Chronic endodontic infections are associated with osseous changes in the peri-apical regions. Dental implants are often placed after the extraction of hopeless teeth with periapical infections. This clinical report describes a patient with a radiopaque mass attached to the root apex of the mandibular right second premolar tooth (#45). The differential diagnosis of the radiopaque mass were bone and tissue borne diseases.  Based upon the clinical and radiological findings (bone density and trabeculation of the bone), the definitive diagnosis of the osseous mass was condensing osteitis. The osseous tumor associated with tooth #45 was atraumatically extracted under local anesthesia. Guided bone regeneration was performed immediately after extraction of #45 and a dental implant was placed in the site after 6 months of healing.

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