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Referral details

Case 221824

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Referral category

Troublesome / painful / cracked tooth (Endodontic)

Region of interest

Limited view 45-47

Referral reason

[Only visible to logged-in users]

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Canaray 221824

1. Bone dysplasia apical to tooth 46

A well-defined, non-corticated, irregularly shaped entity is present in the posterior right mandible. The entity extends between the roots of teeth 45 and 47 and extends superiorly almost to the alveolar crest interproximal to teeth 46 and 47 . Internally, the entity consists of a core of abnormal amorphous bone, mainly surrounding the apex of the distal root of tooth 46. This core is further surrounded by a thick band of granular bone pattern. This entity blends with the adjacent normal bone at the peripheries. The adjacent buccal and lingual cortical plates are irregularly thinned and exhibit mild expansion. The right inferior alveolar nerve canal travels through the inferior aspect of the entity with no evidence of canal displacement. The roots of tooth 47 exhibits distal orientation. These imaging findings are suggestive of the presence of maturing bone dysplasia, such as periapical cemental dysplasia or fibrous dysplasia. No treatment is required. Follow up imaging after one year is recommended. The distalization of the roots of tooth 47 may represent a modified eruption pathway of the tooth through a pre-existing condition. Ossifying fibromas do not have these radiographic features

Normal tooth 46

Tooth 46 is separated from the dysplastic periapical bone by a normal periodontal ligament space. The tooth remains vital, and is unaffected by the lesion. This is a characteristic appearance of the tooth in the vicinity of a bone dysplasia.

Normal tooth 47

The fused roots of tooth 47 exhibits normal lamina duras and periodontal ligament spaces. The tooth has not been damaged by the adjacent bone dysplasia, and the apparent distal displacement of the roots may not be related to the dysplastic bone