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Case 246033

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Referral category

Wisdom Teeth

Region of interest

maxillary posterior

Referral reason

[Only visible to logged-in users]

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Canaray 246033

1. Pericoronal cyst at tooth 18

A well-defined unilocular radiolucent cystic entity is present in the pericoronal region of tooth 18. This entity has thinned and effaced the lateral sinus wall in the region apical and distal to tooth 17. The lesion is also displaced tooth 18 superiorly and posteriorly. No root resorption or damage has occurred to tooth 17. The overall radiographic appearance is suggestive of the presence of a pericoronal cyst at tooth 18, such as a dentigerous cyst.

Note that it is possible that the lesion is incompletely captured in this image. It is possible that the air space represents the partially drained cyst lumen, rather than the sinus cavity.

Estimate of lesion size

These images demonstrate the possible size of the cystic lesion. Further imaging of the complete right maxillary sinus at a higher resolution can confirm these findings.

Impacted tooth 18 in the posterolateral wall of the right maxillary sinus

Tooth 18 appears mesioangularly oriented, superiorly displaced, and embedded in the posterolateral wall of the right maxillary sinus. Root formation is complete. The crown of the tooth has partially erupted through the buccal aspect of the alveolar process and the residual follicle surrounding the tooth is not visualized due to its proximity to the large pericoronal cystic lesion. The periodontal ligament space is not clearly visualized surrounding the root which suggests that ankylosis is present. Hypercementosis is noted on the roots of the tooth. There have been no effects on the adjacent tooth 17.

Axial views of tooth 18

These axial cross-sectional images demonstrate that the periodontal ligament space cannot be fully visualized surrounding the roots of tooth 18. This suggests the presence of ankylosis. The cusp tips of the have partially erupted through the buccal aspect of the alveolar process and the alveolar crest. Note the positions of the roots of tooth 18 in the right maxillary sinus.

Mesiodistal views of the posterior 2nd quadrant

These mesiodistal cross-sectional images demonstrate the position of tooth 18 in the posterior wall of the right maxillary sinus.

2. Cusp fracture on tooth 46D

A cusp fracture is present on the distal aspect of the crown of tooth 46. There is no evidence of periapical pathology on tooth 46.