Cemento-osseous dysplasia, a radiological mimic of periapical dental abscess

In the imaging evaluation of Emergency Department patients presenting with facial pain, there is a condition that can mimic the radiographic appearance of a periapical dental abscess. This condition, cemento-osseous dysplasia, may appear similar on dental X-rays, panoramic radiographs, and computed tomography examinations to and must be distinguished from the more common periapical abscess in order to avoid inappropriate intervention. This review highlights the easy confusion of these two entities based on radiographic appearance and the clinical implications of such a mistake and suggests some approaches to avoid this error.