Periapical lesions can arise from a variety of causes. Beyond traditional imaging tools, the introduction of cone-beam computed tomography (CBCT) has greatly improved lesion visualization. Yet, despite extensive radiographic speculation, only histopathology can provide a definitive diagnosis.

The Department of Oral Pathology and Maxillofacial Imaging at Kaohsiung Medical University Hospital, Taiwan, is among the few clinical departments worldwide that integrate oral pathology and oral radiology. In this session, we will share selected periapical cases from our combined oral pathology and imaging databases—tracing the diagnostic journey from grayscale radiographic findings to the final colorful histopathological confirmation.

By reviewing these cases, we aim to enrich diagnostic experience, promote the use of appropriate diagnostic tools, and encourage analytical thinking among clinicians. Ultimately, this integration enhances the diagnosis and management of periapical and periodontal lesions, advancing the goal of precision dentistry.