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Referral details

Case 186011

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Referral category

Temporomandibular joints (TMJ)

Region of interest

Right and left TMJ

Referral reason

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Canaray 186011

1. Fibroosseous ankylosis in right TMJ

A thick, irregularly shaped shell of sclerotic bone is observed around the circumference of the right condylar head. Both the condylar and temporary components of the right temporomandibular joint exhibit exuberate sclerosis and osteophyte formation. The right joint space appears partially obliterated, with regions of bridging between the condyle and glenoid fossa intermixed with areas of fibrous fusion.

These findings are consistent with fibrooosseous ankylosis of the right temporomandibular joint, with secondary degenerative joint disease. This is the likely source of the progressive limited opening, which may be secondary to a history of trauma with subsequent ossification of the intraarticular hematoma. Correlation with the patient's history is recommended.

Osseous structures of left TMJ: normal

The osseous contours of the left temporomandibular joint appears within the range of normal. The cortices appear fully intact, and the internal trabecular architecture exhibits a normal density and organization. The left joint space is fully visualized, and appears unremarkable. There are no signs of ankylosis or joint degeneration.

Normally positioned left and right TMJs in mandibular closed position

In the mandibular closed position, the left and right condylar heads are centrally positioned in their glenoid fossae. This is normal.

Posteriorly positioned condylar heads in mandibular open position

In the attempted mandibular open position, both condylar heads remain within their fossae, and there is minimal evidence of condylar translation. These findings are consistent with limited opening secondary to fibrooosseous ankylosis of the right temporomandibular joint.

2. Buccal thread exposure on 12

The implant placed at site 12 appears buccally positioned relative to the long-axis of the alveolar process. The buccal threads and apex of this implant appear devoid of osseous support.

3. Healing extraction sockets at sites 25, 26

Granular bone is present within the extraction sockets at sites 25 and 26, which indicates healing. The density of this granular bone is slightly lower than that of the surrounding trabecular bone.

4. Retained root tip at site 28

A small ovoid radiopacity is present in the alveolar process at site 28, which exhibits a density similar to dentin. This radiopacity is surrounded by a periodontal ligament space and lamina dura. There are no signs of inflammatory disease in the surrounding alveolar bone. This likely represents a retained root tip.

5. Mild mucosal thickening in left maxillary sinus

Mild mucosal thickening is evident in the left maxillary sinus, which is suggestive of mucositis. This is a common incidental finding with no clinical significance.

6. Scleral plaque

A scleral plaque is observed within the medial aspect of the left globe. This is an occasional observation in aged individuals.

7. Intracranial calcification of internal carotid arteries

Focal calcifications are visible lining the walls of the cavernous and ophthalmic segments of the left and right internal carotid arteries. These findings may represent signs of atherosclerosis. The significance of this finding cannot be determined based on CBCT imaging alone.

8. Calcification of the vertebral arteries

Focal calcifications are visible lining the third and fourth segment of the left and right vertebral arteries at the base of the skull. This could represent a sign of cardiovascular disease.

9. Calcified stylohyoid ligaments

The stylohyoid ligaments are partially calcified bilaterally. This is an incidental finding with no clinical significance.