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Case 195569

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Troublesome / painful / cracked tooth (Endodontic)

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Canaray 195569

1. Rarefying osteitis at tooth 26

A broad zone of rarefying osteitis is present at tooth 26. This rarefying osteitis extends through the furcal region of the tooth and encompasses all of the root apices of the tooth. The buccal cortical plate has been lost adjacent to the buccal furcation of the tooth. Due to the extensive bone loss in the furcal region, it is not possible to definitively identify any signs of fracture. The bone loss associated with this tooth may represent a long-standing draining periapical lesion or a possible fracture on the distal surface of the palatal root.

2. Open restorative margin at tooth 26P mimics horizontal fracture on submitted periapical radiograph

The mesiodistal view of the cone beam CT scan was oriented to match the submitted periapical radiograph. The edge of the open restorative margin of the palatal root was superimposed over the region of interest, and appears to have mimicked a horizontal fracture of the distobuccal root in the periapical radiograph. However, no fracture is radiographically apparent in the cone beam CT scan.

3. Secondarily affected tooth 27M

The bone loss associated with tooth 26 extends distally to involve the coronal two-thirds of the mesial surfaces of the mesiobuccal and palatal roots of tooth 27. This bone loss extends into the mesial furcation of tooth 27. The remaining periradicular bone appears normal, which suggests that tooth 27 has been secondarily affected as opposed to a contributing source of pathology.

4. Mild mucositis in the left maxillary sinus

Mild mucositis is present within the left maxillary sinus. This is a non-significant incidental finding.