Differential

Diagnosis
1. Contacting teeth:
a. Peri-apical
b. Peri-coronal
c. Inter-dental
2. Multilocular
3. Multiple lesion
4. Ground glass appearance
5. Floating teeth
6. Related to missing teeth
7. Generalized decrease in bone density
8. Sun-ray or Hair on end appearance

a. Peri-apical
1. Radiolucent:(single tooth)

Periapical Granuloma
Radicular cyst
Surgical defect
Periapical abscess
Scar tissue

a. Peri-apical
2. Mixed

Peri-apical cemental dysplasia

 True cementoma
Hyper-cementosis

a. Peri-apical
Radio-opaque

1. Peri-apical cemental dysplasia

2. True cementoma
3. Hypercementosis
4. Condensing osteitis
5. Idiopathic osteo-sclerosis
6. Salivary gland stone

a. Peri-apical radiolucent (multiple

teeth)

1. Traumatic bone cyst

2. Central Giant Cell Granuloma
3. OKC
4. Ameloblastoma
5. Incisive canal cyst
6. Globulomaxillary cyst
7. Anneurymal bone cyst

b. Peri-coronal
Radiolucent:
1. Dentigerous (Follicular)cyst
2. Mural Ameloblastoma
3. Adenomatoid Odontogenic Tumor (AOT)
4. Ameloblastic fibroma
5. CEOC
6. CEOT

b. Peri-coronal
Mixed
1. CEOC
2. CEOT
3. Adenomatoid Odontogenic Tumor (AOT)
4-Ameloblastic fibro odontome

b. Peri-coronal
Radio-opaque
1. Complex odontome
2. Compund odontome
3. Ameloblastic fibro-odontome
4. Dentinoma

c. Inter-dental
Radiolucent
1. Lateral Periodontal cyst
2. Globulomaxillary cyst
3. Traumatic (Solitary) bone cyst
4. Nasopalatine duct cyst
5. Lateral Radicular cyst
6. Ameloblastoma
7. AOT

c. Inter-dental
Radio-opaque
1. Complex odontome
2. Compound odontome
3. Dentinoma
4. Cemento ossifying fibroma
5. Idiopathic osteo-sclerosis
6. Salivary gland stone

2- Multilocular
1. Odontogenic Keratocyst
2. Ameloblatoma
3. Aneurysmal bone cyst
4. Odontogenic myxoma
5. Central Giant Cell Granuloma
6. Cherubism
7. Central Hemangioma
8. Mucoepidermoid carcinoma

3. Multiple lesion
a. Radiolucent
1.
2.
3.
4.
5.
6.

Gorlin syndrome
Multiple myeloma
Hand schuller christian disease
Letterer sewie
Peri-apical cemento-ossous dysplasia
Cherubism

3- Multiple lesion
b. Mixed
1. Peri-apical cemento-ossous dysplasia
2. Florid cemento-ossous dysplasia
3. Familial cemento-ossous dysplasia

3. Multiple lesion
C. Radio-paque
1. Pagets disease
2. Gardner syndrome
3. Osteopetrosis

4. Ground Glass appearance

1. Fibrous dysplasia
2-Hyperparathyroidism

5. Floating teeth
or ill defined radiolucent
A. Radiolucent
. Inflammatory:
1. Localized aggressive periodontitis
2. Osteomyelitis
II. Malignant:
1. Metastatic tumors
2. Eosinophilic granuloma
3. Squamous Cell Carcinoma
4. Malignant Salivary Gland Tumor
5. Osteolytic type of Osteo-sarcoma

5. Floating teeth
b. Mixed
I. Inflammatory:
Osteomyelitis
II. Malignant:
1. Metastatic tumors (breast,prostate)
2. Osteoblastic type of osteo-sarcoma
3. Chondro-sarcoma

6- Related to missing teeth

1.
2.
3.
4.
5.

Residual cyst
OKC
Ameloblastoma
Paradental cyst
Submandibular salivary gland defect (Stafne bone cyst)

7. Generalized decrease in bone

density
1.
2.
3.
4.
5.
6.

Hyperparathyrodism
Osteoporosis
Thalassemia
Sickle Cell Anemia
Osteomalacia Rickets

8. sun- ray or hair on end appearance

1.
2.
3.
4.

Sickle cell anemia

Thalassemia
Osteosarcoma
Ewing sarcoma