The Frequency and Distribution of Idiopathic Osteosclerosis of the Jaw
Identifieur interne : 002C33 ( Pmc/Corpus ); précédent : 002C32; suivant : 002C34The Frequency and Distribution of Idiopathic Osteosclerosis of the Jaw
Auteurs : Yildiray Sisman ; Elif Tarim Ertas ; Huseyin Ertas ; Ahmet Ercan SekerciSource :
- European Journal of Dentistry [ 1305-7456 ] ; 2011.
Abstract
To determine the prevalence of idiopathic osteosclerosis (IO) in the jaw by radiographic evaluation and to investigate the relationship between the findings in relation to age, gender, and localization.
The study included 2,211 panoramic radiographs obtained from the patients (915 men and 1,296 women) whose ages ranged from 10–77 and who visited the Department of Oral Diagnosis and Radiology in the Faculty of Dentistry, Erciyes University between 2008 and 2009.
Of 2,211 patients, 135 patients (6.1%) had IO. The prevalence obtained in our study was in the range reported in the literature. IO was detected more often in mandible rather than the maxilla. In addition, mandibular molar localization was the most common localization, and most of the lesions were associated with root apices.
In view of the findings, IO can be defined as developmental variations of normal bony architecture, which are unrelated to local stimuli. The lesions can arise at any age, any location with no sex predilection, and IO usually requires no treatment other than diagnosis. Because all these lesions were located in the jaw and could only is detected in panoramic evaluations, this indicates the importance of careful diagnostic evaluation of radiographies in dental examinations.
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PubMed: 21912499
PubMed Central: 3170027
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The Frequency and Distribution of Idiopathic Osteosclerosis of the Jaw</title><author><name sortKey="Sisman, Yildiray" sort="Sisman, Yildiray" uniqKey="Sisman Y" first="Yildiray" last="Sisman">Yildiray Sisman</name><affiliation><nlm:aff id="af1-dent05_p0409"> Associate Professor and Chair, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey</nlm:aff></affiliation></author><author><name sortKey="Ertas, Elif Tarim" sort="Ertas, Elif Tarim" uniqKey="Ertas E" first="Elif Tarim" last="Ertas">Elif Tarim Ertas</name><affiliation><nlm:aff id="af2-dent05_p0409"> Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey</nlm:aff></affiliation></author><author><name sortKey="Ertas, Huseyin" sort="Ertas, Huseyin" uniqKey="Ertas H" first="Huseyin" last="Ertas">Huseyin Ertas</name><affiliation><nlm:aff id="af3-dent05_p0409"> Assistant Professor, Department of Endodontics, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey</nlm:aff></affiliation></author><author><name sortKey="Sekerci, Ahmet Ercan" sort="Sekerci, Ahmet Ercan" uniqKey="Sekerci A" first="Ahmet Ercan" last="Sekerci">Ahmet Ercan Sekerci</name><affiliation><nlm:aff id="af4-dent05_p0409"> Research Assistant, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21912499</idno><idno type="pmc">3170027</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170027</idno><idno type="RBID">PMC:3170027</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">002C33</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002C33</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Frequency and Distribution of Idiopathic Osteosclerosis of the Jaw</title><author><name sortKey="Sisman, Yildiray" sort="Sisman, Yildiray" uniqKey="Sisman Y" first="Yildiray" last="Sisman">Yildiray Sisman</name><affiliation><nlm:aff id="af1-dent05_p0409"> Associate Professor and Chair, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey</nlm:aff></affiliation></author><author><name sortKey="Ertas, Elif Tarim" sort="Ertas, Elif Tarim" uniqKey="Ertas E" first="Elif Tarim" last="Ertas">Elif Tarim Ertas</name><affiliation><nlm:aff id="af2-dent05_p0409"> Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey</nlm:aff></affiliation></author><author><name sortKey="Ertas, Huseyin" sort="Ertas, Huseyin" uniqKey="Ertas H" first="Huseyin" last="Ertas">Huseyin Ertas</name><affiliation><nlm:aff id="af3-dent05_p0409"> Assistant Professor, Department of Endodontics, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey</nlm:aff></affiliation></author><author><name sortKey="Sekerci, Ahmet Ercan" sort="Sekerci, Ahmet