Sialolith

Definition: A calcified concretion (stone) formed within a salivary gland duct.

Radiographic Features:

  • Location:
    • Most common: Submandibular salivary gland
    • Less common: Parotid salivary gland
    • Least common: Sublingual salivary gland
  • Edge: Well-defined
  • Shape: Smooth to irregular mass
  • Internal:
    • Radiopaque
    • May show ‘laminated’ appearance (alternating radiopaque and radiolucent bands)
    • Resembles layers of an onion due to continued calcium salt deposition
  • Number: Typically single, but can be multiple

Key Diagnostic Signs:

  • Radiopaque mass in salivary gland region
  • Possible laminated internal structure
  • May be visible near mandibular molar and premolar apices on periapicals

Clinical Significance:

  • Can cause pain and swelling, especially during meals
  • May lead to sialadenitis (gland inflammation) if left untreated
  • Treatment often involves stone removal, either surgically or by minimally invasive techniques

Note: A mandibular true occlusal radiograph is recommended to determine the nature of the calcification. Differentiating sialoliths from other calcifications in the region is crucial for proper diagnosis and treatment planning.