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Case 118019

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Dental implants

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Canaray 118019

1. Healing extraction sockets at sites 24, 25

Granular bone is present within the extraction sockets at sites 24 and 25, which indicates healing. The density of this granular bone is similar to that of the surrounding trabecular bone.

Pneumatized alveolar process at site 26

Air is evident within the alveolar process at site 26, which is consistent with pneumatization. Although this represents a normal physiologic process, the presence of pneumatization will limit the bone height available for regional implant placement.

Clear left maxillary sinus

These sagittal cross-sectional images demonstrate that the left maxillary sinus is clear and free of pathology.

2. Transverse ridges apical to sites 25, 27

Small transverse ridges are evident along the medial aspect of the floor of the maxillary sinus apical to sites 25 and 27, which may slightly impede a sinus lift procedure in these regions.

3. Rarefying osteitis on tooth 27MB: unfilled MB2 canal

There is rarefying osteitis located periapical to the mesiobuccal root of the endodontically-treated tooth 27. The endodontic obturation in this root is buccally positioned, which suggests the presence of an unfilled and heavily calcified second mesiobuccal canal (MB2). The remaining periapical and periradicular bone appears normal, and there are no signs of root perforation or fracture. The obturations of the MB1, distobuccal, and palatal canals of this tooth extend to their radiographic apices.

These findings suggest the presence of persistent endodontic pathology in association with an unfilled MB2 canal.

4. Dense bone island at site 21

A dense bone island is present in the alveolar bone at site 21. This dense bone island demonstrates no effects on its surrounding structures. This is a non-significant incidental finding.

5. Segmental odontomaxillary dysplasia in right maxilla

The alveolar process of the posterior right maxilla appears enlarged as compared to the contralateral side. The internal trabecular bone exhibits a density comparable to cortical bone, and the bone pattern is arranged in vertical streaks. The alveolar process has not been pneumatized by the right maxillary sinus, despite the apparent edentulism. The maxillary right premolar teeth may be developmentally absent: correlation with the patient's dental history is recommended to substantiate this interpretation.

These findings are all features of segmental odontomaxillary dysplasia. No treatment is necessary, but continued radiographic monitoring is advised.

Sagittal views of the right maxilla

These sagittal cross-sectional images demonstrate the presence of dense trabecular bone located within the alveolar process of the posterior right maxilla. These trabeculi are vertically oriented. Teeth 14 and 15 may be developmentally absent. The floor of the right maxillary sinus has not pneumatized this site, despite the apparent edentulism.

Axial views of the maxillae

These axial cross-sectional images demonstrate that the alveolar process of the posterior right maxilla appears enlarged as compared to the contralateral side.