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Temporomandibular joints (TMJ)
Region of interest
Pt is experiencing discomfort in the masseter joint on the right hand side. Sensitive to pressure on tooth 46 and during chewing
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Normal TMJs in mandibular closed position
In the mandibular closed position, both condylar heads are centrally positioned in the glenoid fossae. The osseous structures of both joints appear normal radiographically, and no signs of degeneration are present. No pathology is radiographically evident in the temporomandibular joints.
Normal left TMJ in mandibular open position
In the mandibular open position, the left condylar head translates to a point slightly anterior to the crest of the articular eminence. This reflects normal condylar mobility. The joint space is normal in caliber.
1. Reduced joint space in right TMJ in mandibular open position
The joint space in the right temporomandibular joint is reduced in comparison to the contralateral side on mandibular opening. The possibility of a medially or laterally displaced disc, or a deformed articular disc, should be considered. The condylar translates to a point slightly anterior to the crest of the articular eminence, which reflects normal condylar mobility.
2. Rarefying osteitis on tooth 17MB: Unfilled second canal
The mesiobuccal root of the endodontically treated tooth 17 exhibits a small focus of rarefying osteitis. The existing endodontic obturation in the mesiobuccal root of tooth 17 is eccentrically positioned, which suggests the presence of an unfilled second canal (MB2). This unfilled canal is not radiographically visible and is likely heavily calcified. This pattern of bone loss is suggestive of persistent periapical pathology due to an unfilled MB2 canal. No signs of root fracture are present.
3. Sphenoid sinus mucositis
Mild mucositis is present in the sphenoid sinus. This is a non-significant incidental finding.
4. Mild cervical degenerative joint disease
Small osteophytes 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. Condylus tertius
Two small bony processes emanate from the anterior rim of the foramen magnum, and articulate with the tip of the anterior arch of C1. This reflects a developmental anomaly known as condylus tertius, which is typically an incidental finding with no clinical significance.