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Region of interest
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1. Dilated odontome in the posterior 4th quadrant
A malformed tooth (X) is present distal to the furcation of tooth 48. This tooth exhibits a mixed internal pattern comprised of both soft tissue and dentin-like density, and is surrounded by an intact dental follicle. The malformed tooth has splayed the roots of tooth 48, but has not had any other effects on the surrounding structures. The right mandibular nerve courses inferior and lingual to this malformed tooth, and is moderately compressed. This radiographic appearance is most consistent with a dilated odontome.
Right mandibular nerve inferior to tooth 48
The right mandibular nerve courses inferior to the mesial root of the horizontally impacted tooth 48. No nerve compression is present by tooth 48. There is no radiographic evidence of ankylosis of tooth 48. The roots of tooth 48 have been splayed due to the adjacent dilated odontome. No damage has occurred to tooth 47.
Axial views of posterior 4th quadrant
These axial cross-sectional images demonstrate the lingual and apical course of the right mandibular nerve relative to the dilated odontome located distal to tooth 48. The periodontal ligament space around the roots of tooth 48 is visible, which suggests tooth 48 and the dilated odontome are not fused.
Coronal views of posterior 4th quadrant
These coronal cross-sectional images demonstrate the mixed internal density of the dilated odontome, which is comprised of soft tissue and dentin-like material. This dilated odontome may be removed at the time of extraction of tooth 48.
Sagittal views of posterior 4th quadrant
These sagittal cross-sectional images demonstrate the splayed roots of tooth 48 due to the presence of an adjacent dilated odontome.