The periapical lesions represent a complex group. Granulomas and cysts represent the two most frequent forms in routine clinical practice.

Aim: Highlight the diagnostic accuracy of CBCT imaging in the differential diagnosis between a cyst and a granuloma compared to histopathological examination as a reference technique.

Materials and Methods:

Our literature search involved articles published in the following databases: PubMed, Cochrane, science direct and Google scholar.

Our intention was to review recent articles from the last 5 years and to select studies conducted in significantly changed socio-medical contexts that could have a positive impact on the validity of our results.
The review included observational, comparative, retrospective studies, and excluded case reports, animal studies as well as in vitro studies.

The methodology of this study was submitted for registration on the International Register of Journals systematics PROSPERO : CRD42023427413

the search identified 5 publications that qualitatively or quantitatively evaluated the use of CBCT in the differential diagnosis of cysts and granulomas .
The different variables evaluated in the included studies are: location, periphery, shape, internal structure, effects on the surrounding structure: resorption or displacement of the root, perforation of the cortical plate, volume of the lesion, value of the grey density and parameters analyzing the texture of the images.
The most significant parameters that allowed the distinction between cyst and granuloma were lesion volume, lesion shape and cortical border.
The adjusted gray density values in the small FOV images of the tested CBCT machine could not differentiate a cystic lesion from a solid lesion .


A cyst is predicted when the lesion volume exceeds 247 mm3. A round shape corresponds to a cystic lesion and a curved shape to a granuloma.
Regarding the cortical border, its presence or absence is a characteristic criterion that differentiates a cyst from a granuloma.
Further studies using larger samples and standardized CBCT exposure parameters are recommended to demonstrate the utility of this noninvasive technique.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.