Ercan" uniqKey="Sekerci A" first="Ahmet Ercan" last="Sekerci">Ahmet Ercan Sekerci</name><affiliation><nlm:aff id="af4-dent05_p0409"> Research Assistant, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey</nlm:aff></affiliation></author></analytic><series><title level="j">European Journal of Dentistry</title><idno type="ISSN">1305-7456</idno><idno type="eISSN">1305-7464</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objectives:</title><p>To determine the prevalence of idiopathic osteosclerosis (IO) in the jaw by radiographic evaluation and to investigate the relationship between the findings in relation to age, gender, and localization.</p></sec><sec><title>Methods:</title><p>The study included 2,211 panoramic radiographs obtained from the patients (915 men and 1,296 women) whose ages ranged from 10–77 and who visited the Department of Oral Diagnosis and Radiology in the Faculty of Dentistry, Erciyes University between 2008 and 2009.</p></sec><sec><title>Results:</title><p>Of 2,211 patients, 135 patients (6.1%) had IO. The prevalence obtained in our study was in the range reported in the literature. IO was detected more often in mandible rather than the maxilla. In addition, mandibular molar localization was the most common localization, and most of the lesions were associated with root apices.</p></sec><sec><title>Conclusions:</title><p>In view of the findings, IO can be defined as developmental variations of normal bony architecture, which are unrelated to local stimuli. The lesions can arise at any age, any location with no sex predilection, and IO usually requires no treatment other than diagnosis. Because all these lesions were located in the jaw and could only is detected in panoramic evaluations, this indicates the importance of careful diagnostic evaluation of radiographies in dental examinations.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Halse, A" uniqKey="Halse A">A Halse</name></author><author><name sortKey="Molven, O" uniqKey="Molven O">O Molven</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Geist, Jr" uniqKey="Geist J">JR Geist</name></author><author><name sortKey="Katz, Jo" uniqKey="Katz J">JO Katz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Petrikowski, Cg" uniqKey="Petrikowski C">CG Petrikowski</name></author><author><name sortKey="Peters, E" uniqKey="Peters E">E Peters</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yonetsu, K" uniqKey="Yonetsu K">K Yonetsu</name></author><author><name sortKey="Yuasa, K" uniqKey="Yuasa K">K Yuasa</name></author><author><name sortKey="Kanda, S" uniqKey="Kanda S">S Kanda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mcdonnell, D" uniqKey="Mcdonnell D">D McDonnell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gibilisco, Ja" uniqKey="Gibilisco J">JA Gibilisco</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bsoul, Sa" uniqKey="Bsoul S">SA Bsoul</name></author><author><name sortKey="Alborz, S" uniqKey="Alborz S">S Alborz</name></author><author><name sortKey="Terezhalmy, Gt" uniqKey="Terezhalmy G">GT Terezhalmy</name></author><author><name sortKey="Moore, Ws" uniqKey="Moore W">WS Moore</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Austin, Bw" uniqKey="Austin B">BW Austin</name></author><author><name sortKey="Moule, Aj" uniqKey="Moule A">AJ Moule</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Langlais, Rp" uniqKey="Langlais R">RP Langlais</name></author><author><name sortKey="Langland, Oe" uniqKey="Langland O">OE Langland</name></author><author><name sortKey="Nortje, Cj" uniqKey="Nortje C">CJ Nortje</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="White, Sc" uniqKey="White S">SC White</name></author><author><name sortKey="Pharoah, Mj" uniqKey="Pharoah M">MJ Pharoah</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Macdonald Jankowski, Ds" uniqKey="Macdonald Jankowski D">DS MacDonald-Jankowski</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kawai, T" uniqKey="Kawai T">T Kawai</name></author><author><name sortKey="Murakami, S" uniqKey="Murakami S">S Murakami</name></author><author><name sortKey="Kishino, M" uniqKey="Kishino M">M Kishino</name></author><author><name sortKey="Sakuda, M" uniqKey="Sakuda M">M Sakuda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eversole, Lr" uniqKey="Eversole L">LR Eversole</name></author><author><name