AKA
- Dense bone island, bone eburnation, bone whorl, bone scar, enostosis, focal periapical osteopetrosis
Cause
- Focal area of increased radiodensity that is of unknown cause and cannot be attributed to any inflammatory, dysplastic, neoplastic, or systemic disorders
Incidence
- Increased frequency in blacks and Asians.
- No sex predilection.
- Most arise in late first or early second decade of life. The peak prevalence is third decade, with peak bone mass in the fourth decade.
Location
- 90% in mandible, most often in first molar area.
Clinical Presentation
- Asymptomatic and not associated with any cortical expansion.
Radiographic Features
- Well-defined, rounded radiodense mass.
- Often associated with tooth root apex.
Compare to
- Condensing osteitis, focal chronic sclerosing osteomyelitis.
- For patients with multiple areas of involvement, multiple osteomas in setting of Gardner syndrome should be excluded.
Histopathology
- Dense lamellar bone with scant fibrofatty marrow
Treatment
- Biopsy if symptomatic or if significant cortical expansion is present.
- Little or no tendency for the lesions to progress or change in adulthood.
