Stage N Clinical presentation Radiological findings Optimal radiological
examination method
I 2 None Generalised thickening of cortical plate and lamina dura,
focal area of sclerosis extending from cortical plate		 Periapical/CBCT
II 2 Discomfort, denuded bone
in the posterior/lingual mandible		 Thickening of cortical plate CBCT
III 14 Pain, denuded bone involving alveolar bone Mixed sclerotic and lytic bone destructioninvolving alveolar bone
and basal bone, sequestrum		 Panoramic/CBCT
IV 4 Denuded bone involving alveolar bone,
purulent discharge, numbness,
oro-antral fistula		 Mixed sclerotic and lytic bone destruction involving alveolar
and basal bone, sequestrum, encroachment on the mandibular
canal and maxillary antrum, pathologic fracture		 Panoramic/CBCT