Patient Characteristics

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

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

The borders of the lesion are: Corticated Defined but not corticated Diffuse Unselected

The loculation of the lesion is: Unilocular Multilocular Not loculated Unselected

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

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

Shall we consider prevalence ? Yes No Unselected