sortKey="Stone, Ce" uniqKey="Stone C">CE Stone</name></author><author><name sortKey="Strub, D" uniqKey="Strub D">D Strub</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kawal, T" uniqKey="Kawal T">T Kawal</name></author><author><name sortKey="Hirakuma, H" uniqKey="Hirakuma H">H Hirakuma</name></author><author><name sortKey="Murakami, S" uniqKey="Murakami S">S Murakami</name></author><author><name sortKey="Fuchihata, H" uniqKey="Fuchihata H">H Fuchihata</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wood, Nk" uniqKey="Wood N">NK Wood</name></author><author><name sortKey="Goaz" uniqKey="Goaz">Goaz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Boyne, Pj" uniqKey="Boyne P">PJ Boyne</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Farman, Ag" uniqKey="Farman A">AG Farman</name></author><author><name sortKey="Joubert, Jj Dev" uniqKey="Joubert J">JJ DeV Joubert</name></author><author><name sortKey="Nortje, Cj" uniqKey="Nortje C">CJ Nortje</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kawai, T" uniqKey="Kawai T">T Kawai</name></author><author><name sortKey="Hirakuma, H" uniqKey="Hirakuma H">H Hirakuma</name></author><author><name sortKey="Murakami, S" uniqKey="Murakami S">S Murakami</name></author><author><name sortKey="Fuchihata, H" uniqKey="Fuchihata H">H Fuchihata</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eselman, Jc" uniqKey="Eselman J">JC Eselman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fireman, Sm" uniqKey="Fireman S">SM 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Eur J Dent</journal-id><journal-id journal-id-type="iso-abbrev">Eur J Dent</journal-id><journal-id journal-id-type="publisher-id">Eur J Dent</journal-id><journal-title-group><journal-title>European Journal of Dentistry</journal-title></journal-title-group><issn pub-type="ppub">1305-7456</issn><issn pub-type="epub">1305-7464</issn><publisher><publisher-name>Dental Investigations Society</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21912499</article-id><article-id pub-id-type="pmc">3170027</article-id><article-id pub-id-type="publisher-id">dent05_p0409</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>The Frequency and Distribution of Idiopathic Osteosclerosis of the Jaw</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Sisman</surname><given-names>Yildiray</given-names></name><xref ref-type="aff" rid="af1-dent05_p0409"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ertas</surname><given-names>Elif Tarim</given-names></name><xref ref-type="aff" rid="af2-dent05_p0409"><sup>b</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ertas</surname><given-names>Huseyin</given-names></name><xref ref-type="aff" rid="af3-dent05_p0409"><sup>c</sup></xref></contrib><contrib contrib-type="author"><name><surname>Sekerci</surname><given-names>Ahmet Ercan</given-names></name><xref ref-type="aff" rid="af4-dent05_p0409"><sup>d</sup></xref><xref ref-type="corresp" rid="c1-dent05_p0409"></xref></contrib></contrib-group><aff id="af1-dent05_p0409"><label>a</label> Associate Professor and Chair, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey</aff><aff id="af2-dent05_p0409"><label>b</label> Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey</aff><aff id="af3-dent05_p0409"><label>c</label> Assistant Professor, Department of Endodontics, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey</aff><aff id="af4-dent05_p0409"><label>d</label> Research Assistant, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey</aff><author-notes><corresp id="c1-dent05_p0409">Corresponding author: Ahmet Ercan Sekerci, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey. Phone: +90 352 437 4901/29227 Fax: +90 352 438 0657, E-mail: <email>aercansekerci@hotmail.com</email></corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2011</year></pub-date><volume>5</volume><issue>4</issue><fpage>409</fpage><lpage>414</lpage><permissions><copyright-statement>Copyright 2011 European Journal of Dentistry. All rights reserved.</copyright-statement><copyright-year>2011</copyright-year></permissions><abstract><sec><title>Objectives:</title><p>To determine the prevalence of idiopathic osteosclerosis (IO) in the jaw by radiographic evaluation and to investigate the relationship between the findings in relation to age, gender, and localization.