapical, focal, and florid cemento-osseous dysplasia. Keratocystic odontogenic tumors often mimic the features of an endodontic lesion. Additionally, adenomatoid odontogenic tumors and ameloblastomas can also simulate an endodontic lesion. Other mimicking cysts of the jaw include incisive canal cysts, globulomaxillary cysts, traumatic bone cysts, and nasopalatine duct cysts. Lastly, metastatic disease or lymphoproliferative disease of the bone can also be confused as endodontic lesions. In order to distinguish between these mimicking lesions and endodontic lesions, three key aspects need to be considered: historical data, symptoms and clinical signs, radiographic findings, and histological findings. Emphasis will be placed on the critical role of accurate diagnosis in formulating an effective treatment plan. The presentation aims to equip clinicians with the knowledge and tools necessary to navigate the nuances of these lesions, fostering optimal patient care and outcomes.