Most cases are observed involving the posterior mandible. Radiographic assessment reveals a characteristic, well-defined radiopaque lesion. Most cases are associated with the periapical region of a tooth or teeth, however, in some cases the radiopaque area may be located in an inter-radicular area or in areas of the jaw with no apparent relationship to a tooth. Occasional cases exhibiting root resorption have also been observed. Because few cases of idiopathic osteosclerosis are treated by biopsy, few histologic studies have been reviewed.
Inflammation is absent.
The diagnosis of idiopathic osteosclerosis is usually made based upon the clinical features in association with the radiographic characteristics. The differential diagnosis usually includes condensing osteitis. In general a periapical radiopaque lesion associated with a vital tooth in the absence of a deep restoration or caries is likely to represent idiopathic osteosclerosis. Idiopathic osteosclerosis requires no treatment. Although there is little or no tendency for this condition to progress or change, some lesions may regress or actually disappear in the older individual.