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Case 221767

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Referral category

Wisdom Teeth

Region of interest

2nd qudrant

Referral reason

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Canaray 221767

1. Ameloblastic fibro-odontoma in left posterior maxilla

A well-defined, partially corticated, mixed radiolucent-radiopaque entity is present within the left posterior maxilla, which extends from the distal aspect of tooth 27 to the tuberosity and from the alveolar crest to the left maxillary sinus floor. The internal aspect of this entity is comprised of extensive and prominent radiopacities, some of which exhibit a small central radiolucent nidus. A broad peripheral radiolucency is evident around these centrally positioned radiopacities, which suggests the presence of a soft tissue capsule. Mild palatal cortical expansion is noted, and the alveolar crestal bone and posterior border of the tuberosity are effaced. This entity abuts the follicle associated with the impacted tooth 28, and tooth 28 exhibits distal and superior displacement. The roots of tooth 27 are tipped mesially. No root resorption is noted.

This radiographic appearance is most consistent with an ameloblastic fibro-odontoma in the left posterior maxilla. A biopsy and histopathologic evaluation are recommended for a definitive diagnosis.

Impacted tooth 28

Tooth 28 is vertically impacted, and has been distally and superiorly displaced by the lesion in the left posterior maxillary alveolar process. The distal aspect of tooth 28 abuts the posterior wall of the maxilla, and a thin bony wall separates tooth 28 from the antral cavity. The follicle appears normal in caliber, but abuts the lesion in the left posterior maxilla. No damage has occurred to tooth 28.

2. Caries on tooth 27M

A carious lesion is present on the mesial aspect of tooth 27 at the level of the cementoenamel junction. No direct pulpal communication is noted.

Impacted tooth 38

Tooth 38 is partially captured in this imaging volume and is vertically impacted relative to the long axis of tooth 37. No further comments can be made based on this limited field of view.

3. Left antral pseudocysts

Two small antral pseudocysts are present within the left maxillary sinus. These represent incidental findings with no clinical significance.