I Inflammation of the pulp that has extended to the»periodontal ligament leads to inflammation of theapical tissues, such as periapical abscesses,granulomas, and cysts. Stockdale and Chandler (1988)conducted a study on the incidence of cysts andgranulomas based on existing literature andconcluded that granulomas are encountered morefrequently than other apical lesions. Apical lesionscan be detected via radiographic imaging. However,distinguishing between the radiographic appearancesof apical lesions can be difficult, given that an X-rayimage represents a shadow of the lesion rather thana definitive diagnosis. Furthermore, apical lesionscan sometimes be difficult to differentiate fromjawbone lesions that also present with a radiolucentappearance. Therefore, microscopic examination isnecessary to confirm the nature of the lesion.