Differentiation between periapical cysts and granulomas using computed tomography scans: A literature review

Emmanuel João Nogueira Leal da Silva, Flávia Saavedra, Aline Cristine Gomes, Alexandre Augusto Zaia

Periapical lesions are formed in response to an inflam- matory process involving the periodontal region of ne- crotic teeth. Thus, endodontic treatment is often related to treatment of these lesions which may manifest as cysts or periapical granulomas. Nevertheless, many questions about the differential diagnosis of these lesions remain. Histopathological evaluation of a sample subjected to biopsy remains as the gold standard of determining the type of periapical lesion. In order not only to provide the least invasive endodontic treatment possible, but also with the aim of optimizing it, a nonsurgical method capable of differentiating periapical cysts and granulomas should be identified. Cone-beam computed tomography (CBCT) has been used with a view to seeking a new diagnostic method. However, despite the fact that this method is able to identify periapical lesions, its real potential to provide a distinction between cysts and granulomas remains un- clear. Thus, the main objective of this literature review is to provide a comprehensive overview on the potential of CBCT to differentiate periapical cysts and granulomas. It was concluded that there is a real need for more re- search on alternative and non-invasive methods of per- forming a differential diagnosis that differentiates cysts and granulomas. However, based on studies conducted to date, computed tomography might be considered an important and possibly the most appropriate tool used for differential diagnosis of periapical lesions.

Keywords: Cysts. Granuloma. Cone-beam computed tomography.

How to cite: Silva EJNL, Saavedra F, Gomes AC, Zaia AA. Differentia- tion between periapical cysts and granulomas using computed tomography scans: A literature review. Dental Press Endod. 2014 May-Aug;4(2):29-33. doi: http://dx.doi.org/10.14436/2178-3713.4.2.029-033.oar

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