Patient Characteristics

 CLINICAL FEATURES

What is the sex of your patient? Male Female Unknown Unselected
What is the race of your patient? Black Nonblack Unknown Unselected
What is the age of your patient? 0 - 10 11 - 25 26 - 50 50 + Unknown Unselected
Does your patient have pain or paresthesia? No pain Pain Unknown Unselected


 RADIOGRAPHIC FEATURES

 Location

Which jaw contains the lesion? Maxilla only Mandible only Both jaws Unselected
The lesion center is in what region ? Incisor region Canine/Premolar Region Molar region Ramus region TMJ region Sinus region Unselected
The relationship of the lesion to teeth is: Crown associated Root associated Apex associated (vital tooth) Apex associated (non-vital tooth) Apex associated (vitality unknown) Missing tooth associated Not tooth associated Unselected
Please estimate the number of lesions: One Two Three or more Generalized Unselected
What is the maximum size of the lesion? Less than 2 cm 2 to 3 cm Greater than 3 cm Unselected
Where is the origin of the lesion? Central Peripheral Unselected


 Periphery

The borders of the lesion are: Corticated Defined but not corticated Diffuse Unselected
The loculation of the lesion is: Unilocular Multilocular Not loculated Unselected


 Internal Structure

The contents of the lesions are: Radiolucent Radiopaque Mixed Radiolucent with flecks Unselected
Does the lesion contain one or more teeth ? Yes No Unknown Unselected


 Effects on Surrounding Structures

Does the lesion expand the bony cortex? Yes No Unselected
Does the lesion cause root resorption ? Yes No Unselected
Does the lesion cause tooth displacement or impaction? Yes No Unselected


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Shall we consider prevalence? Yes No Unselected