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Case 150680

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Impacted / delayed / malpositioned / extra teeth

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Canaray 150680

Volume rendering of 2nd quadrant

MP4 Video: Suitable for Apple, Windows and mobile devices, 2nd quadrant

Absent tooth 28

Tooth 22 appears to be congenitally absent.

Mesioangularly impacted tooth 27: possible ameloblastic fibro-odontome preventing eruption of tooth

Tooth 27 is almost fully formed and is mesioangularly impacted. The crown of tooth 27 is positioned distal to the apical half of the palatal root of tooth 26. The follicle surrounding the crown of tooth 27 appears hyperplastic and extends to the distal surface of the distobuccal root of tooth 26. Small calcifications are present coronal to the crown of tooth 27 within the follicular space. This may represent the malformed remnants of the undeveloped tooth 28 or may represent an ameloblastic fibro-odontome, which is preventing the eruption of tooth 27. No resorption is present on tooth 26. The roots of tooth 27 have displaced the maxillary sinus floor, but the sinus floor remains intact. No signs of ankylosis are present on tooth 27.

Axial views of tooth 27

These axial cross-sectional images demonstrate the normal appearance of the periodontal ligament space and lamina dura surrounding the root circumference of tooth 27. Small calcifications are visible in the pericoronal region of tooth 27, which may represent the remnants of the unformed tooth 28 or an ameloblastic fibro-odontome

Mesiodistal views of posterior 2nd quadrant

These mesiodistal cross-sectional images demonstrate the mesioangular impaction of tooth 27 relative to tooth 26. No resorption is present on tooth 26. Note the calcifications coronal to the crown of tooth 27 in the pericoronal region of tooth 27, which may be suggestive of a possible plastic fibro-odontome. The sinus floor is displaced, but remains intact overlying tooth 27, and the roots of the tooth are almost fully formed.

Left mandibular nerve inferior to tooth 38

The impacted tooth 38 is mesioangularly oriented. The residual follicle surrounding the crown of the tooth appears normal. Root formation is at an early stage.

The left inferior alveolar nerve canal passes inferior to the inferior aspect of the root of tooth 38, and is not compressed.

The adjacent tooth 37 does not exhibit caries, resorption, or displacement.

1. Slightly thickened mucosal lining of left maxillary sinus

The mucosal lining of the left maxillary sinus is slightly thickened, which represents an incidental finding with no clinical significance.