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Figures and captions to figures
Fig 1. Radicular cyst. Dental CT. (a) Sagittal reformatted image 1. (b) Panoramic reformatted overview.
Note a well-delineated lesion (asterisk) with an intimate relationship with the apex of tooth 13. There is also resorption of adjacent teeth apices 11 and 12 (arrow).
Fig 2. Pathogenesis of a radicular cyst. Schematic drawing. (a) Occlusal caries may lead to spread of germs via the dental canal and ultimately infect the apex of the tooth. The traject indicated in green represents the route of spread of the germs, whereas the red area represents the normal part of the dental canal (b) Local infection results in formation of a granuloma. (c) After resolution of the infection, further cystification may occur.
Fig 3. Odontogenic keratocyst. (a) Axial CT image in soft tissue window shows an osteolytic lesion in the left body of the mandible (white arrow). The density of the lesion is similar to muscle (b) T2-WI shows a T2-hyperintense lesion in the left mandible, with cortical
breakthrough (best seen on this coupe, some centimetres higher than the shown CT-slice a;
white arrow). This lesion has a characteristic mesiodistal expansion. The small intralesional hypo-intense foci correspond to keratin. Axial T1-WI with fat suppression, before (c) and after intravenous gadolinium administration (d), shows faint rim enhancement of the lesion (white arrow).
Fig 4. Acute osteomyelitis. (a) A panoramic radiography shows a radiolucent lesion in the neck and lateral ramus of the left mandible (black arrow). (b) Axial cone beam CT confirms a radiolucent lesion with cortical breakthrough in the left mandible neck (white arrow). (c) T1-weighted MRI image after intravenous gadolinium contrast administration shows an
intensivemarked contrast enhancement of the bone marrow, loss of delineation of the cortex and soft tissue extension in the adjacent pterygoidal (black asterisk) and masseter muscles (white asterisk). (d) Axial cone beam CT shows another patient with a radiolucent lesion in the left mandible, with cortical erosion medially (black arrow), and surrounding reactive sclerosis.
Fig 5. Dentigerous cyst. Cone beam CT. (a) axial image. (b) coronal image (c) sagittal image (An expansile radiolucent lesion (white asterisk) with cortical breakthrough of at the posterior, olateral (black arrow)) and medial wall of the maxillary sinus (white arrow), with obliteration of the meatus medius of the nasal cavity. This is a well-known possible
complication of a dentigerous cyst. 21There is also partial destruction of the right concha nasalis media. Note the intimate relationship with the crown of the ectopic tooth 18 (black asterisk).
Fig 6. Nasopalatine duct cyst. Cone beam CT, (a) coronal and (b) sagittal reconstructions show a well-defined radiolucent lesion (asterisk) in the midline of the palatum (white arrow).
Note at the inferior border focal cortical thinning and even cortical breakthrough at the inferior border.
Fig 7. Nasolabial cyst. MRI. (a) Axial T2-WI shows a well-delineated lesion in the left anterior maxillary jaw in a 37-year-old man (white arrow). (ab) T2-WI with fat saturation shows a lesion with a high signal keeping with fluid contents (white arrow). (b)
Fig 8. Ameloblastoma. (a) Coronal CT reconstruction in soft tissue window shows
intralesional papillary projections (asterisk). (b) Coronal CT reconstruction in bone window.
breakthrough (white arrow). (c) Axial CT in soft tissue window, shows an expansile soft tissue mass (asterisk) in the ramus ascendens of the mandible, with a buccolingual extension.
Fig 9. Idiopathic bone cyst. Panoramic reconstruction of a dental CT shows a well-defined lesion in the left mandible (asterisk), with associated cortical thinning (white arrow). The lesion extents between the roots of the teeth.
Supplementary online figures:
Suppl. Fig 1. Osteomyelitis. (a) Axial CT image in the soft tissue windows (a) and (b) in the bone window (b). (a). Acute presentation with swelling of the left chewing muscles
(asterisk). (b) One year later persistent (chronic) osteomyelitis complicated by fracture of the left mandible (white arrow).
Suppl. Fig 2. Nasopalatine duct cyst. Cone beam CT, axial reconstruction showing the typical midline location of this well-defined radiolucent lesion. Note focal cortical breakthrough (white arrow).
Suppl. Fig 3. Nasolabial cyst. CT shows a well-delineated expansile radiolucency in the left maxillary jaw, with associated cortical thinning. (a) Panoramic CT reconstruction, (b) axial and (c) coronal reformation in soft tissue window.
Suppl. Fig 4. Residual cyst developed after extraction of tooth 38 couple of years ago.
Coronal CT, (a) soft tissue (a) and (a) bone window (b). A well-defined cystic lesion in the left mandibular angle, with extension in the mesiodistal direction..
Suppl. Fig 5. Ameloblastoma. MRI. (a) T1-WI showing a hypo-intense mass in the right maxillary sinus (asterisk). B(b)T1-WI with fat saturation after intravenous gadolinium
administration showing contrast enhancement of this soft tissue mass (white arrow). (c)The diffusion Diffusion weighted image (ADC map) showing diffusion restriction (white arrow) secondary to a hypercellular structure. (d) Coronal reformatted CT image shows the
expansile feature of the mass (asterisk) with extension into the nasal cavity at the right side.
There is also cortical destruction at the lateral wall and floor of the right maxillary sinus (white arrow).
Suppl. Fig 6. Brown tumor. (a) Axial CT in bone (A) and (b) soft tissue window (B). Osteolytic lesion anteriorly in the mandible, with associated extra-osseous soft tissue mass extending.
There is cortical breakthrough on both sides (white arrows).
Suppl. Fig 7. Squamous cell carcinoma in the mouth floor. (a) Axial contrast-enhanced CT in soft tissue (a) and (b) bone window (b). destructive Destructive osteolytic lesion anteriorly in the mandible, with marked contrast enhancement of the associated soft tissue extension (white arrows).
Suppl. Fig 8. Squamous cell carcinoma in the left upper jaw. (a) Axial contrast-enhanced CT in soft tissue (a) and (b) bone window (b). Osteolytic lesion with associated soft tissue component anteriorly in the left maxilla (white arrows) with irregular delineatedperipheral contrast enhancement.
Suppl. Fig 9. Multiple myeloma in the left mandible. (a) Axial (a) and (b) paracoronal (b) CT in bone window. Destructive osteolytic lesion (white arrows) anteriorly in the left mandible, with cortical breakthrough.
Suppl. Fig 10. Idiopathic bone cavity. Cone beam CT, sagittal reformatted image shows the relationship of the this expansile radiolucent lesion (asterisk) with the tooth. There are No erosive changes secondary to the expansile radiolucent lesion.