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Referral details

Case 238404

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Referral category

Troublesome / painful / cracked tooth (Endodontic)

Region of interest

Teeth #33 and 34

Referral reason

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Canaray 238404

1. Radicular cyst in the left mandible

A well-defined, corticated, hydraulic radiolucent entity is present in the left mandibular alveolar process around the periapical areas of the endodontically treated teeth 33 and 34. This entity involves the full thickness of bone in the buccal-lingual direction and extends mesially to abut the apex of tooth 32. The buccal cortical plate overlying this entity exhibits significant expansion and thinning. The root apex of tooth 32 is possibly slightly displaced in a mesial direction. No signs of external resorption of the involved teeth are present. The overall imaging findings are suggestive of the presence of a radicular cyst. The epicenter of this cystic entity is apical to the root apex of tooth 33. However, tooth 34 could be a contributing source. Biopsy and histopathological examinations are recommended to confirm this interpretation. No signs of roots fractures are present on teeth 33 and 34.

A granule of restorative foreign material is present on the expanded buccal cortex mesial to tooth 34. This represents a non-significant incidental finding.

Orthogonal measurements of cystic lesion in left mandible

These orthogonal cross-sectional images demonstrate the approximate dimensions of the cystic lesion within the left mandible.

2. Secondarily affected tooth 32

The cystic lesion associated with teeth 33 and 34 extends mesially to abut the root apex of tooth 32. The remaining periradicular bone around tooth 32 appears normal, suggesting that tooth 32 is secondarily affected rather than a contributing source of the cystic lesion. There are no signs of a root fracture.

Generalized periodontal bone loss

Moderate horizontal periodontal bone loss is present on the buccal surfaces of the maxillary anterior teeth. Severe vertical periodontal bone loss is present on the palatal surface of tooth 22.

3. Multiple buccal abrasions

Buccal abrasion is present on the anterior maxillary teeth and tooth 34, at the level of the cementonenamel junction.

4. Dense bone island at site 45

A dense bone island is present within the alveolar process at site 45. This dense bone island has not had any effects on its surrounding structures and is a non-significant incidental finding.

5. Mucous retention cyst in right maxillary sinus

A small mucous retention cyst is present on the medial wall of the right maxillary sinus. This represents a non-significant incidental finding.