Juxta-Apical Radiolucency: Prevalence, Characterization, and Association With the Third Molar Status

J Oral Maxillofac Surg. 2018 Apr;76(4):716-724. doi: 10.1016/j.joms.2017.11.023. Epub 2017 Nov 23.

Abstract

Purpose: This study aimed to investigate the prevalence of juxta-apical radiolucency (JAR), assessing its association with third molar status and describing its radiologic features through panoramic radiography.

Materials and methods: We evaluated 1,050 radiographs (1,830 third molars) for the presence of JAR. The JAR and control groups were classified according to the third molar's angulation, impaction, and root development. The presence of radiographic signs of proximity between the mandibular canal and third molar and the imaging features of JAR also were recorded.

Results: JAR was identified in 116 patients (11%) and 130 third molars (7.1%), being significantly associated with female patients and with the second and third decades of life. There also was an association with teeth with a vertical angulation and complete root formation. Radiographic signs of proximity to the mandibular canal were absent in 66.2% of JAR cases. In most cases, there was lamina dura in the juxta-apical area that appeared to overlap the mandibular canal and to have a cortical outline.

Conclusions: JAR is not a rare imaging finding. Given its possible relationship with nerve injuries and its differential diagnostic possibilities, knowing the characteristics of JAR is important to assist professionals in treatment planning and making the correct diagnosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Molar, Third / diagnostic imaging*
  • Molar, Third / surgery
  • Prevalence
  • Radiography, Dental
  • Radiography, Panoramic
  • Tooth Extraction / adverse effects
  • Tooth, Impacted / diagnostic imaging*
  • Tooth, Impacted / epidemiology
  • Tooth, Impacted / surgery
  • Trigeminal Nerve Injuries / etiology
  • Trigeminal Nerve Injuries / prevention & control
  • Young Adult