Which radiographic signs indicate endodontic disease in a tooth without an obvious fracture?

• A. Periapical radiolucency with widening of lamina dura and irregular PDL space near apex.
• B. Fracture line at the root.
• C. Increased vertical bone density near crown.
• D. No radiographic signs.

Answer: (A)

Endodontic disease around a tooth often shows inflammatory changes at the apex that bone responds to with resorption, creating a periapical radiolucency on radiographs. The lamina dura—this thin radiopaque border around the tooth—may become widened or disrupted near the apex as the inflammatory process extends into the surrounding bone. Additionally, the periodontal ligament space adjacent to the apex can appear widened or irregular due to edema and inflammatory infiltration. When you see this combination—periapical radiolucency with lamina dura widening and an irregular PDL near the apex—it points to endodontic pathology even if there’s no visible fracture on the tooth.

Fracture lines would indicate a root fracture rather than endodontic disease, and an increase in vertical bone density near the crown is not typical of endodontic infection. No radiographic signs would argue against disease.