</p></sec><sec><title>Methods:</title><p>The study included 2,211 panoramic radiographs obtained from the patients (915 men and 1,296 women) whose ages ranged from 10–77 and who visited the Department of Oral Diagnosis and Radiology in the Faculty of Dentistry, Erciyes University between 2008 and 2009.</p></sec><sec><title>Results:</title><p>Of 2,211 patients, 135 patients (6.1%) had IO. The prevalence obtained in our study was in the range reported in the literature. IO was detected more often in mandible rather than the maxilla. In addition, mandibular molar localization was the most common localization, and most of the lesions were associated with root apices.</p></sec><sec><title>Conclusions:</title><p>In view of the findings, IO can be defined as developmental variations of normal bony architecture, which are unrelated to local stimuli. The lesions can arise at any age, any location with no sex predilection, and IO usually requires no treatment other than diagnosis. Because all these lesions were located in the jaw and could only is detected in panoramic evaluations, this indicates the importance of careful diagnostic evaluation of radiographies in dental examinations.</p></sec></abstract><kwd-group><kwd>Idiopathic osteosclerosis</kwd><kwd>Mandible</kwd><kwd>Maxilla</kwd><kwd>Panoramic radiograph</kwd></kwd-group></article-meta></front><body><sec><title>INTRODUCTION</title><p>Idiopathic osteosclerosis (IO) is an area of increased bone production in the jaw and generally appears to be round, elliptical, or irregular and radiopaque in shape.<xref ref-type="bibr" rid="b1-dent05_p0409">1</xref>–<xref ref-type="bibr" rid="b3-dent05_p0409">3</xref> According to the literature, although this disorder is sometimes described as a dense bone island, bone scar, focal periapical osteopetrosis, or enostosis,<xref ref-type="bibr" rid="b3-dent05_p0409">3</xref> IO is often preferred because of its unknown origin.<xref ref-type="bibr" rid="b4-dent05_p0409">4</xref>–<xref ref-type="bibr" rid="b6-dent05_p0409">6</xref> These lesions may be accepted as developmental intraosseous anatomic variations<xref ref-type="bibr" rid="b7-dent05_p0409">7</xref> and should be classified separately from the cases resulting from inflammatory origin or systemic disease.<xref ref-type="bibr" rid="b4-dent05_p0409">4</xref>–<xref ref-type="bibr" rid="b6-dent05_p0409">6</xref> These asymptomatic lesions are generally discovered as incidental findings on radiographs taken for other reasons.<xref ref-type="bibr" rid="b7-dent05_p0409">7</xref></p><p>On radiographic evaluation, IO may be detected in various sizes, ranging from 2 or 3 mm to 1 or 2 cm in diameter,<xref ref-type="bibr" rid="b2-dent05_p0409">2</xref>,<xref ref-type="bibr" rid="b3-dent05_p0409">3</xref>,<xref ref-type="bibr" rid="b8-dent05_p0409">8</xref>–<xref ref-type="bibr" rid="b10-dent05_p0409">10</xref> or the lesions may be very large, almost the entire height of the body of the mandible. <xref ref-type="bibr" rid="b11-dent05_p0409">11</xref>,<xref ref-type="bibr" rid="b12-dent05_p0409">12</xref> They may occur at root apexes, between the roots, or in a separate location away from the teeth, primarily in the premolar/molar region and with a predilection for the mandibular arc.<xref ref-type="bibr" rid="b2-dent05_p0409">2</xref>,<xref ref-type="bibr" rid="b3-dent05_p0409">3</xref>,<xref ref-type="bibr" rid="b5-dent05_p0409">5</xref>,<xref ref-type="bibr" rid="b13-dent05_p0409">13</xref>,<xref ref-type="bibr" rid="b14-dent05_p0409">14</xref></p><p>The purpose of this study was to determine the prevalence and distribution of the IO in the jaws of the patients attending our facility by examining the panoramic radiographs the patient records, and to investigate the relationship of the findings to the age and gender in the population of the Cappadocia region.</p></sec><sec sec-type="materials|methods"><title>MATERIALS AND METHODS</title><p>A total of 2,211 dental patients admitted to the Faculty of Dentistry, Erciyes University, in the Cappadocia region of Turkey participated in the study, which was based on the panoramic radiographs (PRs) of the patients taken during routine dental examination, and all the radiographs were examined by YS in terms of the presence of IO on a standard light-box under normal room lighting. All the PRs were obtained with an Orthopantomograph OP 100 (Orthopantomography® OP100, Tuusula, Finland). The PRs were processed according to the manufacturer’s recommendations in an automatic film processor. The radiographs that displayed the jaws, without asymmetry, distortion, or error in patient positioning or exposure processing were included in the study.