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Background: The distinction between radicular cysts and apical granulomas is important in treatment decision. Objectives: The current study aimed to differentiate these two lesions based on radiography images. Patients and Methods: The material consisted of 138 radiographs obtained using Kodak E -speed, in patients aged 29 to 47, divided into two groups: 109 granulomas and 29 radicular cysts. Size of radiography images was measured; the tooth then was extracted and examined in pathologist lab. The results were analyzed by SPSS.15 and ROC curve was created to find cut-off point to differentiate periapical granuloma and radicular cysts. Results: Average size of radiography in periapical granuloma was 7.4 mm and for a radicular cyst was 11.1 mm. Cut-off point was 8.2 mm and the area under curve (AUC) was 0.63. Also, the tests were 83% sensitive and 79% specific. Conclusions: Based on 8.2 mm cut-off point could differentiate 83% periapical granulomas and 79% radicular cysts from radiogra-

Using Periapical Radiography to Differentiate Periapical Granuloma and Radicular Cysts