Radiolucent inflammatory jaw lesions: a twenty-year analysis.

Aim: To determine the range and demographic and clinical features of radiolucent inflammatory jaw lesions.

Methodology: Histopathology reports were reviewed to identify radiolucent jaw lesions. There were no clinical exclusive criteria, and the samples represented a wide range of clinical presentation and treatment history from multiple providers. Data were analysed using SPSS. To evaluate concordance of clinical and histological diagnoses, the clinician's provisional diagnosis was compared with the final histopathological diagnosis.

Results: A total of 17 038 specimens were reviewed; of these, 4983 (29.2%) were radiolucent jaw lesions, of which inflammatory lesions accounted for 72.8% (n = 3626). Periapical granulomas (59.7%) were the largest group followed by radicular cysts (29.2%). The mean age was 44 years (range 2-100 years), men and women were equally represented and the anterior maxilla was the most common site for the biopsied lesions. A provisional diagnosis was correct for only 48.3% of periapical granulomas and 36% of radicular cysts.

Conclusions: This study included all presentations of periapical radiolucent lesions and showed that the incidence of cystic change in periapical lesions of endodontic origin is high at approximately 30% of all inflammatory lesions. Notwithstanding the relative frequencies, demographics and location of radiolucent inflammatory lesions presenting in the New Zealand population are comparable to that of other populations. No inflammatory radiolucent lesion can be reliably accurately diagnosed from clinical presentation and/or radiographic appearance alone.