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Case 106153

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Dental implants

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Canaray 106153

1. Vertical bone loss at tooth 27

Tooth 27 exhibits vertical bone loss that extends from the alveolar crest to the level of the apical third of the root of the tooth. No periapical pathology is present. This bone loss most likely is periodontal in origin. The bone surrounding the remaining root surfaces of tooth 27 appears normal.

2. Transverse septum apical to site 24

These sagittal cross sectional images demonstrate the transverse septum that is present in the anterior region of the left maxillary sinus apical to site 24. This may slightly impede a potential sinus lift in this region.

3. Transverse ridge apical to site 15M

A small transverse ridge is present on the sinus floor in the region apical to the distal aspect of tooth 15. This transverse ridge has not had any effects on the surrounding structures, but may slightly impede a potential sinus lift in this region. The right maxillary sinus is clear otherwise.

4. Mild cervical degenerative joint disease

Small osteophytes and mild subchondral sclerosis are present in the articular regions of the Atlas and dens of the cervical vertebrae. This is a common incidental finding with no clinical significance that is suggestive of mild cervical degenerative joint disease.

5. Inferior median clival canal / canalis basilaris medianus

The inferior median clival canal (also known as the canalis basilaris medianus) is a rare anatomical variant of the clivus, which passes in the sagittal plane from the intracranial surface of the clivus to its retropharyngeal surface. It is generally thought to represent a remnant of the notochord. This structure is present in this patient. This is a non-significant anatomic variant, which does not require treatment or further attention.

Coronal views of clivus

These coronal cross sectional images demonstrate the well-defined corticated periphery of the median clival canal.

6. Possible marsupialized Tornwaldt's cyst in pharyngeal tonsil

A gas-filled cavity is present within the pharyngeal tonsil. Based on the presence of the inferior median clival canal, this structure likely represents a marsupialized Tornwaldt's cyst, which is a benign cyst of developmental origin. In symptomatic patients, these entities present with middle ear symptoms (from Eustachian tube obstruction), halitosis (when associated with a leaking sinus tract), foul taste in mouth, and paravertebral spasm. If any of these symptoms occur, further investigation by an ENT specialist is recommended.