</p><p>For the diagnosis, IO was defined as the symptomless, radiopaque areas that are often elliptical or round in shape and vary in size from a minimum of 3 mm to more than 2 cm. The patients who had a questionable IO and who met the following criteria were excluded from this study.<xref ref-type="bibr" rid="b2-dent05_p0409">2</xref>,<xref ref-type="bibr" rid="b8-dent05_p0409">8</xref>,<xref ref-type="bibr" rid="b15-dent05_p0409">15</xref></p><list list-type="bullet"><list-item><p>Radiopacities directly associated with deep caries or large restorations;</p></list-item><list-item><p>The characteristics of the lesion were mixed with radiopaque-radiolucent areas in the form of periapical cemental dysplasia and other benign fibro-osseous lesions or an odontome;</p></list-item><list-item><p>The remnants of deciduous or permanent teeth were clearly identifiable;</p></list-item><list-item><p>The radiopacities were interpreted as a tori or exostoses, salivary calculus, tonsolith, or calcified lymph node;</p></list-item><list-item><p>There is an increased thickening of the lamina dura around teeth with marked malposition or which were serving as abutments for fixed bridges or partial dentures;</p></list-item><list-item><p>Solitary radiopacities in edentulous regions.</p></list-item></list><p>Radiopaque areas that were depicted as IO were classified as follows<xref ref-type="bibr" rid="b2-dent05_p0409">2</xref> (<xref ref-type="fig" rid="f1-dent05_p0409">Figures 1A–E</xref>):
<list list-type="order"><list-item><p>Interradicular: if the sclerotic area was confined between the roots and interrelated with the adjacent teeths’ lamina dura;</p></list-item><list-item><p>Interradicular and separate: if the sclerotic area was confined between the roots and not interrelated with the adjacent teeths’ lamina dura;</p></list-item><list-item><p>Apical and interradicular: if the radiopacities were at the apices and showed significant extension between the roots;</p></list-item><list-item><p>Apical: if the lesions were located around the apices of the roots;</p></list-item><list-item><p>Separate: if the masses were located apically and clearly separated from the teeth and lamina dura.</p></list-item></list></p><sec sec-type="methods"><title>Statistical analysis</title><p>For each patient, demographic data was recorded in order to investigate the relationship between the findings and age, gender, and localization. The observed results were analyzed with SPSS 16.0 (Statistical Package for Social Science Inc., Chicago, Illinois, USA). Data was obtained using the <italic>chi-square</italic> test, and the results were considered to have a significant difference if the significance level was less than .05.</p></sec></sec><sec sec-type="results"><title>RESULTS</title><p>Osteosclerosis was identified in 135 of the 2,211 patients, for an overall prevalence of 6.1% of patients. In these 135 patients, a total of 153 foci were identified. One hundred twenty-three patients had 1 IO, nine patients had 2 IOs, two patients had 3 IOs, and one patient had four foci of IOs. There is a statistically significant difference between the rates of occurrence in the jaws (P<.001); the vast majority occurred in the mandible, and only 19 foci were detected in maxilla and 134 in the mandible.</p><p>The patient population as a whole consisted of approximately 59% females and 41% males. The prevalence of IO among females was 5.9% (77 females) and 6.3% (58 males) among males. There was no statistically significant difference in the prevalence of IO between the males and females (P=.768).</p><p>The ages of the study group ranged from 10 to 77 years with a median of 26 years. Most lesions were found in patients between the ages of 21 and 30. No significant difference in prevalence of IO was found among age groups (<xref ref-type="table" rid="t1-dent05_p0409">Table 1</xref>) (P=.3654).