The cotton wool appearance seen on jaw radiographs is a characteristic radiographic feature of Paget’s disease of bone. This appearance results from the irregular, patchy sclerosis interspersed with lytic areas due to the disorderly bone remodeling process. The disease causes excessive osteoclastic resorption followed by chaotic osteoblastic bone formation, leading to the bulky, dense, and sclerotic regions resembling cotton wool. This distinguishes it from other systemic diseases affecting bone density or integrity. Recognizing this pattern is crucial for diagnosis and management.

Reference: Oral Radiology, White and Pharoah, 7th Edition.