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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
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1. Non-corticated unilocular radiolucent aggressive benign lesion in mid 1st quadrant
A new unilocular radiolucent entity with a fairly well-defined non-corticated periphery is present in the periapical region of tooth 14. This entity extends anteriorly into the periapical region of tooth 12, postero-superiorly through the anterior wall of the sinus, and buccally through the buccal cortical plate at site 15. No periosteal bone formation is evident, and no sclerosis surrounds the lesion. Soft tissue is present within the sinus at the site of the osseous defect adjacent to the lesion. The lamina dura has been lost in the periapical regions of the roots of tooth 14, but the tooth remains otherwise unaffected. This lesion does not appear to have an endodontic origin. A biopsy is recommended in order to rule out a benign aggressive lytic entity such as an eosinophilic granuloma.
Orthogonal views of lesion relation to right maxillary sinus
These orthogonal cross sectional images demonstrate the placement of the anterior inferior aspect of the right maxillary sinus wall and floor by the unilocular radiolucent lesion in the mid-first quadrant. This pattern of bone loss is unusual, and is not consistent with a lesion of endodontic origin.
Orthogonal measurements of cystic lesion
These orthogonal cross sectional images demonstrate the dimensions of the unilocular cystic lesion from various perspectives.