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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
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1. Periapical osseous dysplasia with simple bone cyst formation in anterior mandible
There are regions of granular and dense, amorphous bone located periapical to teeth 33, 32, 31, 41, and 42, which appear to be surrounded by a radiolucent capsule of variable width. Well-defined, delicately corticated, circular regions of radiolucency are also observed apical to teeth 33 and 31. The buccal cortex overlying these regions appears significantly thinned, but remains intact. There is no evidence of displacement or root resorption in teeth 33, 32, 31, 41, and 42. These findings suggest the presence of multifocal periapical osseous dysplasia with simple bone cyst formation, which does not require treatment. Continued radiographic monitoring is recommended.
Additional orthogonal views of the anterior mandible
These additional orthogonal cross-sectional images demonstrate the presence of granular and dense, amorphous bone located periapical to teeth 33, 32, 31, 41, and 42. These foci of dysplastic bone are surrounded by a radiolucent capsule of variable width. Well-defined, delicately corticated, circular radiolucencies are also evident apical to teeth 33 and 31, which suggests the concomitant presence of simple bone cyst formation. Note the significant thinning of the contiguous buccal cortical plate.
Otherwise normal tooth 31
Tooth 31 appears otherwise normal. The periodontal ligament space around the coronal two-thirds of the root of this tooth appears thin and uniform, and the lamina dura is intact. The root canal system of this tooth is composed of a single, ribbon-shaped canal, which appears thin and tapered at the apex. This apical foramen appears closed. No signs of root resorption are evident, and a displaced fracture plane cannot be visualized radiographically. Given that this tooth reportedly tested vital, these findings suggest the absence of signs of endodontic pathology.