Learning Module:

Not Every Tooth With a Radiolucent Lesion Needs a Root Canal

Learning Type

Problem-Based Case





Many radiolucencies are asymptomatic and discovered on routine radiographs but knowing how to identify and differentiate them from the typical endodontic presentation is critical to ensure ideal management and outcome. In this module, Dr. David Landwehr explains the diagnostic limitations of pulp testing and discusses how the subjective interpretation of radiographs and CBCT imaging can lead to diagnostic misinterpretations or mistakes. Go beyond periapical cysts and granulomas and discover what it takes to accurately interpret radiolucencies that yield a differential diagnosis that could result in earlier treatment and a potentially better prognosis.

Learning Objectives:

  • Employ different interpretation strategies for various imaging techniques.
  • Recognize that radiographs alone won’t make a definitive pulpal and periapical diagnosis.
  • Express how developmental, metabolic, and neoplastic etiologies can closely resemble an inflammatory cause.
  • Recognize that a radiographic lesion, not pupal in origin, warrants further evaluation for accurate diagnosis.


Dr. David Landwehr

Supporting Images