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History: A 40-year-old woman was referred to the endodontist by her family dentist to evaluate a lesion located at the periapical area of tooth #30. The woman was asymptomatic. She did not report paresthesia, and there was no history of trauma.
Her past medical history included seasonal allergies and a recent COVID-19 infection.
The extraoral and intraoral exams were within normal limits. There was no tooth mobility. The endodontist ordered a cone-beam computed tomography (CBCT) scan. Below is a sagittal and axial view of the tooth. Click to enlarge the images.
The endodontist consulted with an oral and maxillofacial radiologist.
What is the LEAST likely preliminary diagnosis?CorrectIncorrect
The oral radiologist evaluated the CBCT films and provided a report to the endodontist. A paragraph from the report is provided below:
Small hypodense lesions (radiolucent) are observed at the mesial and distal apices of tooth #30. The lesions are well defined and well corticated. There is no evidence of expansion in the coronal and axial projections for the small lesion at the distal apex. However, there is evidence of expansion (buccal) of the hypodense lesion located at the apex of the mesial root. Hyperdense bone is present at the periphery of the lesion, indicating a chronic inflammatory process.
Based on the report, what is the most likely diagnosis from the radiologist?CorrectIncorrect
Which of the following is a critical step to perform in determining a precise differential diagnosis?CorrectIncorrect
The endodontist performed an excisional biopsy and a root canal treatment. The histopathology report confirmed the diagnosis of a radicular cyst.
Which of the following is true about the origin of radicular cysts?CorrectIncorrect
Radicular cysts belong to the odontogenic inflammatory cyst group.CorrectIncorrect
Where specifically do radicular cysts originate from?CorrectIncorrect