Mandibular lesions are myriad and common. The presence of teeth results in lesions that are specific to the mandible (and maxilla) and a useful classification that defines them as odontogenic or non-odontogenic. While it may often not be possible to make a diagnosis on imaging alone, this classification is helpful to narrow the differential.
Although a histological classification is probably the most scientifically sound, as radiologists, we are presented with an image, and therefore it is easier to classify lesions according to location in the mandible and their appearance. For a detailed classification of odontogenic tumours, many more than even the keenest neuro/head and neck radiologist can ever remember, please refer to the 2005 WHO histological classification of odontogenic tumours.
Below the lesions are divided into cystic and solid. Cystic should not be confused with lytic as solid radiolucent lesions can also appear lytic (see: radiolucent lesions of the jaw).
- periapical cyst (or radicular cyst): common
- dentigerous cyst (or follicular cyst of the mandible): common
- odontogenic keratocyst (OKC): uncommon
- primordial cyst of the mandible
- Stafne cyst (or static bone cavity): uncommon
- solitary bone cyst of the mandible (or traumatic or haemorraghic bone cysts)
- aneursymal bone cyst (ABC): rare in the mandible
- residual cyst of the mandible
- odontoma: most common odontogenic tumour
- ameloblastoma: relatively common
- odontogenic myxoma (looks just like an ameloblastoma): rare
- calcifying epithelial odontogenic tumour (or Pindborg tumour) (looks just like an ameloblastoma): rare
- cementoblastoma: rare
- ameloblastic fibroma
- adenomatoid odontogenic tumour: rare
- condensing osteitis of the mandible
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