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Case 119803

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Referral category

Temporomandibular joints (TMJ)

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2 Files Info

Canaray 119803

1. Retained endodontic sealer on floor of left maxillary sinus

A small amount of radiopaque endodontic sealer is retained on the floor of the left maxillary sinus. This is a non-significant incidental finding. No pathology surrounds this retained sealer.

Periodontal bone loss in the anterior mandible

Mild horizontal periodontal bone loss is present around the anterior mandibular teeth. The dentition appears normal otherwise.

Clear maxillary sinuses

With the exception of the small amount of endodontic sealer that is retained within the left maxillary sinus, the sinuses are clear. Both sinus ostia are patent.

Coronal views of sinuses and nasal cavity

These coronal cross sectional images demonstrate the absence of any pathology within the nasal cavity. The frontal, ethmoid, and maxillary sinuses appear normal.

Orthogonal measurements of airway

These orthogonal cross sectional images demonstrate the coronal and sagittal airway dimensions. There are no significant constrictions within the airway.

Submentovertex projection of CBCT scan

This submentovertex projection based on the CBCT scan data is included for reference.

Anterior-posterior projection of CBCT data

This anterior-posterior projection of the CBCT data is included for reference.

Lateral projection of CBCT data

This lateral projection of the CBCT data is included for reference.

2. Pagetoid appearance of skull

The calvaruium is thickened and sclerotic, which is an appearance that is reminiscent of Paget's disease. Further investigation for Paget's disease by the patient's physician is recommended.

Normal cervical vertebrae

The cervical vertebrae appear normal radiographically, and do not exhibit any signs of degeneration.

3. Elongated styloid processes

The styloid processes are elongated bilaterally. This is an incidental finding with no significance.

Normal TMJs in mandibular closed position

In the mandibular closed position, both condylar heads are centrally positioned in the glenoid fossae. No signs of osseous degeneration are present and the morphology of both condyles is normal. The overall radiographic appearance is normal. This suggests that if any symptoms are present, they are most likely limited to the soft tissues of the joint, which can be visualized via MRI, and can be ordered by the patient's physician if deemed necessary.

Hypermobility of both condylar heads in mandibular open position

In the mandibular open position, both condylar heads are positioned anterior to the crest of their respective articular eminences. This radiographic appearance is suggestive of lax ligaments and joint hypermobility.