Pulp and Periapical Pathology: Inflammatory Pathology-Periapical lesions are among the most common findings during clinical and imaging examinations. These lesions most typically represent inflammatory pathology of pulp and periapical origin, but they may also represent odontogenic and nonodontogenic cysts an

Periapical lesions are among the most common findings during clinical and imaging examinations. These lesions most typically represent inflammatory pathology of pulp and periapical origin, but they may also represent odontogenic and nonodontogenic cysts an

Back to course

Video Transcription

Video Summary

Dr. David Klingman’s webinar focused on how to evaluate pulp and periapical pathology using a practical diagnostic approach. He emphasized a three-step method: vitality testing, periodontal probing, and appropriate imaging, especially periapical radiographs and small-field CBCT when needed.<br /><br />The lecture reviewed common inflammatory lesions such as periapical granulomas, periapical cysts, and buccal bifurcation cysts, explaining that many are trauma-related or associated with pulp disease. He also discussed how histology can confirm diagnoses and influence treatment, especially in cases involving cemental tears, residual cysts, or persistent lesions after endodontic therapy.<br /><br />Klingman contrasted inflammatory lesions with developmental entities such as nasopalatine duct cysts, lateral periodontal cysts, odontogenic keratocysts, and fibro-osseous lesions like cemento-osseous dysplasia and dense bone islands. He stressed that location, vitality status, radiographic appearance, and symptom history all help narrow the differential diagnosis.<br /><br />The main message was to combine clinical testing, imaging, history, and pathology to guide treatment, avoid unnecessary surgery, and recognize when referral or advanced imaging is needed.

Keywords

pulp pathology

periapical pathology

vitality testing

periodontal probing

periapical radiographs

CBCT imaging

inflammatory lesions

differential diagnosis

endodontic therapy