</p><p>In the maxilla, the most common location of IO was the anterior area whereas in the mandible, most lesions were detected in the molar region. <xref ref-type="table" rid="t2-dent05_p0409">Table 2</xref> shows the distribution of IO when examining the jaws and localization.</p><p>Most of the lesions of IO, approximately 51.6%, were associated with the root apices. Separate localization in which the lesions were apical to and clearly separated from the teeth and lamina dura was the second most common localization with 22.9% prevalence. Seventeen percent of the lesions were detected at the apices and showed extension to the interradicular areas; 6.5% were in interradicular areas; and 2% were detected in interradicular and separate localizations (<xref ref-type="table" rid="t2-dent05_p0409">Table 2</xref>).</p></sec><sec sec-type="discussion"><title>DISCUSSION</title><p>The frequency of IO observed in this study was 6.1%, the same as the prevalence found by Yonetsu et al.<xref ref-type="bibr" rid="b4-dent05_p0409">4</xref> In the literature, the prevalence varies from 4% to 31%, and our findings fall within this range.<xref ref-type="bibr" rid="b2-dent05_p0409">2</xref>,<xref ref-type="bibr" rid="b8-dent05_p0409">8</xref>,<xref ref-type="bibr" rid="b16-dent05_p0409">16</xref>,<xref ref-type="bibr" rid="b17-dent05_p0409">17</xref> One of the reasons for the variation in the studies is the different definitions of osteosclerosis. <xref ref-type="bibr" rid="b4-dent05_p0409">4</xref> Some researchers included radiopacities that are related to traumatic occlusion or pulpal inflammation, while others excluded these kinds of lesions from their study.<xref ref-type="bibr" rid="b2-dent05_p0409">2</xref>,<xref ref-type="bibr" rid="b4-dent05_p0409">4</xref> In our study, solitary radiopacities in edentulous regions were not included, and asymptomatic radiopaque masses within the jaws which had no certain relationship to any known sources of hard tissue production were accepted as idiopathic osteosclerosis.<xref ref-type="bibr" rid="b2-dent05_p0409">2</xref> Another reason may be the choice of radiography. In some studies, periapical radiographs were examined<xref ref-type="bibr" rid="b1-dent05_p0409">1</xref>,<xref ref-type="bibr" rid="b2-dent05_p0409">2</xref> whereas in some others, panoramic radiographs were used as the tool of investigation.<xref ref-type="bibr" rid="b3-dent05_p0409">3</xref>,<xref ref-type="bibr" rid="b4-dent05_p0409">4</xref> In our study, we also preferred using panoramic radiographs in order to detect larger areas in jaws.</p><p>Some researchers reported a female predilection for the incidence of IO<xref ref-type="bibr" rid="b5-dent05_p0409">5</xref> while others showed no significant difference in prevalence between males and females as in our study.<xref ref-type="bibr" rid="b4-dent05_p0409">4</xref>,<xref ref-type="bibr" rid="b8-dent05_p0409">8</xref>,<xref ref-type="bibr" rid="b15-dent05_p0409">15</xref>,<xref ref-type="bibr" rid="b17-dent05_p0409">17</xref> The ages of our study group were ranged from 10 to 77 and there was no significant difference in prevalence of IO among age groups similar to results of Yonetsu et al<xref ref-type="bibr" rid="b4-dent05_p0409">4</xref> and Kawai et al.<xref ref-type="bibr" rid="b18-dent05_p0409">18</xref></p><p>Although in their studies Geist and Katz<xref ref-type="bibr" rid="b2-dent05_p0409">2</xref> and Sun et al<xref ref-type="bibr" rid="b18-dent05_p0409">18</xref> reported the highest occurrence in the premolar region, the results of this study support the previous findings, which indicated the most common location of IO is in the first molar region of the mandible.<xref ref-type="bibr" rid="b4-dent05_p0409">4</xref>,<xref ref-type="bibr" rid="b5-dent05_p0409">5</xref>,<xref ref-type="bibr" rid="b13-dent05_p0409">13</xref>,<xref ref-type="bibr" rid="b18-dent05_p0409">18</xref></p><p>In our study, most of the lesions of IO were found to be associated with the root apices. Traumatic occlusion and traumatic movement of teeth is known to be a possible explanation for IO.<xref ref-type="bibr" rid="b2-dent05_p0409">2</xref> Although the radiopacities around teeth that showed malposition or seemed to be subject to abnormal occlusal forces were excluded from our study group, slight imbalances in occlusion that provide enough vibratory stimulus to provoke bone formation might escape radiographic detection, and this might explain why the highest predilection of the lesions was associated with the root apices.