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Region of interest
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1. Rarefying osteitis on tooth 21
The periapical area of endodontically treated tooth 21 exhibits rarefying osteitis. The endodontic obturation in tooth 21 is filled short of the radiographic apex. This appearance is most suggestive of persistent periapical pathology due to failed endodontic treatment of tooth 21. Correlation with clinical signs and symptoms is recommended to confirm this interpretation.
Impacted tooth 23: possible ankylosis
The crown of the horizontally impacted tooth 23 is positioned apical and palatal to the root apex of tooth 22. Tooth 23 has not caused damage to teeth 22 and 24. The buccal surface of the crown of tooth 23 is rotated and superiorly oriented. The follicle surrounding the crown of tooth 23 is hypoplastic. The root of tooth 23 is fully formed and the periodontal ligament space is not clearly visible around the entire root circumference, which suggests the possibility of ankylosis. The crown of tooth 23 can be surgically accessed from the buccal aspect of the alveolar process apical to tooth 22.
Evaluation of maxillary implant sites
Adequate bone exists for implant placement at sites 15, 13, 12, 11, 21, 22 and 25. Marginal bone levels are present at site 23. Inadequate bone is available at site 26.
Mild mucositis of left maxillary sinus
The left maxillary sinus exhibits focal areas of mucosal thickening, an appearance consistent with mild mucositis. This level of mucosal thickening will not impede a potential left maxillary sinus lift.