Idiopathic osteosclerosis

Idiopathic osteosclerosis is a common incidental finding on dental imaging.


Idiopathic sclerosis is also known as dense bone islands, enostoses, bone scar or focal periapical osteopetrosis .


Idiopathic sclerosis is detected on ~5% (range 4-31%) of dental imaging .


The etiology is unknown but is considered developmental and not inflammatory in nature . Most commonly (90%) in the mandible near the first molar .

Radiographic features

Idiopathic osteosclerosis may be seen on OPG (orthopantomogram), or cone-beam or dental CT :

  • usually solitary but can be multiple
  • size: 2-3 mm to 1-2 cm
  • round, oval or irregular
  • sclerotic
  • sharp margins without a radiolucent rim
  • periapical (80%) or remote to teeth (20%)

Differential diagnosis

  • condensing osteitis: occurs due to chronic inflammation and is often associated with caries, non-vital teeth and other inflammatory lesions