</p><p>In some studies, IO was reported to be an anatomic variation.<xref ref-type="bibr" rid="b2-dent05_p0409">2</xref>,<xref ref-type="bibr" rid="b19-dent05_p0409">19</xref>,<xref ref-type="bibr" rid="b20-dent05_p0409">20</xref> In our study, separate localizations, where the lesions were apical to and clearly separated from the teeth and lamina dura, was the second most common localization with 22.9% prevalence. Because the lesions were clearly separated from the teeth, and there were no residual tooth fragments or the stimulatory effects of excessive occlusion would not be a factor in this localization, may support the possibility that IO may be a developmental anatomic variation.</p></sec><sec sec-type="conclusions"><title>CONCLUSIONS</title><p>In light of these findings, we can define IO as developmental variations of normal bony architecture unrelated to local stimuli. The lesions can arise at any age, at any location, and with no sex predilection, and IO usually requires no treatment other than diagnosis by recognition.<xref ref-type="bibr" rid="b7-dent05_p0409">7</xref> Generally, the lesions are likely to remain for years, and surgical intervention is not recommended. To be sure that the clinical diagnosis is correct, periodic follow-up of the lesions is necessary. 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group</bold></th><th align="center" valign="middle" rowspan="1" colspan="1"><bold>All patients</bold></th><th align="center" valign="middle" rowspan="1" colspan="1"><bold>IO present</bold></th><th align="center" valign="middle" rowspan="1" colspan="1"><bold>Percentage</bold></th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">10–19</td><td align="center" valign="top" rowspan="1" colspan="1">699</td><td align="center" valign="top" rowspan="1" colspan="1">43</td><td align="center" valign="top" rowspan="1" colspan="1">6.2%</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">20–29</td><td align="center" valign="top" rowspan="1" colspan="1">511</td><td align="center" valign="top" rowspan="1" colspan="1">43</td><td align="center" valign="top" rowspan="1" colspan="1">8.4%</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">30–39</td><td align="center" valign="top" rowspan="1" colspan="1">334</td><td align="center" valign="top" rowspan="1" colspan="1">22</td><td align="center" valign="top" rowspan="1" colspan="1">6.6%</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">40–49</td><td align="center" valign="top" rowspan="1" colspan="1">274</td><td align="center" valign="top" rowspan="1" colspan="1">18</td><td align="center" valign="top" rowspan="1" colspan="1">6.6%</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">50–59</td><td align="center" valign="top" rowspan="1" colspan="1">181</td><td align="center" valign="top" rowspan="1" colspan="1">7</td><td align="center" valign="top" rowspan="1" colspan="1">3.9%</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">60–69</td><td align="center" valign="top" rowspan="1" colspan="1">62</td><td align="center" valign="top" rowspan="1" colspan="1">2</td><td align="center" valign="top" rowspan="1" colspan="1">3.2%</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">70–</td><td align="center" valign="top" rowspan="1" colspan="1">14</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">.0%</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Total</td><td align="center" valign="top" rowspan="1" colspan="1">2075</td><td align="center" valign="top" rowspan="1" colspan="1">135</td><td align="center" valign="top" rowspan="1" colspan="1">6.1%</td></tr></tbody></table></table-wrap><table-wrap id="t2-dent05_p0409" position="float"><label>Table 2</label><caption><p>Location of lesions and relation to teeth.