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Troublesome / painful / cracked tooth (Endodontic)
Region of interest
Maxilla and Mandible
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1. Possible history of crestal bone grafting in both arches
All of the remaining teeth in both arches exhibit unusual osseous appearances in that the alveolar crestal regions appear to contain particulate bone graft material that extends around the interradicular regions. If a periodontally-related bone grafting procedure was performed, the clinically observed sequestering bone likely represents non-integrated graft material. The diagnosis of the status of the crestal bone in both arches can only be made based on the clinical history of bone augmentation or lack thereof. If no history of bone augmentation exists, the possibility of the presence of a systemic condition that would induce crestal sequestration should be investigated.
Axial views of mandibular arch
These axial cross sectional images demonstrate the particulate appearance of the crestal bone throughout the mandibular arch. The periodontal ligament spaces are slightly widened around the canine and premolar teeth. No periapical pathology is present, however.
Axial views of maxillary arch
These axial cross sectional images demonstrate the particulate appearance of the crestal bone around the remaining teeth in the maxillary arch. The periodontal ligament spaces surrounding all of the teeth are slightly widened. Vertical bone loss is present at teeth 15 and 16, which may represent a combined endodontic/periodontal lesion. A similar pattern of bone loss is also visible at tooth 26, which was partially captured in this scan.
2. Mild mucositis of right maxillary sinus
The right maxillary sinus exhibits mild mucositis, which represents an incidental finding with no clinical significance.
3. Ectopic bone or graft material at anterior nasal spine
A localized zone of ectopic bone formation or graft material is present at the anterior aspect of the anterior nasal spine. The bone in this region is heterogeneous, but does not appear to have had any effects on the surrounding structures.