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th align="center" valign="middle" rowspan="1" colspan="1"><bold>Interradicular</bold></th><th align="center" valign="middle" rowspan="1" colspan="1"><bold>Interradicular and Separate</bold></th><th align="center" valign="middle" rowspan="1" colspan="1"><bold>Apical and Interradicular</bold></th><th align="center" valign="middle" rowspan="1" colspan="1"><bold>Apical</bold></th><th align="center" valign="middle" rowspan="1" colspan="1"><bold>Separate</bold></th><th align="center" valign="middle" rowspan="1" colspan="1"><bold>Total</bold></th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Maxilla</td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Anterior</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">2</td><td align="center" valign="top" rowspan="1" colspan="1">8</td><td align="center" valign="top" rowspan="1" colspan="1">1</td><td align="center" valign="top" rowspan="1" colspan="1">11/153 (7.2%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Canin</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0/153 (.0%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Canin-premolar</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">1</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">1/153 (0.7%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Premolar</td><td align="center" valign="top" rowspan="1" colspan="1">1</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">1</td><td align="center" valign="top" rowspan="1" colspan="1">2</td><td align="center" valign="top" rowspan="1" colspan="1">4/153 (2.6%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Premolar-molar</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0/153 (.0%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Molar</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">3</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">3/153 (2.0%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Mandible</td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Anterior</td><td align="center" valign="top" rowspan="1" colspan="1">1</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">2</td><td align="center" valign="top" rowspan="1" colspan="1">5</td><td align="center" valign="top" rowspan="1" colspan="1">3</td><td align="center" valign="top" rowspan="1" colspan="1">11/153 (7.2%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Canin</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">1</td><td align="center" valign="top" rowspan="1" colspan="1">14</td><td align="center" valign="top" rowspan="1" colspan="1">2</td><td align="center" valign="top" rowspan="1" colspan="1">17/153 (11.1%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Canin-premolar</td><td align="center" valign="top" rowspan="1" colspan="1">1</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">3</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">3</td><td align="center" valign="top" rowspan="1" colspan="1">7/153 (4.6%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Premolar</td><td align="center" valign="top" rowspan="1" colspan="1">2</td><td align="center" valign="top" rowspan="1" colspan="1">1</td><td align="center" valign="top" rowspan="1" colspan="1">5</td><td align="center" valign="top" rowspan="1" colspan="1">16</td><td align="center" valign="top" rowspan="1" colspan="1">15</td><td align="center" valign="top" rowspan="1" colspan="1">39/153 (25.5%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Premolar-molar</td><td align="center" valign="top" rowspan="1" colspan="1">2</td><td align="center" valign="top" rowspan="1" colspan="1">2</td><td align="center" valign="top" rowspan="1" colspan="1">4</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">3</td><td align="center" valign="top" rowspan="1" colspan="1">11/153 (7.2%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Molar</td><td align="center" valign="top" rowspan="1" colspan="1">3</td><td align="center" valign="top" rowspan="1" colspan="1">0</td><td align="center" valign="top" rowspan="1" colspan="1">8</td><td align="center" valign="top" rowspan="1" colspan="1">32</td><td align="center" valign="top" rowspan="1" colspan="1">6</td><td align="center" valign="top" rowspan="1" colspan="1">49/153 (32.%)</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Total</td><td align="center" valign="top" rowspan="1" colspan="1">10/153 (6.5%)</td><td align="center" valign="top" rowspan="1" colspan="1">3/153 (2%)</td><td align="center" valign="top" rowspan="1" colspan="1">26/153 (17%)</td><td align="center" valign="top" rowspan="1" colspan="1">79/153 (51.6%)</td><td align="center" valign="top" rowspan="1" colspan="1">35/153 (22.9%)</td><td align="center" valign="top" rowspan="1" colspan="1"></td></tr></tbody></table></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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